Sometimes a baby can have a real hard time feeding from a bottle or breast because of a remnant of skin found under the tongue, called a frenulum. It is present in all of us, attached underneath the tongue at the back, but in some babies it extends to closer to the tip.
These babies are quite literally tongue-tied. A minor procedure done by a pediatrician within a few days of birth cuts the frenulum to correct the tongue. There is also an upper frenulum attaching the upper gum to the part just above the upper front teeth.
This does not cause a problem with feeding but as the upper front teeth develop, a gap forms between the teeth, forming the ‘Madonna’ or ‘David Letterman’ gap. This truly is a cosmetic issue but again can be dealt with at an early age to avoid this look.
I have a general approach in considering snipping the lower frenulum of a tongue-tied newborn.
If the baby is feeding well and able to extend the tongue beyond the lower lip when crying I tend to leave the tongue alone, and naturally if the baby is having issues latching on and is unable to protrude the tongue , I recommend treatment.
The frenulum is cut with a tiny sharp scissors in my office. It is a very brief procedure and there is a small amount of bleeding from the cut which heals within a few hours of the procedure
