Ankyloglossia

WHAT YOU SHOULD KNOW:

• Ankyloglossia (ang-ki-low-GLOS-ee-ah) is also known as tongue tie. It is a condition where your child's tongue does not move as freely as it should. The tongue is made up of muscle tissues that help your child during feeding, swallowing, and talking. The tongue is connected to the floor of the mouth through a thin piece of tissue called the frenulum. The frenulum is attached to the middle part of the tongue, allowing the front part to move freely. With ankyloglossia, your child's frenulum may be shorter, thicker, or tighter than it should. This reduces the movement of the front part of his tongue by holding it more tightly to the floor of his mouth. Ankyloglossia can range from mild to severe (very bad) in decreasing the movement of the tongue. The condition can change over time to improve or get worse.
  
  
• Babies with this condition may have problems with breast-feeding or bottle feeding. Older children with it may not be able to push their tongue out past their lower front teeth. When they try to do this with their mouth open, the tongue has a heart-shaped tip. Ankyloglossia is diagnosed by examining the inside of your child's mouth and how his tongue attaches and works. Treatment may be done right away to help your baby with breast-feeding or bottle feeding problems. It may also be done if your child starts having speech problems. The treatment is minor surgery to cut or remove the frenulum. Sometimes, watchful waiting may be all that is needed as your child's tongue and mouth grow and develop. Finding and treating ankyloglossia as soon as possible may prevent further feeding or speech problems in your child.

AFTER YOU LEAVE:

Keep a current list of your child's medicines:

Include the amounts, and when, how, and why they are taken. Bring the list and the medicines in their containers to follow-up visits. Carry your child's medicine list with you in case of an emergency. Throw away old medicine lists. Give vitamins, herbs, or food supplements only as directed.

Give your child's medicine as directed:

Call your child's primary healthcare provider if you think the medicine is not working as expected. Tell him if your child is allergic to any medicine. Ask before you change or stop giving your child his medicines.

Medicines:

• Ibuprofen or acetaminophen: These medicines are given to decrease your child's pain and fever. They can be bought without a doctor's order. Ask how much medicine is safe to give your child, and how often to give it.
  
  

Ask for more information about where and when to take your child for follow-up visits:

For continuing care, treatments, or home services for your child, ask for information.

Activity:

Your child may be asked to do some tongue exercises for one month if he had surgery. The tongue exercises can help your child eat and speak normally. These exercises may also prevent your child's tongue from having scars. Ask your child's caregiver for more information about these tongue exercises.

Problems that may come when your child has ankyloglossia:

• Feeding:
  
  
  • Babies: Babies may have problems with latching-on to their mother's breast during breast-feeding or with bottle feeding. They may not get enough milk because of the condition. Babies may suck even harder and this may cause breast pain in mothers. When this happens, mothers may want to stop or limit breast-feeding with the babies being bottle fed instead.
    
    
  • Children: The older child may have problems with swallowing chewed food or clearing food from his mouth.
  
  
• Oral and dental: Ankyloglossia may cause chronic halitosis (mouth odor) when food is not cleared and stays in the mouth. The trapped food can increase the germs that grow inside your child's mouth. This can cause the bad smell and start tooth decay. A child with ankyloglossia may also have problems with his teeth and gums. Some teeth may not form well or spaces may be seen between his teeth. Ask your child's caregiver about how halitosis, tooth decay and tooth loss may be prevented or treated.
  
  
• Social: Your child may have a hard time coping with having this condition. He may be teased by other children and be sad, angry, or depressed. Your child may have problems doing what other children can easily do. These may include licking an ice cream cone or sticking his tongue out completely. He may also have problems playing wind instruments such as the flute.
  
  
• Speech: Ankyloglossia will not prevent or delay your child's ability to talk. Having this condition may only cause problems in how your child can say or pronounce some words. Words with the tongue sounds T, D, L, TH, and S may be hard for him to say.

For more information:

Contact the following for more information:

• American Academy of Pediatrics
  141 Northwest Point Boulevard
  Elk Grove Village , IL 60007-1098
  Phone: 1- 847 - 434-4000
  Web Address: http://www.aap.org
  

• La Leche League International
  957 North Plum Grove Road
  Schaumburg , IL 60173
  Phone: 1- 847 - 519-7730
  Phone: 1- 800 - 525-3243
  Web Address: http://www.lalecheleague.org
  

CONTACT A CAREGIVER IF:

• Your baby is having problems with latching-on to your breast during breast-feeding.
  
  
• Your baby is not satisfied after feedings or you are having severe nipple pain when breast-feeding.
  
  
• You are concerned about whether your baby is getting enough breast milk or formula during feedings.
  
  
• You are finding breast-feeding painful and are thinking about switching your baby to formula.
  
  
• Your child has problems swallowing food, or has problems saying some words or problems with speaking.
  
  
• Your child's tongue is bleeding, or has pus or a foul smelling odor.
  
  
• Your child is starting to have the same problems as before or you notice new speech problems after his surgery.

SEEK CARE IMMEDIATELY IF:

• Your child is showing signs of dehydration from not feeding well. These signs may include urinating less than he should, crying without tears, or dry, chapped lips. If your child is an infant, he may have a sunken fontanel (soft spot) on the top of his head.
  
  
• Your child is having bleeding from his stitches that is heavy, doesn't stop, or is causing him to choke.
  
  
• Your child has more problems with feeding or is refusing to feed at all.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Learn more about Ankyloglossia (Discharge Care)