Why Tongue Ties Get So Much Attention

If you have ever heard the term tongue tie and wondered what it means, you are not alone. Parents often hear about it from lactation consultants, pediatricians, or even other parents on social media. The topic can feel confusing, especially because advice about tongue ties can vary so widely.

As a speech-language pathologist (SLP), I often work with families who are trying to understand whether their child’s tongue tie is affecting feeding, speech, or overall development. This article will help you understand what tongue ties are, how they are evaluated, what they can impact, when intervention may be necessary, and what treatment options exist.

What Exactly Is a Tongue Tie?

A tongue tie, or ankyloglossia, is when the band of tissue that connects the tongue to the floor of the mouth (called the lingual frenulum) is shorter, thicker, or tighter than usual.

This can limit the tongue’s ability to move freely. For some children, that restriction is barely noticeable. For others, it can make everyday activities, like nursing, eating, or speaking, much more difficult.

Think of the tongue as one of the body’s most important “muscles of movement.” It helps babies latch and swallow, kids explore new foods, and older children form clear speech sounds. If the tongue cannot move the way it needs to, those areas can be affected.

How Tongue Ties Are Evaluated

One of the most confusing parts of tongue ties is that two children can have the same-looking frenulum, but very different outcomes. That is why evaluations do not just look at the anatomy (what it looks like), but also the function (what the tongue can do).

Who Evaluates Tongue Ties?

Pediatricians often check in the newborn stage, but may not always catch functional difficulties.
Lactation consultants are frequently the first to notice ties if a baby is struggling with breastfeeding.
Dentists or oral surgeons can examine the structure of the frenulum and recommend surgical release if needed.
Speech-language pathologists focus on function—whether the tie is interfering with eating, swallowing, or talking.

What Does an Evaluation Look Like?

Checking if the tongue can lift to the roof of the mouth, stick out past the lips, or move side to side.
Observing feeding in babies (latch, sucking, weight gain).
Listening to speech sounds in toddlers and older children.
Asking about challenges like gagging on food, messy eating, or avoiding certain textures.

What Tongue Ties Can Impact

Tongue ties affect each child differently. Here are some of the most common areas families notice:

1. Feeding in Infancy

Poor latch during breastfeeding
Clicking or popping sounds while nursing
Prolonged feedings
Maternal pain during nursing
Slow weight gain

2. Eating in Early Childhood

Difficulty moving food around the mouth
Gagging or choking on certain textures
Trouble licking lips or cleaning teeth with the tongue

3. Speech Development

Some speech sounds, like /t/, /d/, /l/, and /r/, require the tongue to lift toward the roof of the mouth. If movement is restricted, children may have trouble producing these sounds clearly.

It is important to note: not all speech delays are caused by tongue ties. Many children with ties develop clear speech, while others may need therapy or intervention.

4. Oral Health and Growth

Over time, limited tongue mobility may contribute to dental crowding, difficulty brushing teeth effectively, or even changes in jaw development.

Do All Tongue Ties Need to Be Fixed?

Not necessarily. Many children with mild ties never experience feeding or speech issues. On the other hand, even a small-looking tie can cause big challenges.

Here are some helpful questions to consider:

Is my baby feeding well and gaining weight?
Does my child get frustrated while eating or talking?
Is my child avoiding foods that are difficult to manage?
Has my child’s speech development stalled, or do certain sounds remain unclear past the expected age?

If the answer to several of these is “yes,” it may be worth seeking further evaluation.

What Can Be Done About Tongue Ties?

1. Watchful Waiting

If there are no functional concerns, sometimes the best approach is simply monitoring the child’s growth and development.

2. Therapy and Support

Feeding therapy with an SLP or Occupational Therapist (OT) can help babies and toddlers learn strategies to eat more effectively.
Speech therapy can address sound production, oral movements, and teach compensatory strategies if needed.

3. Frenotomy or Frenuloplasty

When a tongue tie significantly limits function, a minor procedure may be recommended.

Frenotomy: A quick procedure where the frenulum is released, often done in infants without anesthesia.
Frenuloplasty: A more involved procedure, sometimes used for older children, typically with stitches and anesthesia.

Both are usually well-tolerated and can lead to noticeable improvements in feeding and speech.

Life After a Release: What Parents Should Expect

If your child undergoes a release, therapy might be recommended afterward. Why? Because the tongue needs to “re-learn” how to move in ways it was not able to before. Exercises, stretches, and speech or feeding practice help the child build new patterns.

For example, a child may need to practice lifting their tongue for /l/ or sweeping food across their teeth while chewing. With guidance, progress can be significant.

Key Takeaways for Families

Tongue ties are more than just how the frenulum looks—it’s about how it functions.
Not every tongue tie needs intervention, but if your child struggles with feeding or speech, it’s worth an evaluation.
A team approach (pediatrician, SLP, dentist, lactation consultant) provides the best picture.
Options range from monitoring to therapy to a simple release procedure.
With the right support, children with tongue ties can thrive.

Parent Tip: Keep a journal of your child’s feeding or speech challenges. Write down what you notice, when it happens, and how your child responds. This record will be invaluable during evaluations and follow-up appointments.

Closing Thoughts

As parents and caregivers, it’s natural to want clarity when it comes to something as important as your child’s ability to eat and communicate. While the world of tongue ties can feel overwhelming, remember: you do not have to figure it out alone. A knowledgeable team—including your child’s speech-language pathologist—can help guide the way.

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Disclaimer: This article offers general educational information. It is not a substitute for professional evaluation or treatment. Please consult a licensed Speech-Language Pathologist for personalized concerns regarding your child’s speech development.