New to this topic? Start with our companion article: Tongue Tie in Children: Facts and Myths Every Parent Should Know
The procedure is done. Maybe it was a quick snip in the first weeks to help with breastfeeding, or maybe your three-year-old had a release in the hope it would help their speech. Either way, you're probably asking the two questions most families ask us: what should happen next, and will this fix things?
We'll be honest from the start. For many children the answer to "what next?" is simply "heal and carry on," and the answer to "will this fix my child's speech?" is usually no, not by itself.
What Recovery Generally Looks Like
The medical side of recovery belongs with the clinician who did the release. Pain relief, how the wound should look, when to feed, what to do about bleeding or a fever: those questions go back to your surgeon, dentist or GP, not to us or a Facebook group.
In broad terms, most children are back to their usual selves within a few days. Babies often feed a little differently straight afterwards and settle quickly. Older children may be fussy about textures for a day or two. If anything worries you, ring the treating clinic.
One thing worth knowing: you may have been given "stretches" or "active wound management" exercises to do several times a day. The Australian multidisciplinary consensus statement on tongue tie found no scientific evidence to support this practice and advised against stretching surgical wounds, because it can slow healing and increase scarring (Australian Dental Association, 2020). If you feel unsure about them, that's a fair conversation to have with whoever prescribed them.
Will Feeding Improve?
If the release was done for breastfeeding, the honest answer is "often somewhat, not always." A Cochrane review found frenotomy reduced mothers' nipple pain in the short term but showed no consistent change in how well babies actually fed, and rated the evidence as low quality (O'Shea et al., 2017). The Australian consensus statement adds that a release carries no guaranteed improvement in the problem it was done for, and that every baby released for feeding reasons should keep seeing a lactation consultant or child health nurse afterwards (Australian Dental Association, 2020).
So keep the feeding support going. The release may have removed a restriction, but the latch and sucking rhythm your baby has practised for weeks don't change overnight.
For toddlers and preschoolers who had a release for mealtime difficulties, see your GP first if these persist:
- Coughing, gagging or choking on food or drink
- Food pocketing in the cheeks, or long chewing with little swallowing
- Mealtimes that still regularly stretch beyond 30 to 40 minutes
- Weight that isn't tracking the way your GP expects
If the problem is more about anxiety or a narrow range of accepted foods, our article on the SOS Approach to Feeding explains how we work with that at home.
The Myth That a Release Fixes Speech
This is the belief that disappoints the most families.
Speech sounds are learned motor patterns. A child who says "wabbit" for rabbit or "tat" for cat has stored a particular way of making those words, and the frenulum has very little to do with it. A Perth study comparing young children with treated ties, untreated ties and no tie found no meaningful difference in their speech sounds (Salt et al., 2020). An expert panel of paediatric ENT surgeons concluded that tongue tie does not typically affect speech (Messner et al., 2020), and a systematic review found only a few small, low-quality studies suggesting articulation improved after release (Chinnadurai et al., 2015).
In plain terms: if your child's speech was unclear before the release, it may well still be unclear afterwards, and that isn't a sign the surgery failed. The errors still need their own assessment, because the pattern behind them tells us what help will work. Some patterns are simply slow to mature and respond to a short, targeted block of therapy. Others are atypical patterns that deserve earlier attention regardless of what's happening under the tongue.
Is Speech Therapy Needed After a Release?
Often, no. If your child's speech was developing well before the procedure, a release doesn't create a need for therapy. Babies and toddlers released for feeding reasons don't need "speech exercises" to use their new range of movement; they explore it on their own as they babble, lick, chew and talk.
Where therapy genuinely helps is when a specific sound was being blocked by a severely restricted tongue, most often "l", and the child has been compensating for years. The tongue can now reach, but the brain still grabs the old way. A speech pathologist helps the child feel and practise the new placement, then build it into words and everyday chat: structured work over a few weeks, tied to sounds we've actually measured as different, never a vague programme of "strengthening the tongue."
Realistic expectations, then:
- If speech was fine before, expect it to stay fine; no therapy needed
- If speech was unclear before, it may stay that way until the underlying pattern is addressed
- If one or two sounds were physically blocked, expect them to need deliberate practice rather than to appear by themselves
- Give healing time before judging anything, and follow your treating clinician's advice on timing; sore mouths don't talk their best
A Note on Hearing
Whenever a child's speech is unclear, hearing needs to be checked, and a tongue tie release doesn't change that. Even mild or fluctuating hearing loss from middle-ear fluid can muddy the speech sounds a child hears and therefore the ones they learn to produce. If your child hasn't had a hearing assessment recently, ask your GP for a referral to an audiologist. It rules out one of the most common contributors to unclear speech before anyone blames the tongue.
When to Seek a Speech Pathology Assessment
For speech and language, book an assessment rather than waiting if, a month or two after the release:
- Your child's speech is still hard for people outside the family to understand
- A sound they were told would "come" hasn't, despite everyday practice
- Your toddler is still saying far fewer words than you'd expect for their age
Feeding is different, and it doesn't sit on a wait-and-see timeline. If your child is coughing, choking or gagging at meals, or mealtimes are still slow and stressful, go back to your GP or the treating clinic promptly, as we said above, and a feeding assessment can be part of what follows.
Our assessment comes to you, at home or at your child's early learning centre, with video sessions by Zoom where that suits. We take a thorough history including the release, watch how the tongue, lips and jaw move now, collect data on your child's speech sounds in words and conversation, and watch a snack if feeding is on the list. You'll come away with a plain-language picture of what is and isn't connected to the tie, and a plan that fits your family.
If that would help, get in touch. Speaking Speech Pathology offers mobile speech pathology across Brisbane's south side and Logan, and we're always happy to be the calm second opinion.
Alexandra Bouwmeester is a Senior Speech Pathologist (MSPA, CPSP), certified in Hanen's It Takes Two to Talk and trained in the SOS Approach to Feeding, with over 14 years' experience and a mum of two boys. She offers mobile speech pathology to families across Brisbane's south side and Logan.
This article is general information and not a substitute for individualised speech pathology assessment or therapy. If you have concerns about your child, please speak with a qualified speech pathologist.
References
- Australian Dental Association. (2020). Ankyloglossia and Oral Frena Consensus Statement (1st ed.). Australian Dental Association.
- Chinnadurai, S., Francis, D. O., Epstein, R. A., Morad, A., Kohanim, S., & McPheeters, M. (2015). Treatment of ankyloglossia for reasons other than breastfeeding: A systematic review. Pediatrics, 135(6), e1467–e1474.
- Messner, A. H., Walsh, J., Rosenfeld, R. M., Schwartz, S. R., Ishman, S. L., Baldassari, C., ... & Satterfield, L. (2020). Clinical consensus statement: Ankyloglossia in children. Otolaryngology–Head and Neck Surgery, 162(5), 597–611.
- O'Shea, J. E., Foster, J. P., O'Donnell, C. P. F., Breathnach, D., Jacobs, S. E., Todd, D. A., & Davis, P. G. (2017). Frenotomy for tongue-tie in newborn infants. Cochrane Database of Systematic Reviews, 3, CD011065.
- Salt, H., Claessen, M., Johnston, T., & Smart, S. (2020). Speech production in young children with tongue-tie. International Journal of Pediatric Otorhinolaryngology, 134, 110035.
