Tongue-Tied Frenulum (Ankyloglossia)

Parent Q&A

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  • Hello, my son (3months) just had his tongue and lip ties cut. We went to Dr Yazdi and the procedure went well but I’m struggling with the exercises (the pulling of the lip and tongue and pushing on wound.) I cannot imagine doing this for another 5 weeks. Looking for others who have been through it. Any advice? Does it get easier?

    I had my twins tongue ties corrected when they were 2 weeks old and also found it difficult to do the exercises. I don't have any advice besides to just grin and bear it basically. I would encourage you to join the Bay Area Breastfeeding Support Group (BABS) on facebook. There are a lot of people who have gotten their kids tongue ties corrected in that group and it was immensely helpful in my own breastfeeding journey. 

    We had the same procedure done by Dr. Yazdi when our son was around 4 months old and I feel your pain! It was so hard to imagine doing those exercises for 5-6 weeks. The good news is it got way easier as we got more comfortable doing the stretches and the wounds became less raw/sore for our baby. For the first few days we used the pain management regime recommended by Dr. Yazdi, including the arnica tablets, which seemed to help.

    How far in are you? I would say things got slightly easier after 3-5 days and then much easier in the last three weeks, especially because we didn't need to do the stretches as frequently. I was also worried about "permanently scarring" our baby or giving him some sort of oral aversion or something but happy to report that nothing like that happened - he obviously doesn't remember anything from that time. The releases seemed to immediately help with breastfeeding and I'm confident that doing the stretches helped us avoid any reattachment. He's 2 now and we haven't had any issues with the ties growing back. You will get through it! 

    Hey there! I'm sorry you're having a hard time with the exercises- they're a lot and it's not easy for the baby or parents! We also saw Dr. Yazdi and had our little one's tongue tie released quite young (9 days old I think) and while I think it made it easier in some respects, she still wasn't a fan. 

    It does get easier, and what helped us was timing the exercises with her wake windows so we'd do them when she woke up and then had a few hours in between to recover :) Sending solidarity and I hope it gets easier for y'all as well!

    we had our son’s ties released when he was 6 days old. the exercises were awful, and my husband refused to do them, so i was left to do them every time. i did find, however, that they helped with breastfeeding especially if i did them right before he nursed— so that gave me some encouragement. anyway, to answer your question, it doesn’t get better, it’s annoying for everyone, the kid will hate it, but it’s really worth it in the end. (btw i used a new pair of gloves each time, and also used coconut oil on my fingers to make the rubbing a little easier). i will say that it’s very easy to reattach so make sure you’re doing them really hard. my son’s reattached and my lactation consultant had to push really hard and detach it again (there was blood). but keep it up! you’re doing something that will be highly beneficial in the long term (in my experience, we went from severely painful nursing/broken nipple skin etc and a god-awful latch to 28+ months of successful breastfeeding and a big fat happy chubby boy.) good luck!

    We had this done for our daughter at 2 months old. It does get easier, but as you seem to know, it is important to stick to the stretches. I was constantly unsure of how much pressure needed to be applied to the wounds and would often push too hard, which resulted in my baby being upset. I found that applying the right amount of pressure to the wounds was best measured by first using a small kitchen scale. Dr. Yazdi should be able to give good guidance on how much pressure to apply if you struggle with this as well.

    In the end, our 3 year old daughter is doing great and has good mobility of her tongue. No issues with feeding, speech, or any other problems that may arise from oral ties.

  • Frenectomy/Tongue tie

    Jan 24, 2023

    Hi parents,

    My daughter is in need of oral surgery to release her tongue tie. Any recommendations in the east bay?

    Thank you

    We used Dr. Shervin Yazdi in Castro Valley for our daughter. His practice uses laser technology. We are happy with the outcome.

    We went to Castro Valley Pediatric Dentistry (Dr. Shervin Yazdi) at the recommendation of our lactation consultant in Fall 2021. We had an overall positive experience for something that is inherently quite stressful and would recommend it.

    My daughter is in the same boat and our bodywork doctor recommended Dr.Yazdi.

    Info

    Hi,

    My son needed a frenectomy and we received a recommendation from a friend to take him to Dr. Niki Boloorchi at the Tooth + Tongue Dental Center in Walnut Creek a few months ago. She used a laser for the procedure and was so professional, kind, and caring. The procedure was very quick and one could tell how experienced and comfortable she is with children. My son is doing great now and we could not be happier! I have also been taking my 6 year old daughter there for dental work as I loved Dr Niki's work, office, and staff. I have recommended this dental practice to many of my friends and every single parent has been extremely happy with their experience and thanked me many times.

    Dr. Yazdi was recommended by almost everyone we spoke with - we had a good experience with him for our son a couple years ago: https://www.cvpd.info/

    Hello! My child had a tongue and lip tie. We took them to Dr. Yazdi at https://www.cvpd.info. We continued to get our dental care from here and have really loved the staff!

    Dr. Yazdi in Castro Valley. I don't know if you're dealing with an infant and breastfeeding issues, or if your kid is older, but Dr. Yazdi is the tongue tie guy. There are other recommended practitioners in East Bay and South Bay. We saw them, and I would not recommend them. My kid had 3 tongue tie surgeries as a baby, and only Dr. Yazdi actually fixed his issues. He's eccentric, but he is the best. https://www.cvpd.info/breast-feeding 

    Our therapist sent us to see Dr Niki boloorchi at Tooth and Tongue in Walnut Creek. She used a laser and we felt very comfortable with her skills and knowledge. I would highly recommend!

  • Hi my 4 year old son who has a tongue tie since born but never had any issues with breastfeeding, so his pediatrician told us that we didn’t need to do anything with it. A few days ago, his new dentist told us that he has a severe tongue tie that will likely impede his jaw development. He already has a cross bite and his dad also has a cross bite. Coincidentally his preschool teacher told us a couple of weeks ago that she is concerned with his annunciations and suggested us to take him to see a speech therapist. Combined the two feedbacks, now I am seriously looking for a Dr. to get him evaluated. It turns out it’s very difficult to find a dr. that can perform this procedure in the office once they are over 1 year old. They all require general anesthesia.

    Any recommendations for a doctor that can perform a frenectomy without general anesthesia? Much appreciated! 

    Have you contact Dr. Yazdi's office in Castro Valley yet? He's an expert in frenectomy, and while he's a nutty Dr., he is absolutely the best! They have an infant frenectomy center, where we got our son's done after two failed procedures at an ear nose and throat Dr., and it seems like even if they don't do the procedure for older kids there, they might be able to make a recommendation for your case. http://www.dryazdi.com/frenectomy.html

    My advice is to do the appropriate procedure for the condition, even if it means a brief general anesthetic. If you try to fix the problem with a lesser intervention (and risk traumatizing him in an office setting while awake), that's 2 bad outcomes. In an otherwise healthy kid, the risks of general anesthesia are far less than putting him in the car and driving him on the freeway (just to give one example, to help put it in perspective). However, make sure he's cared for in a Pediatric OR with a Pediatric Anesthesiologist, like at Children's Oakland or UCSF Mission Bay. Best of luck! 

    General anesthesia is much safer than it was 25 years ago. It might be more traumatic for your child to get intra-oral local anesthetics than a short acting general. Ask the physician doing the procedure what they use - don't force him/her to do something they are unfamiliar with. Your dentist may have a recommendation for a surgeon. 

    I agree with the poster who suggested you have the procedure done under general anesthesia. It will be a very quick and safe procedure, and for your son to have this procedure while he is awake would certainly be extremely painful and traumatic. I do hope you reconsider. 

    Both my kids had surgeries at Children’s in Oakland, and I recommend the anesthesiologists and ENT doctors there highly. I’m sure UCSF is a great option, too. I do think pediatric hospitals are the safest options for children’s surgery and anesthesia; I would strongly advise against an adult facility.

    Thanks for your responses. I called Dr. yazdi’s office and they told me they only treat infants now. I also read about Dr. Robert Wesman from this site who was the head of the ENT at Oakland children’s hospital and obviously would do the procedure in his office while chitchatting. But I called the office and was told he is retired 5 years ago and now general anesthesia is required for young kids. Still searching. 

    I recommend getting a second opinion from another dentist and an official opinion from a speech therapist. Frenectomy is “in style” these days but the evidence is not conclusive that it’s necessary or that tongue tie contributed to the conditions it’s blamed for and I’ve found that some providers tout it as a solution to lots of different problems and others think it is unrelated. If she does need it, please consider anesthesia. It’s painful and expect post op pain in recovery as well as having to relearn to eat and speak for a few days. Sometimes they reattach as well. Agree with dr yazdi or cho ent

  • Hi parents,

    I have a beautiful 4 month old baby girl who is tongue tied. We had a frenectomy done via laser with Dr Yazdi (pediatric dentist in Castro Valley) on day 12 but unfortunately she's still tongue tied. The cause of the re-attachment is unclear - we did the exercises but there was an inflammation that points to a healing process that likely impeded success. We've been seeing a craniosacral therapist (cannot recommend Andrea Byers enough!) and bodywork has helped too. At this point, we are making a decision on a second revision. I'd love to hear a) recommendations for Bay Area practioners that are really good at a scissors release (don't want to do laser again because of all the scar tissue / how she healed after it) and b) any experience you all have with a re-release. Did it help breastfeeding? Did it "work" the second time around?

    Thank you in advance!

    Best, Kelly

    My son who is now a year was also tongue tied. When he was 2 weeks old we had a release performed by Dr. Erin Simms Edwards, a pediatric Ear Nose and Throat surgeon in Berkeley who performs releases with scissors. It helped tremendously. My baby was unable to transfer milk with breastfeeding before the operation and within about 5-6 days he was able to breastfeed on his own. I found Dr. Simms Edwards to be straight forward, clear, honest, and gentle. She came recommended to me by a number of lactation consultants (through Alta Bates, a private LC, and an LC through our pediatrician's office). They each independently seemed to have a lot of trust in her. They said she is cautious and won't do the procedure unless she's sure it's needed. With my son she was immediately able to diagnose that he was tied. 

    Good luck! I hope you can get it all resolved soon. 

    We used Dr. Simms-Edwards in Berkeley to clip a tongue tie when my son was just a few days old and she was excellent. She was recommended by our pediatrician. It went very fast and healed just fine. I highly recommend her. 

  • Hi,

    We recently brought our son home from the Kaiser NICU. He was born in mid-December (I was induced) at 35 weeks 3 days and weighed 4 pounds 2 ounces. He takes a bottle well, but we are coping with latch issues and he tires easily when breastfeeding. After speaking with a lactation consultant who mentioned that he likely has a mild form of tongue tie, I am convinced that we should take him to have this looked at and perhaps revised. Does anyone have any leads regarding decent pediatric dentists or ENTs who take Kaiser insurance? And would we need a referral from his pediatrician? We are willing to travel, if need be... I was told there may be a practitioner in Santa Rosa (Kaiser) who performs tongue tie revisions. I would love to hear from those who have recent experience with this, since the procedure is apparently no longer done at the Oakland facility. :-(

    Thank you so much,

    Larissa

    Sorry to hear you're having this problem with your baby. My son (now 9) was diagnosed with this as well and we had the procedure done in Oakland when he was an infant, and I remember feeling very scared. You didn't say if the lactation consultant was within Kaiser, or outside. Either way, really, I would want to stay in Kaiser for this, so get an appointment with any pediatrician (first available), to get the second opinion and referral if appropriate. I would NOT go to a pediatric dentist with my infant. If Kaiser thinks it should be done, you will get a referral to a Kaiser ENT.

    Hi, we had this procedure done in early August of 2017 by a pediatric dentist Dr Yazdi, who was referred to us by a Kaiser lactation consultant. Dr Yazdi's office is in Castro Valley, and he specializes in tongue tie procedures and has lots of reviews on Yelp. Our Kaiser pediatrician told us that they don't do tongue tie revisions.

    Dr. Yazdi in Castro Valley is the expert in the Bay Area. He treated our daughter for tongue and lip tie at 2 weeks old. I heard of people who went elsewhere and had to repeat the procedure because it was not done right. He uses laser so less bleeding.
    Make sure to do the aftercare exercises!

    I had this done for my son in 2012 at Kaiser Pinole. Not sure if the doctor who did it is still there (and sorry, can't remember her name). Our breastfeeding issues were different (low milk supply--thought perhaps baby could stimulate production more with a more robust suckle) and clipping the tongue tie didn't end up helping much, but neither was it a big deal (quick and easy). 

Archived Q&A and Reviews


Questions

Fixing 5-year-old's "tied" tongue

Aug 2008

My 5 year old son is ''tongue tied'', meaning that he can't fully lift his tongue in his mouth. His dentist recommends a procedure to cut the string attaching it to his mouth and said that either the dentist can do it or a pediatrician. Has anyone had any experience with this and if so, did you have a dentist or Dr do the procedure? It is affecting his speech as well. K.


We got my son's frenulum clipped at five days old. He sat in my partner's lap, I lifted my hand to cover my eyes, and by the time my hand got to my eyes, it was done. No blood. No numbing shot. My younger sister got hers clipped at age 13 or so: same deal. anon


Yes, my daughter was toungue-tied (she could barely stick her tongue out of her mouth at all). The Oakland Public School speech therapist diagnosed it and said we would see no further improvement in our daughter's speech until we had the simple, quick surgery to snip the frenulum that was too short and not allowing her tongue to move adequately.

A very kind and competent Kaiser surgeon did the operation. My 5-year-old daughter was extremely proud at how well she cooperated and participated in the procedure! First a topical anaesthetic was applied. Then an injected local anaesthetic. Then a little snip. Very little pain at all! The speech impediment cleared right up. Suffice it to say she's never been tongue-tied in any sense of the word since!

There's no reason to not get this done soon as far as I can tell from our experience. Hope this helps. Monica


6-month-old has a short frenullum - clip?

March 2008

Our pediatrician diagnosed our 6 mth old son as having a short frenullum or being tongue-tied. Since then, I've noticed he doesn't stick his tongue out past his lower lip because he can't; other babies his age do this a lot. I'd like to know if anyone has had their baby's frenullum clipped and what that experience was like. Any downsides? We have Kaiser Oakland healthcare. Any experience with the frenullum-clipping doctors there? Thanks in advance! C.


I'm a hospital pediatrician who frequently sees newborns with short frenulums. I will often perform a frenotomy if the baby is having difficulty with the breastfeeding latch, but other than that I usually recommend a wait-and-see approach. Some kids with a very short frenulum may have some speech issues later on, but some do just fine. The procedure itself is very simple, with minimal pain and bleeding (at least in newborns), but for a 6-month-old baby you definitely want someone with a good amount if experience. I don't know who this might be at Kaiser Oakland, but perhaps you're pediatrician would if that's the route you want to take. My advice would be, if the short frenulum is not affecting the baby's quality of life and weight gain is adequate, to just see what happens with speech development. The procedure can be performed at any age, and literally takes less than 2 minutes. kh


Our son was tongue-tied when he was born - his tongue didn't lift up when he cried, and breastfeeding was excruciating, as well as ineffecient. On the recommendation of our midwife and a pediatrician, we had him ''clipped'' when he was about two weeks old. (This was in Canada, so I can't recommend a ped to do it.) It was a painless procedure, they didn't even need to use anesthetic. He cried, more from the shock of being held still with his mouth open, and there was some blood, but it really seemed a painless procedure. Basically, we did it because we were told that if he needed to have it done as an adult, or as an older child, then the nerve cluster under the tongue would have been developed and a) it would be very painful and b) could cause further damage. So the younger, the better. In any case, it's been almost two years later, and I can't say that we've noticed any problems with his clipped tongue since. My husband, who is the one who's tongue-tied (it's genetic, appar! ently), wishes now that his parents had done it for him when he was a baby. Anyway, good luck in finding a ped you're comfortable with, but as I said, it really is a very simple procedure. For us, it took about ten minutes, and we were in and out in under a day, and our baby was fine within a couple of hours. baby's no longer tongue-tied


My son had the same trouble with the frenulem, and I got mixed advice about clipping it. When it became obvious that it was affecting his ability to speak properly and making him frustrated, we had it clipped at a dental surgeon's. The biggest downside, which was short-lived, was that he had a sore frenulem for a couple of days. If I had it to do over again, I would have had it done when he was younger (he was three when we had the operation performed). In any event, you might want to find an oral-maxillofacial (AKA, dental) surgeon to do the work. Jennifer


My daughter is the same way, has a short tongue. She is 16 years old and it hasn't made a bit of difference, except that when she sticks her tongue out at someone in anger, it's not quite as effective! I would do nothing, unless your son can't eat or something like that. Good luck anon


Hi Claudia -

My son who was born in Jan 2006 was diagnosed with a short frenullum. Fortunately for us it was caught within a few days of his birth (not by the on staff pediatrician at CPMC but by our pediatrician in Berkeley). So at one week old I took him to have it clipped at Oakland Children's Hospital. He is my first born and my husband couldn't go with me for the procedure. I was sooo nervous but it was really no big deal, very minor. I held him, they cut under his tongue and it was all over in seconds. He cried for a short time and I fed him and that was that. I was much more upset by anxiety than my son was by the procedure. He's now 2 and he can definitely stick his tongue out (ah, the terrible twos). At the time we were on Cinga health insurance (we\x92re a Kaiser Oakland family now and love it).

I found out after he was diagnosed that this runs in my husband's family. My mother-in-law had her son's short frenullum's clipped as well with no negative consequences. Good luck and if you want any other info shoot me an email - Brenda


At the hospital, right after my son was born, a nurse told us he was ''tongue-tied'', which sounded like a death sentence to us new parents. Everyone else we talked to said there was nothing to worry about- that even if his frenulum was a little short, it usually worked itself out as they got older. We did nothing, and he's a perfectly normal 9 year old who has never had a problem speaking or anything else involving his tongue. However, I've heard the surgery isn't such a big deal if you decide to go that way. But in the meantime, I'd get a second opinion. No point in putting him or yourselves through anything that's not completely necessary. I also don't think there's any hurry in doing the procedure- you could actually wait until his language and pronunciation is more important, maybe around age 3. c


Tongue-tie in the long term

April 2006

My son is tongue tied. He can stick his tongue out enough to have it sit on his lower lip. He says a lot of words and phrases but only a few words clearly. He has no problems eating, sings and hums and plays and ''talks'' just fine, he is just hard to understand.

He had his 2 year well check recently and the doctor said that if we were concerned about his speech, he should be tested by a speech pathologist, specifically through our school district. But she also said that children at his age, especially boys will speak like this sometimes and gradually grow out of it naturally. I have nephews who did this, they are not tongue tied but their speech was incomprehensible to me. And now, at age 5 and up, their speech is very clear and articulate.

I would really appreciate hearing from parents whose children are tongue-tied. Specifically:
- Did you get your child tested for speech problems? - How long did you wait before you did this? - Did speech therapy help your child? - Did you get the tongue tie surgically corrected? - If you did not get your child tested, how did he/she do? Does he/she speak clearly now? - Did you feel like he/she would have had less problems had you had her/him tested earlier? - Any other issues that you can address.
Thank you so much


One of my twins was born tongue-tied. At virtually every dr. appointment, I would ask the pediatrician about it, but he always pushed it off, saying we should wait until his speech was more developed. I continued to ask what the harm would be in having it clipped, and he really never expressed any concern.

I thought my son was starting to pronounce some words differently (e.g. would drop middle consonents in his words like ''Dayee'' instead of ''Daddy'', ''Buyyer'' instead of ''Butter'', etc.), he couldn't lick an ice cream cone, and concerns about 'intimacy' for him many years down the road entered my mind on his behalf.

Finally when my boys turned 4, I insisted on getting the names of an ENT from my pediatrician. He gave me 2. One thought it would be 'traumatic' doing it at the age of 4 (thought I should have done it sooner, or wait so he would be less afraid???) and the other was Dr. Robert Wesman at Children's Hospital.

Not only was Dr. Wesman, calm, attentive and informative (ok, he's pretty darn handsome, too!), he also told me he'd perfomed the surgery nearly 1,000 times! Right there at the appt. he said, ''Let's just do it!'' and all my years of questioning and inquiring ended. The 'clipping' took all of 15 seconds. My son sat in my lap, Dr. Wesman applied some numbing solution and clipped.

While I nearly fainted, my newly 'untied' son turned to me and said, ''I was so brave mom. Can I get a toy?'' And THAT WAS IT!

I encourage you to contact Dr. Wesman and get his assessment of your child's condition. I am only sorry I waited so long to insist. I finally did because a friend of mine didn't and both her boys required speech therapy to correct what could have possibly been prevented had they had their tongues clipped.

Good luck!

Mom to three boys, all of whom can lick ice cream cones! Karen


My husband had tongue-tie and had speech problems which he learned to compensate for by using his tongue against the side of his mouth instead of his palette. However, when he was a teenager he began to feel very self-conscious about french kissing, and since this was something he did not feel comfortable discussing with his parents, he got a knife, took a shot of whisky, and cut it himself. He said it didn't hurt too much and he was glad he did it. So that goes to show that speech is not the only long-term complication to consider, and your child may be too shy to discuss it with you as a teenager. When our son was born tongue-tied, we got it snipped so he won't have to go through what my husband did. We waited a year, by which time he had to go under general anesthesia for 15 minutes, but we're glad we did. He's still nursing at 17 months and his latch on greatly improved (after a few days of him not wanting to nurse at all because it felt different). I didn't want him to have to relearn to speak correctly so that's why I wanted to do it before his speech began to develop. anonymous


Tongue-tied baby having trouble with bottle

June 2005

Hello, My daughter is almost 2 months olds and refuses to take the bottle. We first introduced the bottle when she was 3 weeks old. After a few minor battles, she actually drank from it quite well for about 2-3 weeks. Now, however, she is absolutely fighting us. It's very stressful because I will be returning to work in about 2months. I also need to mention that she is tongue-tied. The skin that attaches the tongue to the bottom of her mouth is elongated. I've been told that this may inhibit her from comfortably sucking on a nipple. My oldest is also tongue-tied and he didn't have a problem with our bottles of choice. It just baffles me that she once took it willingly but now screams in our faces. We are currently using Advent bottles? I would appreciate any suggestions regarding what to do. Thanks in advance! dna30


My daughter was the same way - exactly! The bad news is that she NEVER took to a bottle again. The good news is that she started drinking from a sippy cup at 5 months old. She still hasn't perfected it at 9 months but she can do it and get fluids. We tried every single bottle, every single position, every single time, every single liquid, every single temperature, every single person and nothing worked. She just would not go fo rit. But, in the end, I think it made life easier because now we won't have to wean from the bottle, which took a long time with our older girl. Good luck. anon


I am a lactation consultant who is also a mother of baby born tongue tied.

I would urge you to look into having your baby's freunulum cut. The procedure is simple and easy while your baby is young, though pediatricians are often under educated about how they can effect feeding.

We took my son to an oral surgeon. Once she established the tongue tie, she gave him a pacifier dipped in sugar water, grabbed his tongue with a some gauze, injected just a bit of lidocaine, then snipped it. After holding someone gauze on the cut for a moment, she was done.

My son was nursing in 1 minute after we were done. We saw improvement in his weight that very week.

The benefit to doing it now, as opposed to waiting is that waiting can cause health issues- as baby may not be able to adequating drain a breast or bottle, there can be speech issues, and it's a more complicated procedure to do once the child gets older- often times involving general anesthesia.

As far as bottles go, I have 2 suggestions, go with a plastic bottle such as gerber that you can sort of squeeze to help the flow. Or make sure that you use a nipple with a larger hole to allow the milk/formula to come out easier. Rae


Short Frenulum and 4 yr. old's speech delay

March 2005

My four year old son has a short frenulum (skin underneath tongue) also called tongue tied, which is believed to not enable him to talk at his level. I have heard that the procedure is controversial and would like to know of any success stories or horror stories if any? I don't know much about it but am willing to do anything to get a handle on his speech delay. Although I don't want to jump into. I can see how his short frenulum would make words sound different; I held my tongue close to my lower mouth and tried to say words he says and it definately sounds like his words. Could these be two separate issues? His pronunciation of words with this short frenulum or just a typical speech delay?? Please offer any bit of knowledge or advice. Thanks Kat


We had our son's frenulum clipped at 10 days, as he was really struggling with nursing. It made a huge difference in his ability to nurse. We got a lot of pushback from docs about this-- they are not fans of the procedure, but finally my pediatrician agreed that it might be a problem, and we found a great doc in Orinda who did the procedure. Now obviously with a four year old your situation is different, but one of my reasons for going through with the procedure was that I was sure it would be a problem for learning to talk--with our little guy his tongue basically 'forked' when he tried to push it past his lips. I'm really glad we had it done, and at least on a baby it was a very simple procedure. If you really think it's impacting his speech I would give serious consideration to having the procedure done. sdurran


I am not sure from your posting if your pediatrician has raised concerns about your son's frenulum and his speech development and whether or not you have already seen a surgeon. I will assume that you have made this posting because a medical specialist has advised you to consider this surgery and you have more questions and concerns.

I am a plastic surgeon in practice in Berkeley. I worked exclusively at Childrens' Hospital when I first went into practice and have seen this problem frequently. The procedure to release the frenulum is very straight forward and quick. It probably will take about 20 minutes, can be done as an outpatient, will be done with stitches that dissolve, so your son will not be traumatized by having to have stitches removed in the office, and involves making what is called a ''z-plasty'' to increase the length of the frenulum and allow the tongue to move freely. Because your son is only four, this procedure would have to be done under general anesthesia as most four year olds would be too frightened to have someone operating on them while they were awake. Most parents are very concerned about anesthesia, but it is really safe.

I am not a speech pathologist, so I cannot offer advise on whether or not this will help your son's speech, but if the procedure has been recommended to you by professionals who have evaluated your son, you should not be afraid of the procedure itself. It is quick, safe with minimal complications. If it will help your son, don't be scared to do it. Elizabeth Slass Lee, MD


Infant with Ankyloglossia

May 2004

I am looking for advice from someone who's infant has had Ankyloglossia (the bottom of the tongue is attached to the bottom of the mouth by a thin piece of skin, the frenulum). My child's pediatrician says to leave it alone and if down the road a speech impediment develops, then we would deal with it. I am concerned that if the speech impediment is allowed to develop, it may be a problem getting over it. I am breastfeeding successfully. Thank you, Worried mom


My son had the same thing and our pediatrician was not concerned, but I was. Finally at age 4 I persuaded him to give me the names of some ENTs. Dr. Robert Wesman at Children's Hospital performed the 10 second procedure without a peep from my child, who turned to me and asked for a toy as a reward for his bravery. It's so not a big deal, I don't know why the drs. are reluctant to have it done. I conduct workshops for new mothers of twins, and I see this every now and then. My son didn't seem to have speech issues, but couldn't lick an ice cream cone either! We're so happy we did it. It's painless. Be your child's advocate and look into it if you have concerns. Good luck! Karen


I had an attached tongue, and had the frenulum cut and stitched when I was five or six years old. By then I had a rather obvious speech impediment: a lisp, and I pronounced ''v'' and ''f'' sounds with a ''th'' sound. My parents always understood me, but I had a lot of difficulty in new situations. Years of speech therapy followed the snipping and I still have a hard time with the words ''even though'', ''father'', and ''feather''. Whenever I say ''ethen though'' in a professional situation, no one notices, but I usually blush and cringe a little. The snippping and stitching was so painless (our family dentist did it) but the frustration with speech was a real drag. my sister opted to cut the frenulum on her infant son when it looked debatably short, mostly to avert a fate similar to mine. hope this helps. marjorie


Please do not worry about your baby's tongue yet. We were at a friend's house and she was playing with my son, and said, 'oh my gosh, he's tongue-tied!' I hadn't even thought about it and never noticed it. I looked and whaddyaknow.. he was!

I decided not to worry about it yet. I have a very small, short tongue - small jaw in general. On a smaller scale, I think my tongue would look attached as well.. as in, when I was a baby.

A month or two ago (my son is 12 months now) I looked at it again and he appears to no longer have an attached tongue. I think it was just the size of it making it look worse than it was. He seems to be growing out of it, so to speak. I have no speech problems at all. My son is talking and has always nursed like a pro.

Please, please do not worry about it yet. I have done research and most of it says that it is usually not an issue and does not need to be cut. I don't believe in 'preemptive strikes' on a thing like this. anon


I had the condition and so did my daughter. When I was young doctors always operated. On my daughter, doctors kept telling me to wait. By age 1, I could detect a slight speech impairment as a result of her not obtaining the VERY simple procedure to free up her tongue. It took me a year to get the docs to schedule the procedure. Now at 5 I am taking her for pre-kindergarden speech assessment/therapy (people who don't know think she talks with an accent). Her speech patterns are only discernably different, but I hear them. The tongue is a very necessary organ - why the medical community currently finds it fashionable to leave someone tongue impaired escapes my understanding. My daughter shows her appreciation to me every day for fighting for her procedure by engaging in full utilization of her tongue (which she loves to extend beyond her mouth - something she could not do before.) anon


My brother has that, and he is now 23. He has never had any speech problems and is very well adjusted. He can argue and debate with the best of them. He is a graduate from Yale in philosophy and is now in the Peace Corp. As far as we're all concerned, it's just a conversation piece. The only thing I ever wondered about was kissing...??? he he he. I'll have to ask him about that. :) attached tongue's sister


My daughter had this at birth as well. At the time our pediatrician suggested that we watch and monitor it, that most of the time the little piece under the tongue stretched enough to not require anything further, in a very few cases it had to be clipped but he had only done one in 15 years of practice. Other than having a bit of trouble sticking out her tongue (not something infants do purposely), things resolved themselves completely. She is now 13, eats and speaks and manages to stick her tongue out just fine. So as long as feeding, and eventually speaking is not a problem, I'd suggest watching and waiting. anon


My son was born ''tongue tied'' (what they apparently still call it when the frenulum is attached to or near the tip of the tongue) and he was having a lot of trouble properly latching on to breast feed. This was causing both of us a *lot* of distress, and I found my doctors to be totally un-helpful (they said just wait and see what happens and if there are speech problems later then they'll deal with them then, which seemed completely unacceptible to me -- why let something become a problem and then have to deal with TWO issues, the frenulum *and* a speach impediment?). When he tried to stick his tongue out, the frenulum pulled the tip back, making him almost appear fork-tongued! I wanted my son to be able to lick an ice cream cone, french kiss (someday, no rush), stick out his tongue, etc.

My midwife said the frenulum has no nerve endings in it and midwives of old who helped birth tongue-tied babies used to just ''snip'' the frenulum with their fingernails. (!) I didn't think I was up to that so she suggested that many pediatric dentists will do it, however the one we saw said she wouldn't do it without being able to put the child under general anesthesia (!!!) and she wasn't willing to do that to a baby (I wasn't either). At that point I was really wondering what the big deal was -- people perform routine circumcision without general anesthia and this part of the mouth supposedly has no nerve endings, so what's the problem?

When I was exhausted, despairing and kinda at the end of my rope, my saint of a midwife said she'd snip it for us. She'd never done it but she was game to do it anyway. She talked to other midwives who had snipped frenulums and felt comfortable with it. I held my infant son, his father helf his little arms and she got right in there with a little pair of sterile surgical scissors and snip! My boy seemed more upset about being held down and having his mouth held open than anyting else, there was one teensy drop of blood, he latched right on to nurse and was fine literally two seconds later.

After that, every time he stuck his tongue out we were so happy, ''Go Gene Simmons!'' I can't speak for your child but I know it was the right decision for us and I've never regretted it (especially as it seemed about as complicated as clipping a toe nail). isabel


Hi, My 5 1/2 year old son has an attached tongue. I was also worried about it when he was a newborn. However, it hasn't been a problem at all. It stretches out thru the years, and although it won't be totally unattached when he's grown, it is getting better.

He doesn't notice it. His speach is totally normal. The only way you'd or anyone would notice is if he opened his mouth & lifted up his tongue! I think if you're worried, get a second opinion and find out the risks & benefits to either decision. As, I think there are risks (and perhaps pain) to the procedure itself.

I'm happy we let it be. heather


Are you talking about your child being tongue tied? If so, I would not worry. A good friend of mine has a daughter who was born with this condition. My friend is a pediatric nurse practitioner and was not worried. They did nothing and her daughter is now 4 and has no problems with speech or anything else. anon


My son was born with a heart-shaped tongue as well. You know, it is genetic! I have a short tongue and have never had any speech issues. My son is now 21 months and beginning speech. Things sound normal to me. If he has stretched it naturally, I haven't noticed a significant change.... He successfully nurses and has from the start! My ped advised against it until we determine speech issues as well. Since he successfully nursed, we have decided to wait and I am glad we did, as I don't want to do anything unless it's necessary. You have to do what feels right to you! On the side, I have a friend with two brothers, all had the frenulum issue. Her oldest brother had the surgery when he was young. She was left alone. Her other brother ripped it on his own as a toddler. They all speak fine. LogicalMama


I just ran your question by my sister as my sweet little niece was just born with the same problem about six weeks ago. She had the tongue detached, but the baby had some problems latching on when breastfeeding. The doctor said that she may have a lisp as a result, but it was better to handle the issue early rather than when the child was older. anon


When my son was a year old, we had his 'tongue-tie' looked at, and the doctor we spoke to said the same thing yours did, but he also said if it were his own child, that he would go ahead with the procedure then. We followed his advice, and he did it right there in his office with a local anesthetic. It took about 5 minutes, and our little guy did cry quite a bit, but I think more out of fear than anything else. I'm sure it was raw underneath afterwards, so the doctor said not to give him anything too acidic to eat for a day or two, like tomato sauce or OJ. But he also said that when he does the procedure to 5 and 6 year olds, they say the pain is minimal and doesn't last long at all.

I recommend getting it done now if you're up to it, and I agree that it doesn't seem right to wait for the speech impediment to develop first. Good luck deciding what to do. FYI- the doctor we saw has an office at Children's Hospital, and his name is Dr. Robert Wesman at 510.428.3456. Leslie


Tongue-tied baby

May 2003

I have a 10 week old who has been described as mildly tongue tied. The lactation specialist he saw at birth in the hospital described that there are doctors who cut the frenulum in order to avoid difficulties with speech and language development or breastfeeding. While my son is not having any difficulty breastfeeding, I'm wondering if there are other parents who've had a similar experience with their children. My pediatrician says I should wait until around 3 years of age to see if it affects speech and language development, but I'm hesitant to wait that long. I'd hate for my son to fall behind in that domain if the mild tongue tie turns out to be an issue. Any advice? Kristin


Our son (4.5 yrs old)is also mildly tongue tied. He has had some difficulties with speech as well as controlling his saliva. However, in speaking with the many speech professionals that we have worked with, none of them believe that his speech problems are a result of this physical attribute and they do not think that anything needs to be done to correct it. They point to other factors with regard to his speech delay. On the other hand the saliva thing is most likely related but he is learning to control it. Leslie


Our daughter, like her maternal grandmother, was born with a fairly restrictive frenulum (tongue-tie), and in the early weeks, several people (including a lactation consultant) mentioned the possibility of altering our perfect baby by cutting the frenulum! Well, I thought about the fact that my mom talks a blue streak with no speech impediment, and has never had problems with tooth decay or choking that some people will tell you are associated with tongue tie. The only thing is that she can't really stick out her tongue. Not such a bad thing in a rebellious six-year-old, maybe? Anyway, we decided not to intervene, and I'm glad. Our daughter is 1 1/2 now, and starting to talk -- of course, it's early days to say whether it affects her articulation, since like all toddlers she says ''baahw,'' instead of ''ball'' and so forth. She nursed very heartily up to 14 months, and really, I often forget about the tongue-tie. I'd say at the very least, take a wait and see attitude and cherish that little guy and his cute little not- sticking-out too far tongue. Alexa


Speaking from a third-party perspective, perhaps you can follow your ped's advice and wait. My nephew was identified as a ''tongue tied'' infant, but it didn't hamper his ability to breastfeed at all -- nor his speech development. He's a bright kid and was mimicking words very clearly before 20 months. He has no problem now (at age 2-1/2) with talking or enunciating complex and multisyllabic words. Noreen


My friend's midwife told her that her baby has the same thing and suggested to cut it as early as possible. She went on to internet to search and found every information she could find from ''don't worry at all'' to ''do cut right now''. As you can imagine, she drove herself crazy with all the contradicting information. She ended up seeing ENT specialist who told her that it is rare that the those infants have to treated. If he is able to eat and breath, it shouldn't be a concern. In fact, 95% of Japanese people were tongue tied babies!!!! So, I would believe your doctor and wait until you notice something.... good luck shoko


I couldn't tell from your message whether you were considering having someone cut your baby's frenulum? I am a voice professional who has worked for decades with people who have never recovered from this sickening and barbaric practice. Really: medieval. Please, let your child sort out his tongue on his own. If you are concerned, you can pay attention to what you are doing with your own tongue in your baby's presence, since he is watching you to see how to use it. Stick it out for him, do a ''raspberry'' for him, make sure you are making final d's and t's at the ends of your words. When he's older, let him lick popsicles--this is good for tongue strength and coordination. Play rhyming games, do brief tongue twisters with him slowly and laugh your heads off when the sounds get scrambled. These will help his tongue a million times more than someone's cutting it--it makes my blood boil that someone even said that to you. There is no substitute for enjoying the inside of your own mouth, and when someone takes that away from you, it is a long and difficult process to get it back. Sad. You have a long way to go before you need to start thinking there is anything wrong with your child. L T Renaud


Both of our kids, now 6 and 4, had a noticably short frenulum. At age 3, after some worry and language issues, we had the older daughter's cut. And wow, what a nice result. Easier to understand words, no pain ( she completely didn't even gasp at the procedure!) and now, no one even notices. She still compensates linguistically for some words, but the issue is really not on the radar! Easy procedure and good result for the parent who asked. frieda


Three years ago I wrote a lengthy piece for the archives compiling all the advice I got when I asked the same question and outlining our course of action. Perhaps it was wiped from the archives as Dr. Matsuishi's office asked to be deleted from the site (as I recall reading somewhere). Anyway, the upshot is that many people live a completely normal life with a tongue tie, however I felt the procedure as practiced in Dr. Matsuishi's office was so simple that it was worth it if only to eliminate any risk of speech issues - not to mention the fact that licking an ice cream cone would be easier. The ENT doctor we saw would have insisted on general anesthesia which I felt was not worth the risk, but Matsuishi does it with a simple shot of Lanacaine. We had it done at four months. It was quick and easy and my daughter soothed herself by nursing immediately afterward with no side effects. I have almost forgotten that she was born with a tongue tie. I am glad we did it then as opposed to waiting. Others may feel differently, and as I recall, the medical recommendations are mixed. Good luck with your research and decision. y


I was tongue-tied as a baby (I'm now 44). My mother tells me that the family doctor noticed when I was 3 weeks old, and immediately snipped the frenulum in that same office visit. It's my understanding that it's a very simple procedure with very little risk, so I find myself wondering why your pediatrician would want you to wait until *after* your child starts exhibiting speech problems before snipping it? If it were my child, I'd get it taken care of immediately, to prevent the speech problems before they happen. -- no longer tongue-tied


Hi Kristin, My doctor described my daughter as severely tongue-tied when she was two weeks old. We were having a really rough time with breastfeeding and had to decide whether or not to snip. I talked to two pediatricians, one oral surgeon, and my brother-in- law who is in internal medicine/pediatrics about getting the procedure done. All of them told me that they would not recommend the procedure before my daughter turned at least 2 1/2 because the frenulum usually stretches with use (breastfeeding, babbling, etc...). They also said the procedure can be painful and could interfer with established breastfeeding. We decided against the procedure, worked on tongue exercises recommended by a lactation consultant, and pumped to get my milk up. She is now 27 months and you would never know that there was ever any problem. Her speech is clear. Her ennunciation is great for someone her age. In fact, the clarity of her words is better than most of her friends. So now we wouldn't even consider the procedure. Beth


Due to my inexperience as a first time mom, I consulted a lactation consultant for my child, who seemed to nurse forever and with questionable latching on. It turned out (as my mother saw ahead of all of us) that she was ''tongue tied.'' After consulting with the pediatrician, I decided to have her frenulum clipped at about 5-6 days old. I was told that if left, it may affect her speech, particularly rolling her ''r's'' in Spanish. I went ahead with the procedure with a wonderful ENT doctor at Oakland Children's Hospital (I think his name is Wessman).

Anyway, the ''procedure'' was over in less than 10 seconds (she had fallen asleep and only cried for about 2 seconds after being awakened). You hold the child, they put a drop of liquid anesthesia under the tongue and clip. I am relieved to have done it at such an early age to prevent trauma and memories of it. I guess my suggestion would be to do it now if there really is a potential issue. I would think that the whole thing would be much more traumatic to you and your child if you wait until three years old. Good luck. Anon


I read your post about your tongue tied baby and I wanted to share my experiences with this issue. My daughter, who will be 5 in June, was ''diagnosed'' as being severely tongue tied at birth. As the nurse put it, ''Oh that will have to be cut before you leave this hospital. She will never nurse with that tongue.'' Lucky for us, we had an excellent and very experienced pediatrician who suggested the ''wait and see'' approach to medical intervention. For us, the ''wait and see'' approach has worked very well- to this day.

Our daughter never had her frenulum cut. She nursed exclusively until she was just about 15 months old and was weaned when she was 2 1/2 (We needed her to make way for her brother). She was such a great nurser that we often joke that she would still be nursing now, if she hadn't weaned to make way for her brother. She has a slight accent but I think that is more related to her age then her tongue. However, what she says is completely comprehendable & she is one of the most loquacious children I have ever met. She has a clear handle on the language both mentally and physically. I have since met several people who are tongue-tied well-spoken adults. To tell the truth, I wasn't even aware of the possibility of having a short frenulum until she was born. Over time, my daughter's frenulum has stretched a bit as she grew. This is the possibilty that the ''wait and see'' approach is banking on... In short, her in-tact tongue(short frenulum and all) haven't slowed her down a bit. I suggest the ''wait and see'' approach. Nichole


I would not recommend cutting the frenulum. Our daughter also had a very short frenulum which actually did adversely affect her nursing - although I ended up nursing her for 13 months. The lactation consultant was the only one who recommended cutting the frenulum. None of the doctors at our practice would do it because babies have actually bled to death from this procedure. Our daughter is now almost three and is talking up a storm. Her frenulum gradually stretched out and is completely normal now. I would not recommend doing this unnecessary and potentially dangerous procedure. MGD


I was given that diagnosis as an infant - my parents were told I'd need speech therapy, I'd always have problems and that it was an easy surgery. They decided not to do it and it's a good thing as I have the family reputation of a motor-mouth. I was an early talker, with clear speech and zero problems. -anon


My youngest daughter, now 6 yrs old, was mildly ''tongue tied'' at birth. She could not stick her tongue out very far and it deviated to one side. Our pediatrician recommended that we ''wait and see'', and, I am happy to report, the tongue has been a non-issue. Her tissue ''stretched out'' over time, and her tongue looks like anyone elses. We had a friend who had the surgery performed on her son - the first surgery scarred down and he had to have another one. He's now fine. Good luck with your decision. sara


Hi, I missed the original question but just wanted to add our experiences. My son was born with a severe enough tongue-tie that he was having a lot of difficulty latching on to nurse properly, even after several weeks. Kaiser's attitude was ''wait and see if he develops a speach problem in a few years, we'll deal with it then'' which didn't make a whole lot of sense to us -- why have to re-learn how to talk? We then went to a pediatric dentist who had been recommended to us, but she wouldn't do it -- she said the proceedure required general anesthesia and we had no intention of putting him under (esp. to snip something that has no nerve endings!). So nix to that. Finally in desperation we turned to my midwife, who seemed amazed by all the hullaballoo -- she said in the ''old days'' if a baby was born with a tongue-tie that midwives would just snip the frenulum with their finger nails! No nerve endings to feel pain, perhaps a drop of blood quickly staunched by a bit of nursing. And this is what we did (tho' my midwife used a pair of sterile surgical scissors). She made the teensiest of cuts, there was perhaps a microscopic dot of blood and my son seemed more upset about people being in his mouth than anything being snipped. Two seconds later he was absolutely fine and nursing was MUCH better for both of us afterwards. I have no way of knowing how it would have impacted his speach if we'd left it but I *can* say that he has been talking a very clear blue streak since he was 16 months old and has *great* enunciation now at 2 1/2. Isabel


I also had an older post on this topic, which it seems is no longer on the website. My son has a severe tongue tie and could not latch on. We had it clipped at twelve days and it was an incredibly minor procedure. The membrane was really thin, almost transparent. It bled two drops, he cried for a minute and that was it, no follow up care or anything that I recall. So in the case of a real problem I would not hesitate and sooner seems better than later... Leah