Tongue Tie

For Baby :

 · Long feeds

· Very frequent feeding

· Significant weight loss or slow weight gain

· Falls asleep quickly after a few sucks

· Leaking or dribbling milk during feeds

· Unsettled, appearing unsatisfied or hungry

· Clicking during feeds

· Coughing/choking during feeds

For Mum:

 · Sore or cracked nipples

· Misshapen nipples at the end of feeds

· Low milk supply

· Engorgement

· Mastitis

It is understood that as the frenulum of young babies does not have many nerve endings in, so the procedure only causes minimal discomfort for babies, therefore no anaesthetic is required. However, they may cry briefly, like reactions after the heel prick test or vaccination. The procedure itself is very quick and we will aim to feed immediately afterward to provide comfort the baby and minimise any bleeding.

Following the procedure some babies may be more unsettled, so skin-to-skin contact and plenty of cuddles can help. Some babies may want to feed more frequently in the hours following the procedure and others may not feed as much. For babies over 8 weeks old, you can give paracetamol, though it is often not needed.

Tongue tie division (frenotomy) is a very safe procedure that is safe to conduct in the home. However, in rare cases there can be complications such as bleeding, infection, injury to salivary ducts or reattachment of the tongue tie. 

Bleeding:  Immediately following the division, we often see a few spots of blood under the tongue, this normally stops very quickly by feeding the baby.  In the rare circumstances that feeding does not resolve it, gauze will be used to apply pressure to the area to stop any further blood loss. Beyond this any prolonged bleeding is rare (approximately 1:3000-5000) and will be managed safely as per the ATP national guidance. 

Infection:  Cases of infection are very rare (1:10000). Ways to reduce any risk of infection is to ensure anything going into your baby’s mouth (teats, nipple shields, dummies) are thoroughly cleaned and sterilised before use and that any formula milk is prepared safely as per the instructions on the packaging.  Symptoms of infection include raised temperature above 37.5c, increased redness around the wound or discharge from the wound. However, a white or yellow patch may be seen under the tongue and this is a sign of normal healing not infection.

Injury:  Injury to salivary glands is extremely rare and it is so rare that it is difficult to quantify accurately.

Reattachment:  Reattachment is uncommon but is known to occur in approximately 5% of cases. Symptoms of reattachment are usually a return of previous problems which had resolved after tongue tie release. Not all babies with reattachment will benefit from a second division, though some will so if you feel concerned that your baby has a reattachment then please get in touch with me.