The speech pathologist has to weigh in on the subject now that we're all talking about speech sounds and tongue tie (a.k.a. ankyloglossia)! I agree with Cathy Genna, first of all, you can have problems with speech and not breastfeeding or vice versa. The tongue is made up of MULTIPLE muscles and the function is different for different tasks. Second, the "sausages" statement by the dentist kills me. Studies in the speech world (on English speakers) show the "s" sound comes in anywhere from age 4 to as late as age 8 with the average being closer to age 5. The g in sausages (sounds like "j" in "jump") is also a later developing sound, coming in on average after 5 years as well. Not to mention the fact that the word is multi-syllabic. So please, no one panic if your four-year-old can't clearly articulate sausages. She is still well within the range of normal!

See this website for more info on normal speech sound development:
http://www.asha.org/public/speech/disorders/SpeechSoundDisorders.htm

In general the speech pathology world is not seeing speech problems in the majority of tongue tied kids. Someone already posted the link to this article, but it's a great look into the speech perspective on the subject & it has references for some interesting studies:
http://www.asha.org/Publications/leader/2005/051227/f051227a.htm

Now my personal experiences (and perhaps biases), I am married to a man with a very restrictive lingual frenulum with no history of speech problems. He does not make all of his speech sounds in the exact same way that I do, but there are acceptable variations of normal within the speech therapy world. His mother is the same. Small sample size, I know! I have been working with babies and feeding/swallowing for about 5 years now, but in my previous life as an early intervention and elementary school speech pathologist the only tongue tied children I saw who also had speech/articulation disorders were those who did not have normal cognition (i.e. those with learning disabilities and/or mental retardation). I wonder if children with normal cognition are generally able to compensate for their anatomical differences whereas others may not be able to???

I'm also the mother of a tongue tied three-month-old! I don't have all the answers. I did have sore, pinched nipples (no open wounds) for the first four weeks even with perfect positioning, but then it magically got better. Baby boy is gaining weight well and I'm not worried about his speech so we've chosen not to clip. Dad did have orthodontia so we may have to do that at some point BUT dad was only breastfed for three weeks before his mom went back to work. I'm hoping a longer duration of breastfeeding will help form our little guy's mouth better and give his tongue a better range of motion. We'll see!

I've enjoyed hearing everyone's thoughts on the issue!

-Laura Wasielewski MS, CCC-SLP, IBCLC

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