I think my baby might have a tongue tie?...
Tongue-tie (ankyloglossia) is a condition in which an unusually short, thick or tight band of tissue (lingual frenulum) tethers the bottom of the tongue's tip to the floor of the mouth. A tongue-tie can cause feeding and digestive challenges for infants and may lead to a range of issues as the individual grows older, including difficulties with weaning, textures, saliva management (dribbling) dental/oral hygiene, tension, headaches, challenges with speech.
Research shows that around 10% of babies are born with a tongue-tie but only a small percentage will go on to show no feeding difficulties as the tongue function is not impacting on breast/chest or bottle feeding.
However for the babies that their tongue function is impacting on feeding where necessary, tongue-tie can be treated with a surgical cut to release the frenulum.
The procedure to divide a baby's tongue tie is called a Frenulotomy. The membrane under the tongue is divided to enable optimum tongue movement and function enabling babies to feed more effectively.
Problems which may be due to a tongue tie:
Sore damaged nipples,
Misshapen/lipstick shape nipples after a feed
Low milk supply
Excessive milk supply
Fast/strong let down
Restricted tongue movement
Pulling off breast/chest-arching
Chomping the breast
Unsettled behaviour during feeds
Difficulty staying attached to the breast/chest or bottle
Frequent or very long feeds
Excessive early weight loss/poor weight gain/faltering growth
Clicking/smacking noises and /or dribbling during feeds
Colic, wind, hiccoughs
Reflux (vomiting after feeds)
Baby bottle feeding:
Choking/spluttering on the bottle
Shallow attachment to teat
Chomping the teat
Excessive milk dribbling during feeds
Excessive lip blisters
Unsettled/frustrated/fussy during feeds
Prolonged feeding sessions
Baby difficulties with solids:
Difficulty with chewing lumpy foods
Gagging on food
Other common issues
Exhaustion from constant/frequent feeding
Distress from failing to establish breastfeeding
Postnatal mental health concerns
Concerns over infant weight/health
Sadly, due to current NHS pressures, and staff shortages within maternity services, parents are having to endure unacceptable wait times of up to 6 weeks to be seen for a tongue-tie assessment.
Because of this, parents then feel that they have no choice and to go on to make different choices around their feeding journey.
This is why I aim to be able to offer you an appointment for the same day or next day appointment.
It is important if symptoms persist, that you seek support from a qualified specialist tongue-tie practitioner.
Tongue-tie assessment and
Following a booking email request, a home visit will be offered for a face to face consultation.
(Babies under 6 months old, 6-10 months based on an individual assessment)
We will discuss any concerns that you have with breast feeding or bottle feeding. We will discuss any relevant medical history. The procedure and any potential risk factors associated.
An assessment of the tongue function using the Hazelbaker tool whereby assessing babies ability to stick their tongue out (extension), observing movement of the tongue around their mouth (lateralisation) and the lift of their tongue (elevation). Assessing their suck, palate and shape of their tongue and finally the frenulum itself.
Division of the tongue-tie (if deemed clinically necessary) with aseptic technique. Post procedure feeding support will be provided.
*Baby will be wrapped securely in a large muslin or a blanket
*One parent will be requested to steady the babies head
*I will lift babies tongue with index finger and a small incision through the frenulum with sterile scissors will be performed to release the restriction
*Small gause will be held to the would to stem any bleeding (usually a small smear), baby will be unwrapped and given back to the parent to feed which will help to compress the wound and to decrease any further risk of bleeding and provides your baby with comfort
Whilst current research does not support the use of wound massage/stretching post frenulotomy, there are some gentle exercises that can be performed as outlined on the Association of Tongue tie Practitioners (ATP) downloadable PDF Leaflet .
With clean finer and short nails:-
*Poke your tongue out - encourage family/friends to do the same. This will go onto strengthen good tongue extension
*Tug of war - allow your baby to suck on your finger and then play a little tug of war , pulling your finger out a little at a time and letting them suck it back it
*Around the gums - sweep your finger around their lower gum line to encourage them to follow your finger with their tongue aiding laterilisation
Tongue-tie release is one part of a puzzle. During an oral assessment, an open discussion is had around utilising other health professionals for ongoing feeding support to aid the optimal outcome. Where there is a Tongue-tie, there would have been tension that had been created.
*Craniosacral Therapy (body work) to help release tension due to overworked muscles that have been used to compensate for poor tongue function
*Breastfeeding support with an IBCLC, NHS community breastfeeding counsellors, drop-in cafes. Post tongue-tie division baby now has to re learn to use their new tongue function so it it key to utilise as much support as possible.
Please note - If I feel the division is deemed clinically unnecessary or an oral anomaly is found, meaning that I feel division is unsafe or outside of my expertise then the below fees will be reduced to £130. The appointment time will be spent identifying the cause of your feeding issues and working with you to resolve these and formulating a plan together.
*Mileage is included in the pricing for home visits within 10 miles of Redditch.
For home visits further afield £1 per mile*
PAYMENT VIA BACS
Option 1 - £200
TONGUE TIE ASSESSMENT AND FRENULOTOMY
(Twins + £100)
POST PROCEDURE BREASTFEEDING GUIDANCE/SUPPORT
FOLLOW UP VIA TEXT 1 WEEK POST PROCEDURE. PHONE CONTACT FOR ANY ADVICE OR SUPPORT
Option 2- £100
Reformation follow up.
(Re-assessment + procedure if required from 4 weeks post 1st procedure)
2-4% occurance rate.
My name is Anna Branch, a mother to 3 children. I am a registered midwife with extensive experience within all areas of the NHS.
I qualified with a 1st BSc Hons in Midwifery at Worcester University.
I have mostly worked as a community midwife providing antenatal, intrapartum and postnatal care to women and families of Worcestershire and Warwickshire.
I have always had a keen interest in supporting infant feeding even prior to becoming a midwife. I trained with the Breastfeeding Network as a peer supporter, volunteering within NHS on the postnatal wards.
My current NHS job role is as an infant feeding Midwife. I completed my training with Wolverhampton University as a Tongue-tie specialist providing tongue tie assessments and divisions within NHS clinics. I am keen to ensure that all parents receive timely infant feeding support and appropriate Tongue-tie assessments by a qualified practitioner .
I am registered with the NMC & RCM
The Association of Tongue-tie Practitioners (ATP)
I am CQC registered and insured via Private Midwives
Mon - Sat
Appointments on request.
HOME VISITS ONLY: Redditch & surrounding areas of Worcestershire & Warwickshire.
Anna is absolutely amazing! She attended to carry out a tongue tie assessment and tongue tie division on my 8 week old daughter. From the minute she came through the door she put me at ease! Anna had so much information to give and took a full full history of my feeding journey with my daughter before carrying out a full assessment. When carrying out the procedure she explained everything in detail and made sure i was happy with everything. Once carrying out the procedure she went through lots of feeding information to assist us with improving my daughters latch and strength of her tongue. The follow up phone call was also really really helpful as Anna ensured there was improvement and explained everything again.
Personally Anna really helped me also and made me realise I wasnt failing but I had been perservering with my feeding journey with something holding us back. I highly recommend Anna and will always be grateful for her help along my feeding journey!
Thank you for reaching out.
The tongue tie appears to have resolved and Otto is feeding much better. He has gained weight and is a lot happier in himself which is all I really wanted!
Thank you again for your service and follow up, you were really lovely and informative :)
Anna was really thorough during the assessment of our baby and explained everything to us in great detail. Before the procedure she explained the benefits and possible risks before making our decision. Anna made us feel at ease and also supported with a follow up call to check in with how everything is going.
I would highly recommend Anna's services to other parents.