By Dr. Medhat Abu-Shaaban — Specialist Pediatrician, myPediaclinic Dubai
If feeding has felt harder than it should, or you have noticed your baby clicking, slipping off the breast, or struggling to gain weight, you may have heard the words “tongue-tie” from a midwife, lactation consultant, or fellow parent. It is one of the most talked-about — and most misunderstood — topics in early infant care. The good news is that when a tongue-tie genuinely interferes with feeding, the solution is usually a small, quick procedure called a frenectomy (sometimes called a frenotomy or tongue-tie release). This guide explains what tongue-tie actually is, how it can affect feeding and speech, exactly what the procedure involves, and what recovery looks like — written for parents in Dubai who want clear, calm, medically accurate answers.
What Is Tongue-Tie?
Tongue-tie, known medically as ankyloglossia, is a condition present from birth in which the thin strip of tissue under the tongue — the lingual frenulum — is shorter, tighter, or attached further forward than usual. This band of tissue normally allows the tongue to move freely: to lift, extend past the lips, and sweep from side to side. When the frenulum is restrictive, it can tether the tongue and limit that movement.
Tongue-tie is common, affecting an estimated 4 to 11 percent of newborns, and it is more frequently seen in boys. Importantly, not every tongue-tie causes a problem. Many babies with a visible frenulum feed, grow, and later speak perfectly well. The decision to treat is never based on appearance alone — it is based on whether the restriction is actually causing difficulty. This is a point I return to often with parents, because the goal is to treat babies, not photographs.
How the Tongue Works During Feeding
To understand why a tongue-tie can matter, it helps to know what the tongue does during breastfeeding or bottle-feeding. A baby does not simply suck. The tongue cups the breast or teat, lifts to draw it deep into the mouth, and moves in a wave-like motion that, combined with a good seal of the lips, creates the gentle vacuum needed to transfer milk. This requires the tongue to extend, elevate, and stay flexible.
When the frenulum restricts these movements, the baby may compensate by gumming or chomping, breaking suction repeatedly, or failing to maintain a deep latch. The result can be an inefficient feed for the baby and discomfort for the mother. Recognising this mechanical picture is what separates a meaningful tongue-tie from a harmless anatomical variation.
Signs and Effects on Feeding
The clearest reason to consider a frenectomy is feeding difficulty that does not improve with feeding support alone. In babies, signs that a tongue-tie may be contributing include:
- A shallow latch that keeps slipping, with clicking or smacking sounds during feeds
- Long, frequent, or exhausting feeds, with the baby seeming hungry soon after
- Poor or slow weight gain despite frequent feeding
- Dribbling milk at the corners of the mouth, or struggling to hold a teat
- Frequent fussiness, gassiness, or swallowing of air
For breastfeeding mothers, a tethered tongue can cause cracked, pinched, or sore nipples, a misshapen “lipstick-shaped” nipple after feeds, recurrent blocked ducts or mastitis, and a low milk supply driven by poor milk removal. These maternal symptoms are often the loudest signal that something mechanical is going on, and addressing the tie can be as much about the mother’s comfort and supply as the baby’s intake.
Tongue-Tie and Speech
Parents frequently ask whether a tongue-tie will cause a speech problem later on. This deserves an honest, balanced answer. The majority of children with tongue-tie develop speech normally, because speech depends on far more than the frenulum. However, a significant restriction can, in some children, make certain sounds harder to articulate — particularly those that require the tongue tip to lift or touch behind the upper teeth, such as “t”, “d”, “l”, “n”, “s”, and “r”. A tie does not affect language development, vocabulary, or comprehension; it is purely a question of mechanical articulation of specific sounds.
For older toddlers and children, the decision about a frenectomy for speech is made together with a speech and language therapist, who can assess whether the tongue’s mobility is genuinely limiting sound production and whether a release is likely to help. We never release a tie “just in case” for future speech — the evidence does not support that, and most speech concerns have other causes worth exploring first.
The Frenectomy Procedure: Quick and Straightforward
A frenectomy is the procedure that releases the restrictive frenulum so the tongue can move freely. In young infants, it is remarkably quick and minor. The tight band of tissue is divided, which immediately increases the tongue’s range of movement. In babies, the area under the tongue has relatively few nerve endings and a limited blood supply, which is why the procedure is so well tolerated at this age.
Different techniques exist, and the right one depends on the child’s age and the type of tie:
| Aspect | Infant frenotomy (scissors) | Laser frenectomy |
|---|---|---|
| Best suited to | Young babies, anterior (front) ties | Older infants/children, thicker or posterior ties |
| Anaesthesia | Usually none or topical only | Topical or local; general in select cases |
| Duration | Seconds to a minute | A few minutes |
| Bleeding | Minimal, often a drop or two | Very little (laser seals as it works) |
| Stitches | Not usually needed | Not usually needed |
| Feed afterwards | Immediately, on the spot | Shortly after |
The technique is always chosen for the individual child. What matters most is a careful assessment beforehand and an experienced clinician performing the release, not the tool itself.
Before the Procedure: Assessment and Preparation
A good frenectomy begins long before any tissue is touched. At myPediaclinic, the first step is a full feeding and oral assessment. We watch the baby feed where possible, listen to your history, examine how the tongue lifts and extends, and assess the frenulum’s thickness and attachment point. We also weigh the baby and review growth. This assessment is what tells us whether a release is genuinely indicated or whether a feeding-support approach should come first.
Preparation for parents is simple. For a young infant, no fasting is usually required for a straightforward scissors frenotomy — in fact, a recent feed and a calm, swaddled baby help. We explain consent, what you will see and hear, and how to position your baby for an immediate feed afterwards. If a laser or local anaesthetic approach is planned for an older child, we will give you specific instructions in advance.
During the Procedure: What to Expect
For most young babies, the experience is over before parents expect it to be. Your baby is gently swaddled and held securely. The tongue is lifted to expose the frenulum, the restrictive band is divided, and any minor bleeding is settled with light pressure or by latching the baby straight onto the breast or bottle. Many babies cry more from being held still than from the procedure itself, and most settle within moments of feeding.
For older children having a laser frenectomy, topical or local anaesthetic numbs the area first, and the child is supported throughout. The whole appointment is calm, unhurried, and explained step by step. You are not rushed, and your questions are welcome at every stage.
After the Procedure: Recovery and Aftercare
Recovery from an infant frenectomy is typically fast. The single most reassuring thing you can do is feed your baby straight away — feeding soothes them and helps you immediately notice any change in latch. A small white or yellowish patch (a diamond-shaped area) often appears under the tongue where the release was made; this is a normal part of healing, not an infection, and it usually fades within one to two weeks.
Aftercare may include gentle mouth or stretching exercises if your clinician recommends them, particularly after a laser release, to help the area heal openly and reduce the small chance of reattachment. We will show you exactly how and when to do these. Some babies feed better instantly; for others the improvement is gradual over days as they learn a new, freer tongue pattern, sometimes with the support of a lactation consultant. Mild fussiness for a day is common. Significant bleeding, fever, refusal to feed, or signs of infection are not expected and should prompt you to contact us.
How Breastfeeding Can Improve
When a tongue-tie has genuinely been limiting feeding, releasing it can make a real difference. With greater tongue mobility, a baby can often achieve a deeper latch, maintain suction more effectively, and transfer milk more efficiently. For mothers, this frequently means less nipple pain, fewer blocked ducts, and — because milk is being removed more completely — better-supported supply.
It is important to set fair expectations. A frenectomy is not a magic switch, and it is not a substitute for skilled feeding support. The babies who benefit most are those carefully selected because a tie was the mechanical barrier. Pairing the release with hands-on lactation guidance gives the best results, which is why we coordinate the two. If you would like to understand related restrictions, our guide to lip-tie in babies in Dubai explains how an upper-lip tie can also affect latch and is sometimes assessed at the same visit.
When a Frenectomy Is Truly Needed (and When It Isn’t)
This is the heart of the matter. A frenectomy is appropriate when there is both a restrictive frenulum and a real, demonstrable problem it is causing — most often feeding difficulty that has not resolved with good positioning and lactation support, or, in older children, a clearly assessed speech articulation issue linked to limited tongue mobility.
| Often a reason to consider release | Usually not a reason on its own |
|---|---|
| Persistent painful breastfeeding despite latch support | A visible frenulum with no feeding or speech problem |
| Poor weight gain linked to inefficient feeding | Normal newborn fussiness or cluster feeding |
| Baby unable to maintain latch or suction | Reflux or colic without a feeding mechanics issue |
| Restricted tongue movement plus assessed speech difficulty | “Just in case” for hypothetical future speech |
Where feeding is going well and the baby is thriving, the right answer is often reassurance and watchful waiting — not surgery. A trustworthy clinic should be just as willing to tell you a release is not needed as to perform one.
Common Myths About Tongue-Tie
Misinformation around tongue-tie is widespread, so let us address a few myths directly.
- “Every tongue-tie must be cut.” Untrue. Treatment depends on whether the tie causes a real problem, not on its mere presence.
- “A frenectomy guarantees pain-free breastfeeding.” It helps when a tie was the cause, but feeding support remains essential and results vary.
- “If we do not release it now, speech will be ruined.” Most children with tongue-tie speak normally; speech decisions are made later, with a therapist.
- “It is a major operation.” In young babies, an infant frenotomy is a quick, minor procedure, often without anaesthesia.
- “Tongue-tie causes reflux and colic.” These usually have other causes; a tie is only relevant if it is impairing the mechanics of feeding.
Tongue-Tie Care in Dubai: What Local Families Should Know
Families in Dubai benefit from quick access to specialist paediatric and feeding care, which means a tongue-tie concern can usually be assessed within days rather than weeks — valuable in the early newborn period when feeding patterns are still being established. Many parents here are navigating their first weeks of feeding far from extended family, so timely, joined-up support matters.
Costs for an infant frenectomy vary by clinic and by whether feeding support is included, and they may or may not be covered by your insurance policy depending on your plan and whether the procedure is deemed medically necessary; we recommend checking your specific cover with your provider in advance. At myPediaclinic in Dubai Healthcare City, assessment, the procedure where indicated, and lactation support are coordinated under one roof, so you are not sent between multiple clinics during an already demanding time. While you are planning your baby’s early care, it is also worth reviewing the children’s vaccination schedule in the UAE so visits can be combined where convenient.
Why Choose myPediaclinic for Your Baby’s Frenectomy
Tongue-tie sits at the meeting point of paediatrics, feeding expertise, and careful clinical judgement. At myPediaclinic, our specialist team — including myself, Dr. Medhat Abu-Shaaban, alongside our paediatric dentistry colleagues Dr. Mustafa Abdalla and Dr. Shaima Buhamer — assesses each baby individually and only recommends a release when it is genuinely in your child’s interest. We combine the procedure with hands-on feeding support, clear aftercare guidance, and honest expectations. Our promise is simple: a calm assessment, an experienced pair of hands, and the willingness to tell you when nothing needs to be done at all.
Frequently Asked Questions
What is a frenectomy?
A frenectomy (also called a frenotomy or tongue-tie release) is a quick procedure that divides the tight band of tissue under the tongue, allowing the tongue to move more freely. In young babies it is minor, fast, and usually needs little or no anaesthesia.
Is a frenectomy painful for my baby?
In young infants the area under the tongue has few nerve endings, so discomfort is minimal. Many babies cry more from being held still than from the release itself and settle quickly once they feed. Older children having a laser release are numbed first.
How long does the procedure take?
An infant scissors frenotomy often takes only seconds to a minute. A laser frenectomy in an older child takes a few minutes. The appointment itself is longer because it includes assessment, explanation, and feeding support.
Will my baby bleed a lot?
No. Bleeding is usually minimal — often just a drop or two — and settles with light pressure or by latching your baby to feed straight afterwards. Laser techniques tend to involve even less bleeding.
Can I feed my baby immediately after?
Yes, and we encourage it. Feeding right away soothes your baby, helps any minor bleeding settle, and lets you notice changes in the latch immediately. It is one of the most reassuring parts of the visit.
Does every tongue-tie need to be released?
No. Many babies with a visible frenulum feed and speak perfectly well. A release is recommended only when the tie is genuinely causing a problem, such as feeding difficulty that has not improved with support. We are happy to reassure you when treatment is not needed.
Will a frenectomy fix all my breastfeeding problems?
It can make a real difference when a tongue-tie was the mechanical barrier, but it is not a magic fix. The best results come from pairing the release with skilled lactation support, which we coordinate for you.
Does tongue-tie cause speech problems?
Most children with tongue-tie speak normally. A significant restriction can occasionally make certain sounds harder, but a release for speech is only considered after assessment by a speech and language therapist, not pre-emptively.
What is the white patch under my baby’s tongue afterwards?
A small white or yellowish diamond-shaped area at the release site is a normal part of healing, not an infection. It usually fades within one to two weeks.
Are aftercare exercises necessary?
Sometimes. Gentle stretching or mouth exercises may be recommended, particularly after a laser release, to help the area heal openly and reduce the small chance of reattachment. We will show you exactly what to do, if anything is needed.
Is a frenectomy covered by insurance in Dubai?
It depends on your policy and whether the procedure is considered medically necessary. Coverage varies between plans, so we recommend checking the details with your insurance provider before your visit.
When should I contact the clinic after the procedure?
Mild fussiness for a day is normal. Contact us if you notice significant bleeding, fever, refusal to feed, or any signs of infection — these are not expected and should be checked promptly.
If you are worried about your baby’s feeding or have been told they may have a tongue-tie, the calmest next step is a proper assessment. Book a tongue-tie and feeding assessment at myPediaclinic Dubai and let our specialist team give you clear, honest guidance — including reassurance when no procedure is needed at all.
