BFESS - Tongue Tie
What is tongue-tie?
Tongue-tie (ankyloglossia) is a condition where the membrane underneath the tongue (lingual frenulum) is tight or short. This may be attached at the tongue-tip or further back, and as a result, the tongue-tip can appear heart-shaped, forked or blunt, and may affect feeding.
There may be a family history of tongue-tie.
Does tongue-tie cause problems?
Not always, however babies need to be able to protrude the tongue forward to the lower gum in order to attach effectively at the breast and maintain the attachment for the entire length of the feed.
If this is not possible it may lead to sore and damaged nipples, painful, prolonged feeding, reduced milk supply and mastitis for mothers.
The baby may be slow to gain weight, unsettled and colicky following feeds. Feeding may be noisy and frequent with excessive dribbling or gagging.
Longer term issues which are worth considering are: oral hygiene, possible problems managing solid foods and speech development.
How can a tongue-tie be managed or treated?
Some problems resolve spontaneously as the baby grows and develops.
Assistance with trying different positions for feeding and working on the baby's attachment at the breast is helpful. It is advisable to seek specialist breastfeeding support.
Tongue-tie release (frenulotomy).
What is frenulotomy?
This is a simple procedure to release the tightness under the tongue.
The tongue-tie is snipped using sterile, sharp, round-ended scissors without the need for anaesthetic.
There may be a small amount of bleeding; pressure is applied using sterile gauze, before being encouraged to feed.
Babies usually cry for a short time (although many sleep through the procedure).
Assistance is given with feeding techniques; most mothers report that feeding improves immediately.
Follow-up support is given.
Where can I look for further information?
UNICEF UK Baby Friendly Initiative Information on Tongue-tie
For parents
For health professionals
Locations/ hospitals providing frenulotomy
The National Institute for Health and Clinical Excellence (NICE)
Guidelines on Tongue-tie division
Tongue-Tie Parent Information Sheet
Lactation Consultants of Great Britain
Tongue-tie leaflet
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