Infants

According to statistics, ankyloglossia or tongue-tie is a congenital anomaly present at birth in close to 5% of newborns. Male newborns have a higher incidence than females, with the condition sometimes running in families. 

Depending on the degree and severity of the tongue tie, it can affect an infant's oral development and function to varying extents.  

Although tongue-tie can have a defining heart-shaped appearance at the tip and it's clear a baby or child has difficulty extending, lifting, or moving the tongue from side to side, the tongue can seem normal. However, when problems with feeding, as described below, exist, further assessment may reveal the baby has ankyloglossia.  

An infant with tongue-tie may exhibit the following signs & symptoms when breastfeeding: 

• Breastfeeding difficulties- The tongue cannot extend far enough or remain in position to facilitate effective sucking
• Difficulty latching on and chewing on the mother's nipple instead of sucking
• Inadequate, poor breastfeeding that results in inadequate nutrition and poor weight gain
• Frequent or prolonged feeds with interruptions
• Clicking noises when feeding
• Fussiness when feeding
• Sensitive gag reflex
• Digestive issues, including gas, colic, hiccups, reflux 

Breastfeeding an infant with tongue-tie can also prove challenging and uncomfortable for the mother. It can lead to irritated misshapen nipples, engorgement, blocked ducts, and even mastitis. 

Likewise, infants who bottle feed can have some or all of the following difficulties:  

• Slowed ability to take a bottle
• Frequently seems to let go and push the baby bottle nipple out
• Chewing/chomping on the baby bottle's nipple 
• Unfulfilled hunger and frequent feedings
• Gagging
• Dribbling

Lip-tie 

Feeding issues may also be associated with "lip-tie". Although not as common as tongue-tie, the conditions can sometimes occur hand-in-hand. Representing the membrane that connects the upper lip to the upper gums, the maxillary labial frenulum provides stability to the lips, keeping them in place as function and growth occur.