Tongue-tie Division and Breastfeeding Support
provided by Luci Lishman RGN, RM, IBCLC

Independent Nurse and Lactation Consultant
Professional Indemnity provided by the Medical Defence Union

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, forked or blunt. 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 problems can it cause?

The mother may experience painful feeding, damaged nipples, mastitis and difficulty establishing an adequate milk supply with resulting exhaustion and distress.
The baby may have difficulty sustaining feeds and may need to feed frequently and for prolonged periods of time to be satisfied. There may also be weight problems, noisy feeding, dribbling and increased windy behaviour.
Long term problems may include tooth decay as there can be difficulty in removing food debris from the back teeth. Although controversial, there may be an increased risk of speech problems but this is difficult to tell at this point.

How can a tongue-tie be treated / managed?

Some babies can feed perfectly well despite having a tongue-tie and adjustments to positioning and attachment may be all that is needed if there are problems with feeding. It is advisable to seek specialist breastfeeding support.
If problems continue despite this support then tongue-tie division or frenulotomy is an option. You may be able to get an NHS referral from your local breastfeeding clinic or GP. See the link to the baby friendly website where you will see a list of hospitals that provide this treatment. There may well be a waiting list for NHS treatment.
If you would prefer to be seen more promptly and have breastfeeding support as well as the procedure then Luci can provide this privately in her tongue-tie clinic or in the comfort of your home. She also runs a session that you can book on to for free tongue-tie assessment and follow up.
See the clinic page for details.

What does the procedure 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 and encouraging feeding as soon as possible.
You will be given support afterwards and an agreed plan will be discussed with you to help you with your ongoing breastfeeding experience.

Where can I find more information?

If you would like more information please contact us or have a look at the following links,

Baby Friendly information on Tongue-tie
For parents
For health professionals
Locations / Hospitals providing frenulotomy

NICE guidelines on Tongue-tie division

Leaflet on Tongue-ties produced by Lactation Consultants of Great Britain

Midirs article on Tongue-tie.