Infant Frenectomies Explained (Part 1)

🍼 Why Are So Many Babies Getting Tongue-Tie Releases?

Lately, there’s been a noticeable surge in frenectomies (tongue-tie releases) in newborns—and many parents are asking:
Why is this happening? Are these procedures truly necessary, or are they being overdone?

Let’s start with the basics.

👅 What is a tongue-tie?

According to the International Affiliation of Tongue-Tie Professionals:
Tongue-tie (or ankyloglossia) is a medical condition involving the tissue under the tongue—the lingual frenulum—which restricts the tongue’s range of motion and function.
The frenum is the band of tissue that connects the bottom of the tongue to the floor of the mouth.

🤰 Are babies born with their tongues "tied"?

Yes—sort of.
During fetal development, the tongue is initially tied to the floor of the mouth. It’s gradually released by a natural process called apoptosis, allowing the tongue to move freely.

When apoptosis doesn’t fully complete, the tongue remains tethered—resulting in a tongue-tie.

➡️ Babies practice sucking and swallowing in utero by drinking amniotic fluid. By the time they’re born, a fully functional tongue is crucial for feeding—especially for establishing the suck-swallow-breathe rhythm needed for breastfeeding.

🚼 When apoptosis doesn’t complete…

A restricted tongue can limit a baby’s ability to latch, feed efficiently, or coordinate their movements.

This can cause frustration, exhaustion, and even pain—not only for the baby but for the mother as well.
➡️ In fact, one of the most overlooked signs of a tongue-tie is maternal nipple pain—including cracked, bleeding, or misshapen nipples.

👩‍🍼 Signs & symptoms of a tongue-tie in infants:

Because breastfeeding is a dyad process—an intimate interaction between mother and baby—both may show signs something’s off.
Here’s what to look for:

• Difficulty latching or staying latched

• Painful breastfeeding (nipple damage, bleeding, or visible shape change)

• Frequent, prolonged feedings that don't satisfy baby

• Gassy, colicky behavior

• Baby falling asleep during feeds

• Clicking sounds while nursing

• Incomplete milk transfer (baby not emptying the breast)

• Weight gain issues or poor milk supply

🇧🇷 Did you know?

In 2012, Brazil passed a law requiring that no newborn be discharged from a hospital without a proper tongue-tie assessment.
In 2014, the Brazilian government mandated the Protocol for the Evaluation of the Lingual Frenulum in Babies in every hospital and maternity ward—making Brazil the first country to implement this screening nationwide.

🩺 Who can diagnose and treat tongue-ties?

Tongue-ties can be diagnosed and treated by multiple professionals, including:

• Pediatricians

• ENTs (Ear, Nose & Throat specialists)

• Dentists

• Chiropractors (diagnosis only)

But remember...

❗️ Surgery should never be the only step.

I strongly believe that surgery should be the last resort, not the first.
A baby and mother deserve comprehensive support before, during, and after any procedure.

That’s why a functional care team is critical. Ideally, this team includes:

• IBCLCs (International Board-Certified Lactation Consultants)

• Speech-language pathologists

• Occupational therapists

• Craniosacral therapists

• Chiropractors trained in infant care

➡️ This multidisciplinary approach ensures the dyad’s physical, emotional, and feeding needs are addressed wholistically—not just surgically.

📩 Coming next:

In our next newsletter, I’ll explore what a truly collaborative care team looks like—and why it’s essential for the well-being of both mom and baby.

📚 Sources:

• Narsat MA, Beygirci A, Özdönmez GT, Yıldız E. Grouping of Ankyloglossia According to Coryllos Anatomical Classification and Follow-Up Results for Breastfeeding.

• Lau C. Breastfeeding Challenges and the Preterm Mother-Infant Dyad: A Conceptual Model.

• Martinelli RLC. Relação entre as características anatômicas do frênulo lingual e as funções de sucção e deglutição em bebês. Universidade de São Paulo, 2013.

🌱 True wellness starts in your mouth.

Dr. Norma Cortez
Your Biological & Airway Dentist