TONGUE TIE
I set up an NHS Tongue tie clinic in west London in 2012 and I currently continue to run this clinic as well as working privately.
“I offer frenulotomy to baby’s up to 5 months old and I am confident to cut posterior submucosal ties.
What is tongue-tie?
Tongue-tie is a condition where there is a short or tight membrane underneath the tongue. This can be attached at the tongue tip or further back and as a result the tongue-tip can appear heart-shaped or forked. Movements to lift, move from side to side and protrude the tongue can be restricted which may affect the way the baby feeds. From a study in the Southampton area 10% of babies were found to be tongue-tied with half having associated feeding difficulties. It was also found that there was a family history of tongue-tie in half the babies seen.
What are the symptoms of a tongue tied baby?
Sometimes mothers will experience painful feeding or even mastitis. Babies may latch on poorly, require several attempts to attach and become frustrated. They may make a clicking noise when feeding. Feeding may be prolonged, and the baby may still be hungry and irritable, or feeding frequently. Some babies also have trouble bottle feeding and may dribble excessively, or swallow too much wind. These are some of the more common symptoms of a tongue tie.
How can a tongue-tie be treated / managed?
Some babies can feed perfectly well despite having a tongue-tie and for some babies adjustments to positioning and attachment may be all that is needed. A very thin tongue tie may break spontaneously or a very elastic tongue tie may not require any treatment. If problems continue despite this support then tongue-tie division (or frenulotomy) is an option.
What does the procedure (frenulotomy) involve?
The procedure is very simple and takes a few seconds. Your baby is swaddled and held gently to keep the head still. The tongue-tie is snipped using sterile, sharp round- ended scissors without the need for an anaesthetic. Babies may feel a small amount of pain, if any, and usually settle quickly and are able to feed. (Some babies actually sleep through the procedure).
There is usually very little bleeding and any oozing is controlled by applying pressure to the area with sterile gauze. You will be encouraged to breastfeed as soon as possible after the procedure to offer comfort, clean the wound and get his/her tongue moving straightaway. You will be given breastfeeding support afterwards and an agreed plan will be discussed with you to help you with your ongoing breastfeeding experience.
What happens after the procedure?
The inside of a baby’s mouth heals very quickly. Under the tongue where the freunulum has been cut a small white blister will appear that will last for 3 to 4 days. This is part of the natural healing process.
Most babies under 12 weeks of age do not require any pain relief after the procedure but if your baby is hot, appears unwell, or if you have any other concerns, you should contact your GP.
If the problems you were having don’t resolve.
Sometimes a mother notices an instant improvement in her comfort during breastfeeds but sometimes it takes a week or two for a baby to adjust to increased tongue mobility and tongue exercises may be recommended. Occasionally a baby’s frenulum needs dividing a second time, usually because the division was not quite extensive enough the first time.
My qualifications
I am a practising Midwife for 25 years. I am a qualified Lactation Consultant and member of the IBCLC and LCGB (lactation consultants of great Britain)
http://www.lcgb.org/
I am also a member of the Association of Tongue Tie practitioners. Please see link
http://www.tongue-tie.org.uk/
I trained to carry out tongue tie division in Southampton with consultant paediatrician Mervyn Griffiths and LC Carolyn Westcott and I am insured by the Medical Defense Union.
I only treat infants under five months old.