Tongue Tie Assessment & Treatment
Areas we cover
£100 for assessment if no Frenulotomy performed
During the visit we will run through a full history, discuss any symptoms and complete an oral exam. A comprehensive functional assessment of the tongue will assess the mobility, appearance and specifically how your baby is using it.
We can observe a feed and can help identify why you or your baby are struggling.
If a tongue tie is identified and you would like the option of treatment, our experienced practitioner will explain the treatment and the small risks involved.
We will discuss what to expect after the procedure, healing, feeding and aftercare. We will support you with a feed immediately afterwards. An appropriate care plan can be put in place if necessary.
Our fully comprehensive aftercare package, included as standard, means you can contact us via phone, text or email if you have any questions or concerns. We will happily re-assess in person if needed.
Appointments last approx 45mins.
We are fully insured and CQC registered.
What makes Cheshire Baby Support different from other tongue-tie division practitioners?
We firmly believe that tongue-tie division should not be done in isolation from feeding support. For this reason every tongue-tie division appointment will be attended by Jennifer, a tongue-tie practitioner and Amanda, a lactation consultant (IBCLC). This ensures that a full and holistic assessment is made for each individual baby and family. This is then followed up by expert and ongoing feeding support, at parental request.
Amanda will gently and firmly hold your baby’s head during the division. This means that parents do not have to do this job. It also increases the safety of the procedur
Jennifer is qualified to Master’s level in the tongue-tie division procedure and has received the highest recognisable qualification in the country. Amanda holds the highest qualification in clinical infant feeding support, recognised across the world.
We will visit you in home or at our clinic.
Appointments often available at short notice.
We offer ongoing support for 14 days afterwards, by text or phone. Please contact us for support. We will re-assess a tongue-tie free of charge, in our clinic.
We pride ourselves on looking at your whole picture and not just relying on a tick box exercise. Feeding issues can also affect sleep, digestive issues and mental health. This is why we have a multidisciplinary team which includes feeding support, tongue tie assessment/division and bodywork. This helps us give you the best care possible.
Tongue Tie Information
What is a tongue-tie?
A tongue-tie (also known as Ankyloglossia) is caused by a short or tight membrane under the tongue (the lingual frenulum).
Where the membrane is attached at, or close to the tongue tip, the tongue tip may look blunt, forked or have a heart shaped appearance. However, where the membrane is attached further back the tongue may look normal.
Research suggests that approximately 1 in 10 babies may be born with some membrane under the tongue. But only about half of those babies display significantly reduced tongue function, making breast or bottle feeding difficult.
These babies are likely to benefit from treatment to release the restriction that the membrane is having on the tongue and enable to baby to feed effectively.
Tongue-tie practitioners often talk to parents who have had conflicting advice around whether or not their baby has a tongue-tie so it may be helpful for parents, and professionals who do not assess and divide tongue-ties, to have an understanding of what an assessment for tongue tie involves.
The decision on whether or not a tongue-tie is impacting on feeding and whether it is appropriate to offer to divide it should be made after a detailed feeding history has been taken. This will usually include information about the pregnancy and birth and the medical history of both mum and baby. The baby is usually observed at the breast. This may be done by the person who divides tongue-ties or by someone who has been supporting you with feeding, prior to you being referred for division, such as a MW, HV or breastfeeding counsellor/lactation consultant. The function of the tongue will also be assessed to establish if the baby is tongue-tied and if this is impacting on feeding.
Assessment for tongue-tie requires training and skill and involves placing a finger in the baby’s mouth. It cannot be done by just taking a look. Assessment is usually carried out with the baby on the assessor’s lap or a flat surface such as a table or couch. It involves observing how the baby uses their tongue.
Professionals assessing babies for tongue-ties should assess elevation, lateralisation and extension. Elevation can most easily be assessed when baby cries. With the mouth wide open, the tongue tip should lift up to at least the mid mouth. In tongue-tied babies the tongue often stays quite flat in the floor of the mouth or the edges curl up to form a bowl shape or ‘v’ shape. Babies should be able to poke their tongue tip out well over the bottom lip when the bottom lip is stimulated. When the assessor runs their finger along the top ridge of the bottom gum the tip of the baby’s tongue should follow the finger so the tongue sweeps side to side (lateralisation).
Some assessors perform a suck assessment by placing their finger in the baby’s mouth (pad side up, nail side down) and feeling how the baby is cupping and using their tongue. Assessors sweep their finger under the baby’s tongue so they can feel the extent of the tongue tie and the tongue will also be lifted to visualise the frenulum. The appearance of the frenulum is also documented including the shape of the tongue tip, where it attaches to the floor of the mouth and the underside of the tongue and how long and stretchy it is.
Problems which may be due to a tongue-tie:
Nipples which look misshapen or blanched after feeds
Low milk supply
Exhaustion from frequent/constant feeding
Distress from failing to establish breastfeeding
Restricted tongue movement
Small gape resulting in biting/grinding behaviour
Unsettled behaviour during feeds
Difficulty staying attached to the breast or bottle
Frequent or very long feeds
Excessive early weight loss/ poor weight gain/faltering growth
Clicking noises and/ or dribbling during feeds
Colic, wind, hiccoughs
Reflux (vomiting after feeds)
Your baby may not display all of these signs and there can be other causes for these symptoms so thorough assessment by a practitioner skilled in breastfeeding is essential.
Information from https://www.tongue-tie.org.uk/