Everything you need to know about tongue ties & lip ties

Picture this: The year is 1679, and the doctor pulls out a wooden knife to cut the tight membrane under your baby’s tongue. Your child cries, but you hope that now you’ll be able to nurse your little one easier and better. 

Contrary to popular belief, tongue and lip ties are not a new phenomenon. A medical drawing from 1679 portrays this exact scenario of a doctor manually cutting a baby's tongue tie. In the 1800s, midwives supposedly loosened lip ties with a long fingernail after birth. 

However, what is relatively new is the debate around which course of action is best for children with ties. While babies have been born with tongue and lip ties for centuries, how they should be treated is still hotly contested by parents around the world.

So What Are Tongue & Lip Ties?

A tongue tie (or ankyloglossia) is when a thick membrane connects the tongue to the floor of the mouth, making it more difficult for the person to move their tongue. A lip tie is when the upper lip is unusually tied to the gum line. In both cases, children can (but don’t always) have difficulties breastfeeding and/or speaking.

Sometimes a tie can loosen enough on its own, without causing the child any difficulties. Other times, the child may struggle and require medical intervention. I've helped children on both ends of the spectrum, so that's why I've compiled some frequently asked questions to provide you with everything you need to know about both tongue and lip ties, including: How to check if your child has one, what difficulties they could potentially have, and whether or not you should get the tie released.

What Signs Demonstrate My Child Might Have A Tongue Or Lip Tie?

Believe it or not, tongue and lip ties aren’t always obvious — some parents don’t even notice their child has one until they struggle with speech. Other parents may notice sooner, but their children might not have any adverse consequences.

If you think your child may have a tie, here’s what you should look for:

• Breastfeeding difficulties. If your baby struggles to latch on or you experience pain during feeding, your baby could have a lip/tongue tie. However, keep in mind that it could also just be because you’re new to breastfeeding, and it ain't easy! 

• Clicking sound during bottle feeding. A lip or tongue tie impacts how your baby can suck, so you may hear a soft clicking while your baby is breastfeeding if they have this condition.

• Heart-shaped tongue tip. Take a peek at your baby's tongue. If you notice this when they stick their tongue out, it could be a clue that they have extra tissue causing a tongue tie.

• You can see the tie. You may be able to physically see your baby’s tongue tie when they’re crying. You can also check for a lip tie by lifting their upper lip — the tie usually attaches near where the teeth pop out.

Still not sure if what you see is normal? Book a free consultation here.

Can Tongue Or Lip Ties Impact Speech?

If your child has a tongue or lip tie, lots of parents ask me: How will it impact their future? For many little ones, it won’t change anything — but it is important to watch for speech delays. 

Some children with ties struggle to elevate their tongues to make certain sounds. Tongue ties can also make it more difficult for children to put their tongues in the right place to pronounce ‘S’ and ‘Z’ sounds. While these speech delays can be challenging, they’re not insurmountable. Many of these difficulties can even be solved in therapy — without surgery (if that's what you and your family decide is best for your child).

If your child has a lip tie, dentists may note that your child has an increased risk of developing a gap between their front teeth, but this side effect rarely impacts speech.

And finally, if your baby has a tie but learned how to breastfeed, any future speech difficulties are likely unrelated to the tongue tie (because if they can move their tongue well enough to breastfeed, they have more than enough movement to talk).

How Do I Know If I Should Get My Baby's Tie Released?

Deciding to get your child’s tongue/lip tie released (or not) is completely a personal decision. If you do any research on this subject, you’ll find experts who both strongly support and strongly oppose surgical intervention.

Releasing a tongue or lip tie is a surgical procedure that comes with its own set of risks. I always advise parents to compare the pros and cons with a neutral healthcare provider – someone who won’t financially benefit either way – before making a decision.

The possible risks of surgery include infection, scarring, oral aversion, and strict recovery procedures to ensure the tissue doesn’t reattach. For some children, this procedure positively changes their lives; for others, it is an unnecessary horror story they'll never forget. And unfortunately, all scientific studies surrounding this type of surgery have mixed results, so the official verdict is out.

So… What Should I Do?

If your child isn’t struggling with breastfeeding or experiencing speech delays, I generally would not recommend releasing the tie preemptively. If a release isn’t going to improve anything for your child right now, the best thing you can do is monitor it with an orofacial myology SLP (like me!) and your child’s dentist.

If your child does have speech delays or impairments, consult with a speech-language pathologist before making any decisions. Studies show that improved speech is not an outcome when children 2-3 years old have surgery, but that there are benefits when children ages 3-4 have surgery. So if your child is still young, remember that their delay may resolve through receiving speech therapy alone.

When it comes to breastfeeding and tongue/lip tie releases, the research is even more mixed than that for speech. Some studies say the procedure can make breastfeeding easier, while others show it may only result in temporary pain reduction for the mother, but has no lasting benefit otherwise.

So if your child is struggling with breastfeeding, I recommend working with a lactation consultant to see if they can help before opting for surgery — you may be surprised at how helpful these professionals, in conjunction with speech therapy, can really be. 

Next Steps

Yes, I know all the mixed messaging, especially from experts, can be confusing. That's why I wanted to put all of this information in one place so you can make an educated decision on what's best for your baby and your family.

If you’re still not sure what's right for you and your baby, book your free consultation where we will discuss your options in detail so you can feel confident making a decision. We provide speech therapy, consult, and assessment services in Calgary and across Alberta.