Underneath the tongue there is a string of tissue that attaches the tongue to the mouth. If this tissue is short then there is difficulty for the tongue to move around and then this causes difficulty in breast feeding,and later on maybe speech. The baby has trouble latching on to the breast and slips off while feeding. The baby may not gain weight. The mother gets frustrated and gets painful nipples. The diagnoses is usually made at the routine intial examination of the newborn baby,by putting the finger in the mouth and feeling the cord like structure below the tongue. It occurs in 4 to 11 percent of babies. Some doctors do not believe that this needs any treatment,however if there are feeding diffuculties it is easier to snip it. A very fine scissors is used and the baby is supported so it does not move. No anesthesia is required. There is no bleeding. Sometimes there is a blood vessel in this and you have to be careful to watch this. I have generally found that there is immediate improvement after the tongue tie is snipped. Mostly a frustrated mother leaves my office with a big smile.