Tongue Tie Specialists - Assessment & Division

What is a Tongue Tie?

This is when the frenulum (the strip of tissue connecting the tongue to the floor of the mouth) is short, inelastic or thickened.

The frenulum can be joined from the tip of the tongue to anywhere along the underside of the tongue. It can make the tongue look 'flattened' or 'heart' shaped and can restrict the movement of the tongue.

Infant Symptoms

• Poor latch/difficulty in staying attached
• Gumming the nipple
• Ineffective milk transfer
• 'Fussy' feeding
• Slipping off the breast
• Continuous feeding cycle
• Poor or slow weight gain
• 'Clicking' noises when feeding (at breast or bottle)
• Long feeds up to an hour or more or very short feeds under 5 mins

Maternal symptoms

• 'Chomping' the nipple
• Ineffective milk transfer
• 'Fussy' feeding
• Poor or slow weight gain/sometimes excessive weight gain
• 'Clicking' noises when feeding
• Long feeds
• Mastitis /engorgement

The above are some examples of symptoms a tongue-tie can present with, but they are not exclusive. Equally the symptoms described above may also have other causes. Some babies who appear to have a tongue-tie, have no problem feeding or growing.

Why is it a Problem?

For some babies this is not a problem and it needs to be assessed on an individual baby as to whether it is affecting the feeding.

Can anything be done about it?

There is a quick and simple procedure that can be performed called frenulotomy / tongue tie division/ tongue tie release, which helps in the majority of cases.

If a tongue tie division is offered at your baby’s appointment, here is some useful information for you to consider beforehand.

You are required to read the Tongue Tie Parent Information Leaflet before your baby’s appointment, it covers the tongue tie procedure and any possible risks.

Will I be offered any follow up care?

Tongue tie division package includes a follow up phone call/text or email in the next few days to check how you and your baby are getting on and offer further support if needed by email/text/videocall. Most families do not need further follow-up, but please get in contact with your practitioner if feeding has not improved rapidly. This virtual follow-up support for a 2 week period is included in the consultation fee.

Sometimes we may reccommend seeing an Osteopath to support your baby. Search the Register - General Osteopathic Council

What types of tongue tie do you divide?

All grades of tongue tie can be divided, if appropriate, including the less obvious ones.

Do you divide tongue tie on bottle fed babies?

YES. Sometimes bottle fed babies can find feeding difficult with a tongue tie, although they don’t need to use the tongue quite as much as breastfed baby. We have seen many babies feeding much better on a bottle straight away after tongue tie division. Typical signs a bottle fed baby is struggling with restricted tongue movements are:

• Leaking milk for either side of the teat during a feed
• Long, slow feeds
• Coughing and spluttering a lot with a faster flow teat
• Windy “reflux” type issues. These babies will typically be very windy, as the seal around the bottle teat is not good
• Slow weight gain

There is no formal evidence yet that bottle fed babies feed better after frenulotomy but this is because no one has collected the data. The majority of tongue tie practitioners around the UK divide tongue tie on bottle fed babies and audit their practice, and will tell us that babies usually improve after frenulotomy.

Does tongue tie affect speech?

This is much debated, and research can support either a yes or no answer. No one wants to divide a baby’s tongue tie ”just in case” there may be speech problems later. NICE (National Institute for Clinical Excellence) guidance allows us to divide tongue ties for feeding difficulties only. If your child does need tongue tie division at a later stage for speech problems with an ENT surgeon, it can still be done on an older child but involves a quick general anaesthetic and possibly an overnight hospital stay.

Wasn’t my baby checked for tongue tie at the new birth check?

"Full assessment and recognition of tongue tie is not part of the standard medical or midwifery training, or the NIPE (Newborn Infant Physical Examination) training. Tongue tie checks are not routine at birth."

Some parents assume this will always be checked for at birth NIPE but this will depend on your maternity provider policies. Some providers feel that checking all babies, if they are not having feeding difficulties, will lead to unnecessary concern. Examining the tongue appearance and function in detail is not part of the standards NIPE training at present. You are required to read the Tongue Tie Parent Information Leaflet before your baby’s appointment, it covers the tongue tie procedure and any possible risks.

If you think your baby has a tongue-tie, please contact us to book a private assessment with us, or ask your midwife, health visitor, breastfeeding advisor or GP to assess and refer to you your local NHS provider.

Clinic appointment: £190 for assessment and division of a tongue tie - reduced to £100 if no division is needed

Home visit: (Within 35 miles of SN2 2PN) £290 for assessment and division of a tongue tie - reduced to £190 if no division is needed

Booking is available on line via this website so you can choose a time to suit your family. If you have any questions, or want to discuss anything before you book an appointment, please feel free to phone, text, WhatsApp or email for a chat first.

Baby Acorn Ltd accepts payment via bank transfer or cash. Details given at your appointment.

You are required to read the Tongue Tie Parent Information Leaflet before your baby’s appointment, it covers the tongue tie procedure and any possible risks

Our refund policy

After services have been provided and as the balance of payment is requested at the time of the consultation, refunds are not permitted.

Cancellation of bookings

Simply cancel via Cliniko - please ensure you give more than 24 hours notice of cancellation to allow other parents to take up your appointment slot.

If you need to cancel your appointment for non medical reasons then a £20 cancellation fee will be charged

Cancellation by Baby Acorn Limited

Baby Acorn Ltd reserves the right to cancel any appointments, in case of emergency circumstances. In the unlikely event that this should occur, an alternative appointment will always be made as soon as possible and at your convenience.

In order to fulfil our services to you Baby Acorn Ltd will need to collect some information about you. We take your privacy and our obligations under data protection legislation very seriously. We are also obligated under law as a healthcare provider to maintain certain records for significant periods of time as regulated by the professional bodies in the footer below.

How we use your information

• We collect and hold data about you and your baby for the purposes of providing safe and effective healthcare
• We will use non-identifiable patient data for audit purposes and may need to share these with partner organisations e.g. Association of Tongue tie Practitioners and the CQC
• We will only share your information with outside agencies in very rare circumstances, for example if we are concerned about your safety or your baby’s safety. Our separate safeguarding policy is available on request
• If you do not want your information to be used for any purpose beyond providing your care please let us know so we can amend your record appropriately

If you have a complaints or feedback about our any part of our service, please find our Complaints Policy document here

Complaints can also be made directly to the midwives and nurses governing body: The Nursing and Midwifery Council (NMC) or the Care Quality Commission (CQC).