Sometimes babies may experience difficulty latching on, or the mother may find it difficult to breast feed due to lingual frenulum (diagnosed as tongue tie).

 

Tongue-tie is a condition which affects up to 1 in 10 babies and is more common in boys than girls. Most of us have a lingual frenulum (a membrane situated towards the base of the tongue which extends from the under surface of the tongue into the floor of the mouth) so the presence of a visible or palpable lingual frenulum is normal anatomy.  However, in some individuals this lingual frenulum may be short, tight, and attached close to the tip of the tongue and/or on the gum and cause restrictions in tongue movement and function.  These restrictions may then cause feeding difficulties. These restricted lingual frenula are known as ‘tongue-tie’.

 

Consultations

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I offer tongue tie assessment and division as well as support the mother and baby to maintain successful Lactation or with her preferred method of feeding her baby.

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I offer frenulotomy privately to parents of babies with tongue tie. I have been conducting this service over 30yrs now. Following retraining in 2014 to equip with the latest research, I worked at the NHS in this field for some years. Currently, I set up a private practice to overcome the long waiting list and associated stress that parents go through while waiting for their child to have the procedure. Parents can contact me directly to make an appointment. Online booking system is also available. I do not need a referral to see you. I routinely treat babies up to 6 months old. For babies aged over 6months, I make a judgement based on the size and temperament of the baby and how many teeth they have.

 

I also offer home visits for frenulotomy within 30 miles travelling distance when I have capacity. The are covered includes East London.

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What to Expect Afterwards

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• You will be given an appointment for a home visit or clinic consultation.

• You should avoid feeding baby for an hour before the appointment so he or she will be interested in feeding during the consultation.

• If coming to a clinic bring your red book and a blanket to wrap baby in and if baby is having top ups or is bottle fed bring some expressed milk or if using formula a carton of the readymade formula you usually use. In the home you will need to provide a flat clean surface, such as a kitchen/dining table, clean changing mat, good lighting and blanket for swaddling.

• I will take a detailed medical history for both mother and baby, birth history and feeding history from you and I may observe baby feeding.

• I will assess tongue function and then discuss my findings with you.

• We will go through strategies, which may be more appropriate than tongue-tie division, or which may be needed alongside division, to improve feeding such as positioning and attachment, boosting milk supply, suck training, etc.

• If tongue-tie division is appropriate, I will go through the potential outcomes and risks of the procedure with you so you can make an informed decision on whether to go ahead or not.

• You will be asked to sign a consent form. There is no obligation to go ahead, I am happy for parents to go away and spend time researching and thinking more about the procedure if they wish to.

• I will swaddle your baby in a towel or blanket and place them on the couch in the clinic room under a bright lamp or surgical lighting. In the home they will be placed on a changing mat on your table or other flat, clean surface.

• If I have an assistant in clinic then they will hold your baby’s head (unless you prefer to). However, if I am working alone then a parent will need to hold baby’s head.

• Using my index finger to lift the tongue I will visualise the frenulum (tongue-tie) and snip it using a pair of single use, sterile, curved, blunt tipped scissors.

• Once the frenulum has been fully divided to form a diamond shaped wound, I will place a piece of gauze under baby’s tongue and pass baby to mum to feed.  Babies usually latch on within a minute and bleeding is usually very light and stops quickly once baby is feeding. Most babies tolerate the procedure well with just a short cry before they feed.

• I will observe baby feeding and provide support with this.

• I will also go through some simple, gentle tongue exercises you can do with your baby and explain to you what to expect in terms of healing and recovery.

• A feeding plan will be agreed with you to manage any ongoing feeding issues and get feeding back on track.

• I will stay with you until any bleeding has settled.