Baby with restrictive tongue-tie — ankyloglossia French-speaking Switzerland >

What is a tongue-tie and what are its symptoms?

How to identify a lingual frenulum?

The lingual frenulum

The lingual frenulum is a thin membrane that connects the tongue to the floor of the oral cavity. When a frenulum is present, the term ankyloglossia may be used — a word derived from the Greek 'agkilos' (deformed or curved) and 'glossa' (tongue).

Embryological formation and the lingual frenulum

During intra-uterine life, the tongue is initially attached to the floor of the mouth. Around the 12th week of gestation, a natural process called apoptosis separates the tongue, partially or fully destroying the membrane connecting the tongue to the floor of the mouth. If this process is incomplete, a lingual frenulum may persist and limit tongue movements.

Anatomy and diagnosis of lingual frenulum in babies, French-speaking Switzerland
Restrictive tongue-tie in infants, French-speaking Switzerland

You cannot walk with your shoelaces tied together

"Imagine your shoes are tied together by their laces."

You could still walk, or even trot if the tie is not too tight, but it would be much more difficult than moving freely. The same applies to a restrictive tongue-tie: the tongue can move or even protrude slightly, but its freedom of movement is limited.

This constraint can have repercussions on the functions in which the tongue participates, such as swallowing (deglutition), chewing (mastication) or speaking (language), among others.

What is a restrictive lingual frenulum?

Restrictive tongue-tie

A restrictive lingual frenulum, as defined by the IATP ("International Affiliation of Tongue Tie Professionals"), is an embryological frenulum located at the midline under the tongue, restricting its normal mobility.

This frenulum can be more or less restrictive depending on its shape and size. It is possible to have a frenulum without symptoms (non-restrictive) or, conversely, a frenulum causing dysfunction (restrictive).

A tongue with a restrictive frenulum functions like shoes tied together by their laces: movement is possible but limited, making certain actions much more difficult.

Evaluation of restrictive lingual frenulum, consultation in French-speaking Switzerland

Symptoms of a restrictive lingual frenulum

In the baby

  • Difficulty latching onto the breast or teat
  • Prolonged feeds (>30 minutes) or ineffective sucking
  • Milk loss from the corners of the lips
  • Delayed weight gain
  • Clicking sounds during sucking
  • Heart-shaped tongue or white tongue (pseudo-leukoplakia)
  • Mouth often open or mouth-breathing
Symptoms of tongue-tie in a breastfed baby, French-speaking Switzerland
Symptoms of tongue-tie in the breastfeeding mother, French-speaking Switzerland

In the mother

  • Pain during breastfeeding
  • Nipple cracks or bleeding
  • Difficulty breastfeeding (poor latch by the baby)
  • Breast engorgement or mastitis
  • Feeling of feeding constantly

In the older child

  • Oral feeding and speech disorders
  • Recurrent ENT infections (ear infections, etc.)
  • Orthodontic difficulties
  • Musculoskeletal disorders
Tongue-tie in a child with oral feeding disorders, French-speaking Switzerland
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