A tongue-tie diagnosis is made by a practitioner who has appropriate specialist training and competence in tongue-tie assessment, including assessment of tongue function and feeding. A midwife, health visitor or any other healthcare professional who has not undertaken specialist tongue-tie training may identify a suspected tongue-tie and feeding difficulties, but this does not in itself constitute a specialist tongue-tie assessment or diagnosis. If in doubt, ask for evidence of qualification. 

Not all tongue ties require treatment. Recommendations are based on feeding assessment, tongue function and parental goals. Frenulotomy may be considered when restricted tongue function is affecting feeding and conservative support alone has not resolved difficulties. 

• History of pregnancy and birth​

• Feeding assessment

• Functional oral assessment ATLFF score

• Frenulotomy (Division)

• Post division feeding support and advice

• After care/exercises

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Yes, tongue -tie will affect tongue function which will impact on breast or bottle feeding .. 

• Choking/spluttering on the bottle

• Taking a long time to feed >1hour

• Prolonged feeding sessions

• Shallow attachment to teat

• Chomping the teat

• Excessive milk dribbling during feeds

• Excessive lip blisters

• Unsettled/frustrated/fussy during feeds

Yes, A restrictive tongue tie may limit how well the tongue can:

• move food around the mouth,

• lift to the palate,

• clear food from gums/cheeks,

• chew effectively,

• trigger coordinated swallowing

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 Possible side effects

• gagging or choking more than expected

• difficulty moving textured foods

• pocketing food in cheeks

• prolonged mealtimes

• preference for soft foods only

• messy eating

• tongue thrusting food out

• coughing during meals

For most parents, pain is their first concern when thinking about whether their baby should have a tongue tie division.  The discomfort is similar to having an injection -  briefly painful but no on-going pain.  Most babies under 2 weeks will cry for less than 20 seconds (if at all).  It is unusual for a baby under 8 weeks to cry for more than 1 minute, whilst older babies may cry for up to 5 minutes. Babies are normally settled by cuddles and offering a feed straight after the tongue tie division. Sucking produces natural painkillers called endorphins and so babies are generally only upset for a very short time.  

​Yes, babies will be offered a feed whether breast or bottle fed post division for babies comfort and to help clot the wound and stop any bleeding from the procedure.