11/14/2025
Tongue Tie is not a fad! Let’s talk about actual anatomy. Find someone who is well trained in assessment and rehabilitation. Collaboration and teamwork is key to success! Thanks Bobby Ghaheri MD for all your efforts to educate 🙂
www.BLCbaby.com 💙
“Tongue tie” Actually Describes a Medical Condition
What I always find curious is how many parents tell me that “they didn’t know tongue tie was an actual thing” - the implication is that they thought it was a figure of speech and not an actual medical condition. My fear is that many doctors don’t know it’s a real thing either (hence the insinuation that tongue tie as a medical condition is some “fad” practiced by doctors just looking for a quick buck or something).
Let’s start with an analogy. There is a medical condition called a trigger finger, where a tendon leading to the finger is tethered and the finger is bent in. It’s not a perfect analogy, as trigger finger is acquired over time whereas tongue tie is congenital, but the concept is similar - there is an actual anatomical restriction to the movement of a muscle that needs to be treated if we want that structure to work again.
When it comes to tongue tie, it’s important for everyone (even doctors) to understand that the description is accurate - the tongue (well, part of it) is ACTUALLY tied. For real - it’s tied. That’s the real underlying pathophysiology here. It’s not just a band that is holding the tongue down that, if cut, magically allows the tongue to spring into action. A frenulum that is a tie (one that actually restricts) prevents the actual motion of the tongue by grabbing on to and holding a very specific muscle. That muscle is the genioglossus muscle. It’s the muscle depicted in the picture above.
There are actually 2 genioglossus muscle bellies, a left and a right. Imagine a handheld fan (the foldable kind) - the muscle starts by attaching on the inside of the jaw in the mid-portion, and then like a deployed fan, it is a primary determinant in two motions - protruding the tongue and elevating the tongue. If you’ve read my previous posts, you would know that it is this latter motion (elevation) that is the most important for infant suction generation. If the tongue isn’t allowed to move up, then it cannot form a seal with the breast/palate. If there’s no seal, then there’s no suction. This forces the baby to compensate and that is where the dominos start to fall.
Tongue tie isn’t a fad. Tongue tie isn’t “controversial”. If a doctor or lactation consultant says they “don’t believe” in tongue tie, then you should consider getting an opinion from someone who doesn’t inject beliefs about actual anatomy.
