Does a Tongue-Tie Need to Be Cut? Checking Feeding Problems

A short-looking tongue-tie needs no treatment if feeding goes well. What the band under the tongue does, how to check feeding, and when to ask for help.

When you look under your baby's tongue and the band there looks short, it's natural to wonder if it should be cut. You may even hear from others that it should be snipped now to avoid speech problems later. Here's what the frenulum is, when it needs to be evaluated, and what parents can watch for.

Every baby's tongue tie looks different

If you lift the tongue, you'll see a thin band connecting the underside of the tongue to the floor of the mouth. This is the lingual frenulum. There's a similar band between the inside of the upper lip and the gum, called the labial frenulum. Everyone has both. They're a normal part of the mouth.

How long and thick this band is varies from baby to baby. Some are long and thin, others short and thick. Even when it looks short, most babies grow up without any problem. That's why you can't tell there's a problem just from how it looks.

When a baby nurses, the tongue reaches forward, cups the nipple, and moves in a wave. Only when the band really restricts this movement does it become hard for a baby to latch deeply. So if the band looks short but the tongue moves well and feeding is going well, there's no need to worry.

That's why cutting it as a precaution isn't recommended. A professional evaluation is needed only when there's a real feeding problem, like when the tie keeps your baby from latching well or mom's nipple pain doesn't go away.

The myth parents hear most is "cut it while they're little, or their speech will suffer later." If feeding is going well, there's no need to cut it now for future speech or prevention. If you're still concerned, your pediatrician or pediatric dentist can keep an eye on it with you as your child grows.

Just watch how feeding goes

What matters isn't how the band looks, but whether feeding is going well. Check in this order.

1. See whether your baby latches on deeply and you can hear swallowing.
2. At regular checkups, make sure your baby is gaining weight well.
3. Notice whether mom has ongoing pain or damage on the nipple during or after feeds.
4. If feeding is hard, first have the latch and positioning checked. With help from a lactation consultant, simply changing position often makes things better.
5. If that doesn't solve it, ask a pediatrician or pediatric dentist to evaluate the frenulum.

A common mistake is jumping straight to the tongue-tie as the cause when feeding gets hard. Feeding can be difficult for many reasons, such as positioning, how deep the latch is, or how your baby is feeling. That's why checking position and latch comes first.

In the first few days, both mom and baby may still be learning. It's also important to see whether the feeding problem continues or slowly gets better. Jotting down when feeds are hard and how long each one takes will help when you talk to someone. Struggling with feeding isn't your fault, so don't push through alone. Ask for help early.

Frequently asked questions

When to ask for help

• Your baby keeps losing the latch during feeds
• Feeds take unusually long and weight gain is slow
• Mom's nipple pain or damage continues with every feed
• The problem isn't solved even after having latch and positioning checked

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The information in this article is for general educational purposes and does not replace professional dental care. Talk to a dentist about your child's condition.

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