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 and is more common in boys than girls.

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.

Your baby has been referred to our specialist tongue-tie clinic because your healthcare professional suspects your baby may have a tongue-tie that is affecting your baby’s feeding ability.

The gap between referral and being seen may be up to two weeks or more and so your situation could change.

Please contact us if:

• Your baby’s feeding issues have resolved.
• You or your baby are unwell.
• Your baby has signs of oral thrush – white coating on tongue, inner lips and cheeks.
• Your baby’s immunisations are due within a week of your appointment.

We can then discuss cancelling or postponing your baby’s appointment to save you a wasted journey. If your baby’s space is not needed then we would like to reallocate it to someone who might need it more urgently.

What to bring?

• A blanket
• Your baby’s Red Book
• Usual feeding equipment if needed, feed ready prepared (if formula -powder needs to be mixed with water that is at least 70 degrees).
• Your baby will need to feed within 30 minutes after the appointment time.

• When you arrive at the clinic you will need to report to the receptionist who will show you where to wait.
• You will shortly be greeted by your tongue-tie practitioner who will show you and your baby into the consultation room. Partners, relatives or friends are most 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 and express any concerns.
• 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. If you choose not to have the procedure done then further feeding support will be offered.
• Appoximately 50% 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

Further information is available from:

• Unicef 
• Assoication of Breastfeeding Mothers
• Lactation Consultants of Great Britain
• Baby Centre
• Association of Tongue-tie Practitioners
• Kelly Mom 

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 739 239 between 9.00am and 5.00pm, Monday to Friday.