Paisley Morrison-Johnson, a 16-month-old born in South Dakota with an unusually large tongue, is “doing phenomenally” after undergoing life-changing tongue reduction surgery, her mother says.

The baby’s enlarged tongue was caused by Beckwith-Wiedemann syndrome, a rare genetic condition that can lead to excessive growth in certain parts of the body. The condition affects approximately 1 in 13,700 newborns worldwide.

Paisley’s mother, Madison Kienow, told BuzzFeed News that she had no idea her daughter had the condition until an emergency C-section two months before her due date.

“During my C-section, they got her out and noticed that her tongue was unusually large,” Kienow said. Doctors immediately took Paisley for breathing support because they were concerned her tongue could affect her airway.

“I never got to see her, touch her or hear her cry,” Kienow recalled.

Paisley spent three and a half months in a neonatal intensive care unit (NICU) in Sioux Falls, where she eventually received her diagnosis.

Following medical advice, Paisley underwent her first tongue reduction surgery at six months old, followed by a second procedure at 13 months.

“The surgeon was like, ‘This is the largest tongue I’ve ever seen, especially for an infant this small,'” Kienow said.

Since the procedures, life has become so much easier for the little girl and her family.

“I don’t have to worry about her choking, she has started saying words, she can eat regular food, and she’s starting to get her teeth now,” Kienow said. “She took her first step five days ago.”

And perhaps the sweetest change of all is that Paisley can now smile.

Her mother described seeing her daughter’s smile for the first time as “the best feeling.”