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Restrictive tongue and lip ties can affect your child's speech, feeding habits, sleep & airway.

What is a Tongue Tie?

The condition known as ankyloglossia has been around for thousands of years. The most recent definition proposed by the International Affiliation of Tongue Tie Professionals (IATP), states that the tongue tie is "an embryological remnant of tissue in the midline between the undersurface of the tongue and the floor of the mouth that restricts normal tongue movement." This connective tissue remnant, the frenum, may prevent the tongue from functioning properly, leading to restrictions in oral motor development, feeding skills, and respiratory habits. In order for the oral structures to meet the criteria for a tongue tie, there must be a true functional limitation. The process of diagnosing a tongue tie is a collaborative one that involves taking an in-depth history, completing in-person pretreatment assessments, and examining the oral cavity and extraoral structures.

Symptom Checker

  • struggle to nurse or take a bottle

  • leak milk from his or her mouth while eating

  • make clicking or smacking noises when eating

  • have sucking blisters or callouses on lips

  • wake often or sleep restlessly

  • exhibit poor or slow weight gain

  • display reflux or colic symptoms

  • experience lots of gas or continually fuss

  • have constipation or irregular stools

Ties & Infant Feeding

The nursing relationship between mother and baby is vital, and plays a significant role in the baby's health during a critical time of development. A proper functional exam for ties starts with the feeding assessment. How does the baby latch and position at the breast? Red flags that often arise with feeding are low-tone sucking, in which the baby cannot latch or latches poorly, and high-tone sucking, which may result in pain and damage to the nipples due to improper balance or forces of the lips and cheeks. Tongue ties may cause disorganized swallows, producing clicking or smacking sounds while feeding, in addition to gulping, coughing, gagging and choking. We strongly encourage our families to establish care with Lactation Consultants who will support mother-baby dyads on their feeding journeys. Patience, time and effort through therapy are required for successful rehabilitation.

Ties & Whole Body

  • Coordination of a variety of oral structures along with adequate air flow is required for speech sound production.  Limited range of motion when a tongue tie is present can affect the tongue's ability to reach various placement points in the mouth to produce different speech sounds. This can also affect oral resonance, which is a vital part of speech production, articulation, voicing and fluency.

  • If movement of the tongue is restricted, a person may not be able to raise the back of their tongue to create the "k" and "g" sounds, or have difficulty coordinating their tongue muscles to make "l" and "r.' 

  • Tongue ties may also cause distortion of speech sounds. This is due to the airflow coming from the lungs being directed or restricted in a different way.

  • Fluency of speech may also be affected because a tie can cause incoordination and inefficiency, which can lead to stuttering.

  • Speech-related symptoms that can be caused by a tie are

    • frustration with communication

    • poor speech intelligibility

    • speech delays or disorders, particularly errors with sounds "k", "g", "ng", "sh", "ch", "-dge", "th", "l", "r", "s", "z"

  • ​It is pertinent to have your child evaluated by a speech language pathologist prior to and after a tongue tie release.

Dr. Hershko has dedicated a large focus of her practice and education to infant tongue and lip ties. She is passionate about unlocking children's greatest potentials to thrive.

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