Seeing any sort of swelling in your little one can be scary for a parent. But a swollen tongue is fairly common and usually clears up on its own. Here’s what to look for and when you may need to call the doctor.
What Causes a Swollen Tongue in Babies?
There are a few potential culprits behind tongue swelling in infants and toddlers:
Teething
When babies are teething, extra fluid builds up in their gums. This can cause swelling and discomfort throughout the mouth—including on the tongue. As new chompers break through, the swelling should go away within a day or two.
Injury
Babies explore the world mouth-first. So it’s not uncommon for them to bite their tongues while teething or accidentally scrape the underside on a sharp edge. This can lead to minor swelling from trauma.
Allergic Reaction
If your child is exposed to a new food or medication they’re allergic to, swelling of the tongue can sometimes occur along with hives, respiratory distress, or other symptoms. This is considered a medical emergency.
Infection
Viral or bacterial infections like hand, foot and mouth disease, oral thrush, or strep throat often target the mouth. A swollen tongue may indicate the infection has spread internally.
Blockage
Extreme swelling on one side of the tongue can signal a blocked salivary gland duct. Saliva backs up, causing a large, painless lump called a mucocele.
Signs of a Swollen Tongue
How can you get a look inside your squirmy baby’s mouth to inspect their tongue? Take advantage of natural opportunities:
- When they yawn or cry with their mouth wide open
- While breast or bottle feeding
- During teething when they readily accept a cool spoon or toy for gum relief
- When they stick out their tongue to explore new textures and flavors
Keep an eye out for these hallmarks of tongue swelling:
Change in Size
Carefully observe the size and symmetry of your baby’s tongue at rest. One half should not be significantly larger than the other. The edges should not bulge beyond the gums or teeth. The surface should not appear stretched or inflated.
Subtle changes in shape or contour—like visible indentations from teeth—can indicate irritation. More pronounced swelling extending toward the back of the mouth is a red flag.
Change in Color
Your baby’s tongue should be its normal pink color, perhaps with some white coating. Redness, paleness, or purplish hues can denote inflammation.
Be sure to check both the top surface and underside of the tongue by gently lifting with a clean finger. A color change on just one side can mean a localized problem.
Difficulty Breastfeeding
If your baby struggles to properly latch, slips off the nipple frequently, or seems frustrated and fussy while nursing, tongue swelling may be interfering.
Problem feeding after a period of smooth sailing can also signal abnormal enlargement. Check for other symptoms too.
Trouble Swallowing
Listen closely during feeding times and watch your baby’s face. Do they seem to gag, cough, or choke while drinking breast milk or formula? Does milk dribble out of their mouth? These may be signs of pain or difficulty manipulating a swollen tongue to swallow safely.
Excessive Drooling
It’s normal for young babies to get some extra saliva flow during typical mouth development. But copious drooling could indicate tongue inflammation makes it hard to swallow spit.
Note whether drooling increases on one side in particular, which may pinpoint the location of swelling.
Irritability
If tongue enlargement is causing discomfort, babies may get fussy and refuse food that requires vigorous sucking. Crying for no clear reason or increased restlessness could also signal a developing problem.
Muffled Crying
Listen to your baby’s normal lusty newborn wail and familiar hungry cries. If their vocalizations suddenly become muffled or weak, swollen tissues may be partially blocking air flow over the tongue.
Bad Breath
An unpleasant smell on your baby’s breath—especially if sudden or localized to one side—might indicate infection and inflammation.
Check for other symptoms and monitor smell changes. Simple bad breath alone rarely signals serious tongue swelling.
When to See the Pediatrician
In most cases, minor tongue irritation resolves on its own within a day or two. Try the home treatments covered below to ease swelling and pain in the meantime.
Definitely make an appointment if your baby shows multiple symptoms of significant swelling. Seek urgent medical care if they have:
- Breathing difficulty
- An obstructed airway
- Trouble swallowing
- Loss of appetite
- Severe drooling
- Skin reactions like hives
Also call right away if the tongue is very enlarged on one side or the surface is purplish or bright red. These can indicate an infection needing antibiotics or an allergic reaction requiring epinephrine.
Finally, monitor swelling that doesn’t improve within 48 hours, as extended inflammation may signify an underlying condition needs diagnosis.
5 Home Treatments for a Swollen Tongue
While waiting to see if time resolves slight to moderate tongue swelling, try these at-home remedies to keep your baby comfortable:
1. Cool the tongue
Gently rub an ice cube wrapped in cloth over the surface of the tongue and underside for several minutes. The cold can help reduce inflammation.
You can also allow them to suck on chilled (not frozen) teething toys. Avoid extreme cold that could damage sensitive tissues.
2. Massage the gums
Use clean fingers or a cold damp washcloth to gently rub your baby’s gums. This soothes teething pain that can translate to tongue swelling.
Rubbing also stimulates saliva production, keeping tissues moist and flexible.
3. Try cold foods
Let older babies snack on chilled purees or frozen breast milk in a mesh feeder. The cold numbs pain and inhibits swelling.
Great options include plain yogurt, applesauce, blended fruit, and coconut water ice pops.
4. Keep hydrated
Offer extra breast or bottle feeds to ensure your little one stays well hydrated. More fluids reduce inflammation and prevent dehydration from reluctance to nurse.
Older babies can try a cup, straw, or syringe if nursing is too difficult.
5. Use over-the-counter pain relievers
Children’s acetaminophen or ibuprofen can alleviate tongue discomfort if swelling is severe. Follow dosage on the bottle based on your baby’s age.
Never give aspirin to infants or young children due to risk of Reye’s syndrome.
When Can Baby Go Back to Solid Foods?
If your child’s tongue enlarged due to an allergic reaction, talk to your pediatrician before reintroducing the suspect food.
For swelling from minor injury or infection, keep feeding soft and pureed for a day or two until inflammation resolves. Then slowly reintroduce favorite treats and textures.
Monitor for reactions and stop any foods that seem to aggravate swelling. With irritation from teething, normal weaning can usually continue.
Preventing Future Tongue Swelling
While some cases of tongue swelling arise spontaneously, you can take steps to avoid trauma and allergic flare-ups:
- Choose soft silicone teethers and monitor baby closely while chewing
- Keep small objects out of reach that could be mouthed
- Introduce new foods gradually after 6 months, watching for reactions
- Ensure proper latch while nursing
- Wipe gums and tongue gently with water and soft cloth to clean
- Keep pacifiers clean and replace frequently
- Sterilize bottles, nipples, and teethers
- Avoid unnecessary medications
With close observation and prompt treatment, most infants bounce back quickly from minor tongue swelling. Pay attention to feeding changes, irritation, and vocalization for clues. And partner closely with your pediatrician if swelling lasts over 48 hours or involves multiple symptoms. Soon your baby will be happily gumming and babbling away again!
When to Worry About Baby’s Swollen Tongue
Seeing swelling in your baby’s mouth can be alarming for parents. A swollen tongue is often painful and interferes with feeding. But in most cases, the condition is not serious if treated properly. Learn when to seek urgent care.
Monitor for Breathing Issues
The tongue is vital for manipulating food, forming sounds, and directing air flow. Significant swelling can obstruct the airway, causing raspy, noisy breathing and a muffled cry.
- If your baby shows signs of respiratory distress, call 911 or go to emergency care immediately. Difficulty breathing requires prompt medical intervention.
Watch for Trouble Swallowing
Babies use their tongues to move milk or formula to the back of the throat during feeding. Enlargement makes this challenging and uncomfortable.
- Difficult, irritable feedings and gagging or choking during swallows warrant a same-day pediatric visit. Trouble eating needs quick resolution.
Check for Skin Reactions
Hives, rash, or puffy lips and eyes may indicate a severe allergic reaction. Anaphylaxis requires epinephrine.
- Rush to the ER if swelling occurs alongside other allergy symptoms like wheezing, vomiting, or flushing. This is an emergency.
Note the Size and Location
Swelling on just one side or at the back of the mouth is often from blockage vs. injury or teething.
- Have pronounced one-sided enlargement evaluated promptly—it may necessitate antibiotics for infection or surgical release of blocked ducts.
Consider the Color
Normal tongue color is pink, sometimes with white coating. Redness, purple hues or paleness can mean inflammation, poor blood flow or trauma.
- Seek same-day care if the tongue surface or underside shows abnormal color, which could signal infection or vascular compromise.
Watch for Duration
Many cases of mild irritation subside within 24-48 hours. Swelling lasting over a week likely requires intervention.
- Make an appointment if tongue enlargement persists over several days without improvement. Prolonged problems need diagnosis.
Partner with Your Pediatrician
When in doubt, check with your child’s doctor, especially if multiple symptoms concern you. Describe the changes you’re seeing.
- Ongoing collaboration ensures problems get treated promptly. Don’t hesitate to be seen for peace of mind.
While scary, most tongue swelling in babies is minor and temporary. Stay alert for signs of respiratory impairment, trouble feeding, poor blood flow or blockage that may indicate a serious issue requiring urgent care. Trust your instincts!
What’s Causing Your Baby’s Swollen Tongue?
Seeing a swollen tongue when you check your baby’s mouth can be alarming. But the cause is often benign. Here are the most common sources of inflammation and enlargement.
Teething
Extra fluid in the gums from erupting teeth leads to swelling of nearby tissues like the tongue. It may look slightly bumpy or ridged. Teething irritation usually clears within a day or two as teeth break through. Massaging swollen gums can provide relief.
Injury
Babies explore using their mouths and can accidentally bite, scrape or burn their tongues on toys, utensils or hot foods. This causes temporary inflammation and pain. The tongue may appear red or develop a sore. Minor injuries typically heal within a week.
Allergic Reaction
If your baby is exposed to a food or medication they’re allergic to, the tongue can rapidly swell due to histamine release. It may occur along with hives, breathing issues or flushing. This requires prompt epinephrine and antihistamines. Prevent additional exposures to the allergen.
Infection
Viral or bacterial illnesses like oral thrush, hand foot and mouth disease or strep can initiate tongue swelling. You may notice white or red spots, foul breath or enlarged papillae. Antibiotics may be needed for bacterial infection. Boosting immunity helps fight viruses.
Blocked Duct
A blocked salivary gland duct causes saliva to back up, forming a painless cyst called a mucocele. Swelling occurs on one side at the base of the tongue. Surgery may be required to unblock the duct if it fails to clear on its own.
Poor Oral Posture
Babies who rest their tongue between the teeth or bite it habitually can irritate the muscles and tissues, causing chronic mild swelling and scalloping along the edges. Dentists can provide tongue positioning appliances and exercises if needed.
Don’t hesitate to have your pediatrician examine any abnormal tongue enlargement to pinpoint the underlying cause and appropriate treatment. But in most cases, it will disappear harmlessly within a few days with attentive care at home.
Tips for Soothing a Swollen Tongue in Babies
Seeing your baby uncomfortable with a swollen tongue can be upsetting. Try these simple at-home measures to ease inflammation and pain while the swelling resolves.
Use Cold Compresses
- Rub a cool wet washcloth on the tongue surface and underside
- Allow baby to suck on chilled (not frozen) teething toys
- Avoid extreme cold that could damage tissue
Massage Swollen Gums
- Use clean fingers to rub sore gums gently
- Stimulates saliva production to keep tissues moist
- Relieves teething pressure on the tongue
Offer Cold Foods
- Give chilled purees, yogurt or ice pops
- The cold reduces inflammation and numbs discomfort
- Great for older babies who can swallow safely
Keep Baby Hydrated
- Provide extra breastfeeds or bottle feeds
- Fluids reduce swelling and prevent dehydration
- Try different nipples or cup/spoon if nursing is difficult
Use OTC Pain Relievers
- Children’s acetaminophen or ibuprofen can help
- Follow dosage directions carefully based on age
- Never give aspirin to infants or toddlers
Take Preventive Measures
- Use soft silicone teething toys under supervision
- Introduce new foods gradually after 6 months
- Monitor for reactions and avoid allergens
- Sterilize pacifiers, bottles and teethers
Most cases of minor tongue irritation resolve in 1-2 days. But if swelling worsens or causes feeding problems, be sure to call your pediatrician. Staying calm and keeping your baby comfortable are key!
Reassuring Parents When Baby’s Tongue is Swollen
As a pediatrician, I sometimes see concerned parents who notice swelling in their baby’s mouth. Here is my advice for reassuring families while evaluating tongue enlargement:
Affirm Their Concerns
- Thank parent for bringing baby in to be evaluated
- Acknowledge seeing changes in their child’s mouth would worry any caregiver
- Their vigilance helps ensure problems don’t go unchecked
Ask About Onset and Location
- When did they first notice the swelling? Has it changed?
- Is enlargement on one side or general? Specific location helps determine cause.
- Have they seen baby’s tongue actually get larger or just look different?
Discuss Associated Symptoms
- Is the baby cranky, refusing to nurse, drooling more or breathing hard?
- What about rash, difficulty swallowing, or choking during feeds?
- Symptoms give clues about severity and needed treatment.
Explain Common Causes
- Most tongue swelling arises from minor teething, accidental bite or scrape, or transient infection.
- It often resolves harmlessly within 48 hours without intervention.
- Discuss options like cold compresses, pain relief, soft foods and fluids.
Conduct Focused Exam
- Perform visual inspection, palpation, testing of nerve function and range of motion.
- Note size, color, surface texture, and location of swelling.
- Assess effect on latch, swallowing, and airway.
Determine if Referral Needed
- Where indicated, refer to allergist, ENT, or oral surgeon.
- Order blood work or imaging if infection, cyst, or blockage suspected.
- Admit for observation if swelling is pronounced or breathing compromised.
Provide Reassurance and Follow Up
- Reassure parents the tongue is very resilient and rebounds quickly.
- Review home care and what signs should prompt an urgent call or return visit.
- Schedule recheck in 24-48 hours to ensure swelling is resolving.
- Praise parents for their attentiveness and offer encouragement!
Allaying parental anxiety while conducting a thorough evaluation allows me to optimize care when babies present with tongue swelling. My calm guidance empowers families to manage recovery confidently.
Common Parent Questions About Baby Tongue Tie
Many newborns have a normal variant called a tongue tie. Here are answers to frequent concerns parents may have if their pediatrician diagnoses this finding.
What exactly is a tongue tie?
A tongue tie means the thin band of tissue connecting the bottom of the tongue to floor of the mouth is shorter than usual. This restricts mobility and elevation of the tongue.
What causes a tongue tie?
They occur during fetal development if the tissue strands that form under the tongue don’t open fully before birth. True shortening of the connective tissue produces a physical tethering.
Does it affect feeding or speech?
If severe, tongue ties can interfere with latching and milk transfer while nursing. They may also later impact speech production. Mild cases cause no issues.
Is treatment necessary?
Many mild tongue ties resolve on their own without intervention. Release may be recommended for severe cases impairing feeding and nutrition. The procedure is called a frenotomy.
How is a tongue tie released?
A simple in-office procedure, it involves placing a thin paper shield between the tongue and gums, then quickly dividing the restrictive tissue with sterile scissors. Bleeding is minimal.
What is recovery like?
Immediately after the procedure, baby is cranky from discomfort. Within hours, they are usually nursing more efficiently. Full healing takes 1-2 weeks. Stretches help prevent reattachment.