Tongue-tie

Some tongue-ties are easily seen and may be detected soon after birth. Some, however, are less obvious and are identified as a result of feeding difficulties and detailed assessment of tongue function.

Prior to your referral a full breastfeeding assessment needs to be completed by a health professional.

Tongue-tie affects approximately one in ten babies.

To be able to attach to the breast and feed effectively a baby needs to be able to open their mouth wide, extend their tongue and draw an adequate amount of breast tissue in their mouth. The tongue needs to then move effectively to remove the milk.

Some tongue-tied babies may not be able to achieve some of these things and so may present with some of the following symptoms:

• In mother – sore, damaged nipples, misshapen nipples after breastfeeds, poor drainage of the breast leading to engorgement or mastitis, reduced milk supply, exhaustion from frequent feeds.
• In baby – visual restriction of tongue, difficulty getting and or sustaining a deep attachment to the breast, frequent or very long feeds, weight concerns, difficulty controlling milk flow, dribbling / choking easily, making clicking noises, wind problems.

Please note that there may be other causes of these problems aside from tongue-tie and so skilled breastfeeding support is very important.

If your healthcare professional suspects your baby may have a tongue-tie that is affecting their feeding ability, your baby will be referred to a specialist tongue-tie clinic.

From 1 July the referral age limit for referral to the Tongue-tie service will be 14 weeks.

We aim to see you within 2 weeks of a referral but, due to demand, this may be longer. Whilst you are waiting for your appointment, you can access help and support at a breastfeeding support group or by telephoning the Advice Line.

Clinics are held at:

• Epsom Clinic
• Leatherhead Clinic
• Molesey Clinic
• The Orchard, Redhill.

Please note:

• If your baby has a history of cardiac conditions, please ask your GP to refer you to the Max Fax team as we are unable to undertake a Tongue-tie procedure in a community setting.
• If your baby has a history of bleeding or clotting disorders, please contact the practitioner who referred you or the advice line as your baby may not be suitable for the procedure to be undertaken in the community setting. The Advice Line number is 01883 340 922.
• Please ensure any immunisation appointments for your baby are not booked one week before or after your baby’s tongue-tie appointment. If you do have an immunisation appointment, please reschedule with your GP.

• On arrival, please wait in the reception area.
• You will be greeted by the tongue-tie practitioner who will show you and your baby into the consultation room. Partners, relatives or friends are welcome to join you.
• There will be an initial discussion where a feeding and medical history will be taken.
• The tongue-tie assessment process, the tongue-tie division procedure and risks will be explained to you. You will have a chance to ask questions.
• Following this, with your verbal consent, your baby will be physically assessed for tongue-tie. This will be looking at the function and the appearance of the tongue. To ensure that there aren’t any other reasons for the feeding difficulties your baby’s neck, jaw and palate will be examined briefly and a short feed may be observed.
• If a tongue-tie is thought to be the cause of your feeding difficulties then the tongue-tie division procedure will be offered to your baby. The aim is for you to make a fully informed choice. Your decision will be respected and supported. You will need to sign a written consent form before the procedure takes place. If you choose not to have the procedure done then further feeding support will be offered.
• Around half of those babies referred for the procedure will not require the tongue-tie division.

Call our Advice Line

Families with children from birth to 19 years old can call our Surrey-wide 0-19 Advice Line on: 01883 340 922

The advice line is available from 8am to 5pm, Monday to Friday (excluding bank holidays) and provides support on all aspects of child health, development and parenting.

Other organisations

• Unicef 
• Association of Breastfeeding Mothers
• Lactation Consultants of Great Britain
• Association of Tongue-tie Practitioners 

Referrals are made by health visitors or other health professionals through the One Stop Referral Service.

Please speak to your health visitor or health professional if you require more information about the service and/or procedure.

To cancel a tongue-tie appointment, please call 07738 739 238 between 9am and 5pm, Monday to Friday.