Tongue-Tie (Ankyloglossia)

Pediatricians typically diagnose tongue-tie soon after a baby is born. They work with lactation consultants, who can identify whether variations in a baby’s tongue anatomy may cause breastfeeding difficulties.

Just because a baby has a frenulum that’s tighter or shorter than usual doesn’t mean they have tongue-tie or need treatment. Healthcare providers only diagnose this condition in babies who have a restrictive lingual frenulum and limited tongue function.

To determine if your baby has tongue-tie, your providers will:

• Ask about your breastfeeding history. This includes any breastfeeding experiences with other children. If your baby has tongue-tie, you might notice that the latch feels different compared with other babies you’ve breastfed. Your providers will also ask how often you breastfeed, how long each session lasts and whether you pump and/or supplement with formula.
• Ask how you feel when breastfeeding. If breastfeeding is often uncomfortable for you, your providers need to know. This doesn’t necessarily mean your baby has tongue-tie. There are many causes of painful or difficult breastfeeding. But any discomfort you feel is one clue that can help them understand what’s going on.
• Review your baby’s medical history. Many different factors can affect your baby’s ability to breastfeed. These include neurological disorders, heart conditions and blockages in their nose or airways. Treating tongue-tie won’t help your baby with breastfeeding if other factors are also contributing to the difficulty.
• Give your baby a physical exam. As part of this exam, a pediatrician will closely examine your baby’s tongue and all areas of their mouth. They’ll look for signs of tongue-tie or other medical conditions.
• Directly observe breastfeeding. A lactation consultant will observe you and your baby during a breastfeeding session. They’ll look at your breastfeeding position (how you hold your baby during nursing) and how your baby latches on. In some cases, adjustments to positioning and latching can clear up the difficulties, even in babies with tongue-tie.

What tests will be done to diagnose tongue-tie?

Your baby doesn’t need any tests. Some healthcare providers use different grading systems or assessment tools that evaluate how well a baby’s tongue moves in their mouth. But they get the information they need just by looking at your baby’s tongue and feeling the lingual frenulum.

These grading systems help providers describe how a baby’s tongue looks and functions. This information can help providers reach a diagnosis.