Tongue Tie: Causes, Symptoms, and Treatment
Medically reviewed by Harsha Moole, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Tongue Tie?
A pediatrician, a children's doctor, usually checks a baby for tongue tie. A surgeon can do a small surgery if it is needed. A lactation consultant, a person who helps with breastfeeding, can help with feeding problems. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is tongue tie?
Tongue tie is when the bottom of the tongue is attached to the floor of the mouth. Its medical name is ankyloglossia. This may make it hard for the tip of the tongue to move freely.
A band of tissue called the lingual frenulum connects the tongue to the bottom of the mouth. In people with tongue tie, this band is overly short and thick. Tongue tie is present at birth and is most common in babies. It may not cause any problems.
Symptoms
In a baby, tongue tie can make feeding hard. A baby may:
- Act fussy or irritable, even after feeding.
- Have trouble keeping suction on the nipple, and get tired in 1 or 2 minutes or fall asleep before eating enough.
- Feed for a long time, need to be fed very often, or take only a small amount of milk at each feed.
- Dribble a lot during feeds, or cough, choke, or make clicking noises while feeding.
- Lose weight or struggle to gain weight.
A breastfeeding mother may have sore nipples, plugged milk ducts, or painful and swollen breasts. Older children may have speech and pronunciation difficulties. Some people also find it hard to move the tongue from side to side, lift it up, or stick it out. On rare occasions, tongue tie has been linked to problems with tooth development, swallowing, or speech.
Causes and who gets it
The exact cause of tongue tie is not known. Genes may play a role, and the problem tends to run in some families. About half of babies with tongue tie have another family member who also has it. Tongue tie is thought to affect about one in ten babies and is more common in boys than in girls.
How doctors diagnose it
Tongue tie is sometimes found during a baby's newborn physical exam, but it is not always easy to spot. It may not become obvious until a baby has trouble feeding. Most experts do not recommend that health care providers examine newborns for tongue tie unless there are breastfeeding problems.
Treatment
Treatment is not usually needed if tongue tie is not causing any problems. Most breastfeeding problems can be managed easily, and a lactation consultant can help. If tongue tie is causing problems, treatment may include feeding advice from a trained health professional.
Tongue tie surgery is called a frenulotomy and is rarely needed. The surgeon cuts and releases the tight frenulum under the tongue. It is most often done in the surgeon's office. In young babies, the surgery is usually done without any anesthetic, which is medicine that numbs pain or causes sleep. In older babies, children, and adults, it is usually done with general anesthetic. Surgery for more severe cases or for older children is done in a hospital operating room. A procedure called a z-plasty closure may be needed to prevent scar tissue from forming.
After surgery, most babies get better quickly and are able to feed better. A baby may be fussy for a few days, and it may take a few weeks before feeding is fully comfortable. As with any surgery, there are risks, but they are rare. They include heavy bleeding, infection, ulcers, pain, and damage to the tongue and nearby tissue.
When to see a doctor
Talk to your baby's doctor, midwife, or health visitor if you think your baby has tongue tie or has trouble breastfeeding or bottle feeding. Weight loss or struggling to put on weight can also be a sign of tongue tie, so mention it to the doctor. Call 911 or go to the emergency room if your child has trouble or abnormal breathing, bluish or grey skin, or swelling of the face, eyes, or tongue.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. Either kind of doctor can listen to your concerns, follow your baby's weight and feeding, and refer you to a feeding specialist or surgeon when needed.
Common questions
Does tongue tie always need surgery?
No, tongue tie does not always need surgery. Surgery is rarely needed, and most breastfeeding problems can be managed easily with help from a lactation consultant.
Can tongue tie make breastfeeding hard?
Yes, it can. Babies may have trouble latching on or keeping suction, and the mother may have breast pain, plugged milk ducts, or sore nipples.
Does tongue tie cause speech problems?
It can in some children, but most children with tongue tie have no trouble with speech. Tongue tie has been shown to affect how some children say certain sounds, and doctors cannot predict which children will be affected.
Is tongue tie surgery safe?
Yes, it is considered a safe and simple procedure. Infection or bleeding afterward is possible but rare.
Does tongue tie run in families?
Yes, it tends to run in some families. About half of babies with tongue tie have another family member who has it too.
Sources
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
