What is Posterior Tongue Tie and How to Know if Your Child Has it

A tongue tie (also known as ankyloglossia) is a type of congenital defect that hinders the tongue’s movement. This makes it difficult for the child to push their tongue beyond their lower teeth and may have trouble moving their tongue from left to right. Tongue tie is a term used to describe anomalies underneath the tongue that makes it stiff, tight, and short. A baby with tongue tie may have trouble latching onto their mother’s breast and may experience difficulty with breastfeeding.

If you’re interested in knowing more about tongue tie, then you came to the right place. Today we’ll be discussing everything you need to know about tongue tie and how to tell if your child has it.

What is posterior tongue tie

According to Dr Jill Orford, a posterior tongue tie is a form of ankyloglossia that’s located beneath a mucous membrane under the front of the tongue. Parents may struggle to identify if their child has a posterior tongue tie because it’s quite tricky to detect. Because the posterior tongue tie is located further underneath the tongue, it isn’t immediately apparent. An experienced paediatric surgeon will usually inspect the tongue and feel it to determine if the child has a posterior tongue tie.

Tongue tie affects roughly 11% of newborn babies and most of them don’t display immediate symptoms or complications. To correct the tongue tie, the child will have to undergo speech therapy and/or outpatient surgery. Sometimes the condition will loosen up and relax as the child grows, but of course it’s better to have it evaluated by a pediatrician.

Symptoms of posterior tongue tie

While it can be difficult to detect posterior tongue tie, it does exhibit similar symptoms to anterior tongue tie (which is easier to detect since the condition is located near the child’s gum line). Here are the most common symptoms of posterior tongue tie:

  • Breastmilk spilling when the child feeds
  • Colic (constant crying and fussiness)
  • Slow weight gain or lack thereof

Mothers may experience painful breastfeeding when their child has a posterior tongue tie. This can lead to:

  • Sore nipples
  • Bleeding/cracked nipples
  • Reduced supply of milk

The child may also exhibit speech problems and may struggle with making certain sounds. Posterior tongue tie can make it difficult for the child to eat certain foods like ice cream and may have trouble maintaining good oral hygiene.

Causes of posterior tongue tie

Usually, the lingual frenulum separates before the child is born, thus allowing the tongue to move freely. With tongue tie however, the lingual frenulum remains attached even after birth.

To this day, pediatricians aren’t sure of what exactly causes tongue tie, but there are risk factors that may contribute to the condition. For one, researchers believe that genetics play a role in a child developing posterior tongue tie and is more prevalent in boys than in girls.

Complications associated with posterior tongue tie

A child with posterior tongue tie may not be able to breastfeed properly due to the tongue’s restricted range of motion. A baby’s natural instinct of sucking onto a mother’s nipple can be hard to achieve when the tongue’s mobility is limited.

Spoon-feeding may also prove challenging for children with posterior tongue tie. As your child grows older, they’ll become more comfortable eating solid foods. Even if you use a baby spoon, foods that require slurping or licking can present obstacles and make it difficult for your child to eat.

Speech and dental issues

Posterior tongue tie can contribute to speech and dental problems as the child transitions into preschool. This can affect your child’s speech development and encounter problems pronouncing certain words. A posterior tongue tie positions the tongue closer to the bottom of the mouth which increases the likelihood of the child developing a gap in their lower teeth.

As your child matures, they’ll understand the importance of proper oral hygiene. However, with tongue tie they may struggle with cleaning their tongue due to the limited range of motion.

How posterior tongue tie is corrected

There are several treatment options for correcting posterior tongue tie. If your child is struggling with breastfeeding, a lactation consultant may be able to help you in this regard. They will suggest breastfeeding positions and techniques to ensure your child receives adequate nourishment and reduce your pain and discomfort. The pediatrician may also recommend supplementing your child with a formula to help with weight gain.

Another option for treating tongue tie is with the help of a speech pathologist. They will recommend certain tongue exercises to free up the tongue tie. These exercises help stretch the frenulum until the desired tongue mobility is achieved.

If you wish to have the condition fully corrected, you can choose to have your child undergo a surgical procedure called a frenotomy. A qualified pediatric surgeon will perform the procedure by using surgical tools to cut the lingual frenulum and free the tongue from restriction. For children under 6 months old, a frenotomy doesn’t require anaesthesia. But for children 1 year old and above, they will require anaesthesia.

When to see a pediatric surgeon

While a posterior tongue tie won’t cause significant harm to your child’s health, it can negatively impact their quality of life. If you notice any of the following signs, consult a pediatric surgeon, preferably one with experience for Perth tongue tie as soon as possible.

  • You have sore, cracked, and bleeding nipples as a result of breastfeeding.
  • Your child has colic (frequent episodes of crying).
  • Lack of noticeable weight gain in your child.
  • You suspect your child has posterior tongue tie.

When your child reaches the age of 4 or 5, their mouth structure changes to which symptoms of a tongue tie may disappear gradually. If you choose not to have your child undergo frenotomy, chances are the condition won’t have long-term effects throughout their childhood.

A tongue tie is a common birth defect that can present problems for both the mother and the child. The good news is that it’s very easy to correct and most children who undergo frenotomy are able to breastfeed properly and develop better speech as they grow older.

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