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Tongue Clipping: What is it and Does Your Child Need it?

Recently, I was meeting my friend’s new baby and she was telling me how the poor thing has already had to go through a variety of procedures. “Like what?” I asked. As she was running down the list, she finished up by saying, “Oh, and he’s had his tongue clipped.” “What?!?” I had never heard of such a thing, but yes, what sounds like an ancient tribal custom is actually a procedure that is more common than you think. Breezy Mama turned to Go-To Pediatrician, Dr. Jon Conti to give us the lowdown. Read on to learn more, and more importantly, if your child needs to have it done.

What exactly is tongue clipping?

Tongue clipping, or frenulotomy, is a simple office procedure in which an extra piece of tissue, the lingula frenulum, is clipped, releasing the tip of the tongue from the floor of the mouth.  As easily seen here, a piece of skin restricts this tongue tip from freely moving outside the mouth of this crying infant.

Does this hurt the baby? Is it comparable to circumcision: i.e. cut, the baby cries, then immediately forgets about it?

Unlike a circumcision, this is such a quick procedure; most infants cry only for a brief period and almost immediately resume normal behavior.

Why is it necessary?

It’s necessary to help an infant feed properly.  If an infant cannot bring her/his tongue to the top of the palate, suckling breast milk or formula from a bottle can be a problem.

How can a parent know if they need to cut the baby’s tongue?

Many infants have tongue ties; however, the procedure should be considered only in those infants that are having trouble establishing breast feeding, are not gaining weight, are gassy, or whose mothers are experiencing pain during breast feeding.  As a rule of thumb, if your child has a tongue tie, and the mother has received at least 2-3 days of support from a breast-feeding (lactation) specialist without improvement, consult your provider.

At what ages is tongue clipping done?

Typically in the newborn period, before 4 months of age.

Can a child be too old to have the procedure done?

No, but after 4 months of age it may better be performed in the ENT’s (Ear, Nose & Throat, or Otolaryngologist’s) office.

Are there options to avoid having it done?

Patience and working with a skilled lactation consultant can sometimes avoid it.

What can happen if a parent chooses NOT to clip the tongue?

Not clipping the tissue may result in increased gas, reflux, fussiness, tiring before feeding has finished and eventually poor growth.

I’ve heard that if a tongue isn’t clipped, it can affect speech.  Is it better to wait and see once the child is talking, or to go ahead and clip it when they are a baby?

If the tongue tie is not causing feeding difficulties, one can wait.  Some older children who have tongue ties can develop ‘lisps’ due to the difficulty of producing some sounds made at the top of the mouth.  In those cases, being evaluated by an ENT is a good idea.

If a parent decides to move ahead with tongue clipping, who does the actual clipping?  And where is it performed?

It depends upon the age of the child.  Under 4 months, many pediatricians can perform the procedure.  The Otolaryngologist can evaluate and treat older patients.

About Jon Robert Conti, MD FAAP: Dr. Conti earned both a BA in Psychology and a BS in Biological Sciences from the University of California, Irvine. He went to medical school in Michigan, and completed his pediatric residency from the Children’s Hospital of Los Angeles in 2001—consistently ranked by US News-‘Nation’s Best Hospitals’ since the 1990’s.  Dr. Conti is Board Certified in Pediatrics & Adolescent Medicine and presently cares for patients & their families at Sea View Pediatrics in Laguna Hills & San Clemente.  He can be reached for consultation at Sea View Pediatrics: (949) 951-KIDS (5437)

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  1. Katie Kohn says:

    My daughter had a frenulectomy (tongue clip) at 2 weeks and it was the best decision but a very hard one. My pediatrician didn’t think it was necessary but I was having so much pain nursing (2nd baby and 2nd time nursing) and she wasn’t sleeping very well. It was the Lactation Specialist who recommended it and sent me to an ENT. I was still so nervous and unsure at the appointment but after researching on the web (and seeing that it can cause speech problems) it seemed as though it was a very safe procedure with more benefits than negatives. It took a few seconds and she didn’t even cry! One dose of Tylenol (infants) and NO BLOOD! That afternoon my daughter started nursing like a champ and I was in no pain. Soon after that she was sleeping in 8 hour stretches and gaining lots of weight. I’m so glad I listened to my Lactation specialist!!!!

  2. My son had a Frenectomy at age 2 in a pediatric dentist office with an anesthesiologist present as he had to be put under for the procedure. We were never told that could have been the reason he had poor growth and a hard time nursing the entire time he was an infant. Many people told us it was a waste of time and wouldn’t do anything. My son was 2 yrs old and could not talk…AT ALL not even Hi or Mama. The next day after the procedure, my son had starting making sounds with his mouth and talking within the next 24 hrs….best $2,000 my husband and I spent. We finally got to hear what our little boy wanted to say and now I can ask him questions. I never thought I’d hear him say I love you and he says it now often :). Even if somebody tells you that your child doesn’t need a Frenectomy…I would go with your gut as well as get a second opinion. We had MANY Speech Pathologists and Drs. say we were just flushing money away and when in reality we got the greatest gift ever!

  3. I had never heard of this before until recently. A friend of mine just had this procedure performed on her infant as she wasn’t nursing. She’s almost a month old now and is doing fine.

  4. Nedra Saunders says:

    This is an excellent article. The only word of caution I have is regarding older children who have NO HISTORY of feeding difficulties, but may be experiencing speech articulation challenges. If tongue clipping has been recommended by someone as a treatment for the child’s speech difficulty I urge the parent to first have the child receive an evaluation by a speech and language pathologist. It is relatively uncommon for a short frenulum to be the cause of speech articulation problems.

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