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Tongue-tie (also known as Ankyloglossia) is caused when the membrane (frenulum) that anchors the tongue to the bottom of the mouth is tight and/or very close to the tip of the tongue. When the attachment is right at the tip of the tongue it is called anterior tongue-tie. A less visually obvious attachment, that occurs towards the back of the tongue, is called posterior tongue-tie.
Around 10% of babies have tongue ties but many of them have no problems associated with it. However some babies find it difficult or impossible to breastfeed effectively. Some mothers experience pain whilst breastfeeding, which is unresolved by optimisation of the positioning and attachment of the baby at the breast. Some babies may also find it very difficult to bottle feed. To resolve these issues the tongue-tie can be released (cut) by a procedure called frenulotomy and this often leads to an improvement in feeding, leaving babies and mothers feeling much happier.
Symptoms associated with infant tongue-tie:
Mother:
Baby:
These problems may have other causes, so thorough assessment of your baby's feeding by an IBCLC is essential prior to division.
(source: Association of Tongue-tie Practitioners)
Around 10% of babies have tongue ties but many of them have no problems associated with it. However some babies find it difficult or impossible to breastfeed effectively. Some mothers experience pain whilst breastfeeding, which is unresolved by optimisation of the positioning and attachment of the baby at the breast. Some babies may also find it very difficult to bottle feed. To resolve these issues the tongue-tie can be released (cut) by a procedure called frenulotomy and this often leads to an improvement in feeding, leaving babies and mothers feeling much happier.
Symptoms associated with infant tongue-tie:
Mother:
- Sore/damaged nipples
- Nipples which look misshapen or blanched after feeds
- Mastitis
- Low milk supply
- Exhaustion from frequent/constant feeding
- Distress from failing to establish breastfeeding
Baby:
- Restricted tongue movement
- Small gape resulting in biting/grinding behaviour
- Unsettled behaviour during feeds
- Difficulty staying attached to the breast or bottle
- Frequent or very long feeds
- Excessive early weight loss/ poor weight gain/faltering growth
- Clicking noises and/ or dribbling during feeds
- Colic, wind, hiccoughs
- Reflux (vomiting after feeds)
These problems may have other causes, so thorough assessment of your baby's feeding by an IBCLC is essential prior to division.
(source: Association of Tongue-tie Practitioners)
Tongue-tie release
(Frenulotomy)
I treat babies who have difficulties with feeding related to tongue-tie. This includes breastfed, bottle-fed and mixed fed babies.
Before offering to do the procedure, I will always take a full feeding history and undertake a full assessment of the baby's tongue appearance and function. I will explain the risks and benefits in a way that you understand and give you time to ask questions and make the decision about whether to proceed or not. In some instances I will not offer to undertake the procedure, if there is, for example, an unusual oral anatomy, absence of feeding difficulty or where the feeding difficulty is not associated with tongue-tie.
The procedure is relatively simple. Whilst the baby is swaddled and held gently by a parent or friend, a finger is inserted under the tongue to lift it. When the frenulum can be seen clearly it is cut with a pair of sterile curved scissors. A finger is used to sweep under the tongue to ensure full release has been achieved and in some instances more than one cut will be necessary. Once I am satisfied the tongue-tie has been released, light pressure is applied using a sterile gauze and your baby is returned to you to offer a feed.
There is usually very little bleeding and within 24-48 hours usually a white / grey area appears under the tongue. This is a normal part of the healing process and can remain for up to 14 days.
Here is a link to a parents-eye-view of "What to expect on the day"
Before offering to do the procedure, I will always take a full feeding history and undertake a full assessment of the baby's tongue appearance and function. I will explain the risks and benefits in a way that you understand and give you time to ask questions and make the decision about whether to proceed or not. In some instances I will not offer to undertake the procedure, if there is, for example, an unusual oral anatomy, absence of feeding difficulty or where the feeding difficulty is not associated with tongue-tie.
The procedure is relatively simple. Whilst the baby is swaddled and held gently by a parent or friend, a finger is inserted under the tongue to lift it. When the frenulum can be seen clearly it is cut with a pair of sterile curved scissors. A finger is used to sweep under the tongue to ensure full release has been achieved and in some instances more than one cut will be necessary. Once I am satisfied the tongue-tie has been released, light pressure is applied using a sterile gauze and your baby is returned to you to offer a feed.
There is usually very little bleeding and within 24-48 hours usually a white / grey area appears under the tongue. This is a normal part of the healing process and can remain for up to 14 days.
Here is a link to a parents-eye-view of "What to expect on the day"
"I wouldn’t hesitate to recommend Vicky to other mummy’s. Vicky carried out a tongue tie division on my son, she made what we imagined to be a stressful situation a straightforward procedure because we felt in totally safe hands."
Feedback, May 2021
