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An adult gently kisses a baby’s face while holding the baby close. An adult gently kisses a baby’s face while holding the baby close.

I’m Worried My Baby Has Tongue Tie

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Tongue tie (restricted frenulum) is a common condition where the strip of skin under the tongue is shorter or tighter than usual. It can sometimes affect feeding and how the tongue moves, which can be worrying for you or your child. The good news is that support and guidance are available, and many people find simple ways to manage or improve the problem.

More about i’m worried my baby has tongue tie

Some tongue-ties (restricted frenulum's) are easy to see and may be picked up soon after birth. Others are less obvious and may only be identified if your baby has feeding difficulties which can not be resolved with skilled support. Tongue-tie (restricted frenulum's) affects approximately 1 in 10 babies.

For your baby to attach to the breast and feed well, they need to be able to open their mouth wide, bring their tongue forward, and take a good portion of the breast into their mouth. Their tongue then needs to move in a coordinated way to remove milk effectively.

There may be times when it is not appropriate for your baby to be referred into our service but this will be discussed with you by the Health Care professional. This might happen for babies older than 14 weeks, babies with complex health conditions and/or under Paediatric care, cardiac conditions, family history of clotting disorders e.g. haemophilia and babies who have not received IM (injection) Vitamin K or 2 oral doses of Vitamin K.

For these infants an NHS referral can be completed by your GP to hospital services. We ask that your baby’s immunisations are not given/booked within 72 hours of your baby’s appointment.

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Questions and answers

What is a tongue-tie (restricted frenulum)?
This is when the lingual frenulum, which connects the tongue to the floor of the mouth, is found to be tight or thick in structure. Sometimes, the frenulum can restrict tongue movement and impact on feeding, this is also known as tongue tie. Not all lingual frenulum restrictions cause feeding difficulties.
What impact does tongue tie have on feeding my baby?
Feeding challenges can show in different ways for both your baby and you. Your baby may find it hard to latch on or stay attached, may slip off the breast during feeds, or feed for long periods (often over 40 minutes). Some babies fall asleep at the breast, make clicking noises, or seem unsettled and still hungry after feeding. Feeding may also look messy, and there may be concerns about slow weight gain. You may experience pain during feeds, sore or cracked nipples, a reduced milk supply, or repeated symptoms of mastitis. These difficulties can have causes other than tongue-tie (restricted frenulum), so getting skilled breastfeeding support is very important.
What will happen if I am referred to the tongue tie service?
Before a referral is made, a full breastfeeding assessment will be carried out by a health professional. If your baby is experiencing feeding difficulties that have not improved with additional support, a referral for a tongue-tie assessment may be considered and discussed with you. In some situations, it may not be appropriate to refer your baby to this service. This will be explained by your healthcare professional. For example, this may include babies over 14 weeks old, those with complex health needs or under paediatric care, babies with heart conditions, a family history of clotting disorders such as haemophilia, or babies who have not received Vitamin K. In these cases, your GP may refer your baby to a hospital service instead. Please ensure your baby does not have any immunisations booked within 72 hours of the appointment. Waiting times can vary depending on demand, so speak to your healthcare professional for the latest information.
What should I expect to happen at the appointment?
On arrival, please wait in the reception area. You will be greeted by the tongue-tie practitioner. Your partner, relative, or friend are welcome to join you. We kindly ask that suitable childcare arrangements are made for younger siblings as it is not appropriate for them to come into the appointment room. There will be an initial discussion around your feeding, birth and medical history. An oral assessment will be carried out, with further discussion of your options. (Please scroll down and click on the link titled Tongue Tie Assessment for a video showing an oral assessment video). If a tongue tie (restricted frenulum) has been identified, the procedure will be offered at your appointment. If you choose not to have the procedure, then further feeding support will be offered, your decision will be respected and supported. Written consent is required prior to the procedure taking place.
What does a tongue tie procedure mean?
The tongue tie release is simple and quick. Your baby will be securely wrapped in a blanket and held by a member of staff, on a bed. You are welcome to be present in the room during the procedure. Babies tongue tie (restrictive frenulum) will be released using a sterile technique. There may be a small amount of bleeding post procedure, this is very normal. You will be asked to feed your baby immediately after the procedure. This is why we ask you not to feed your baby before the procedure.
What will happen after my baby has had the tongue tie procedure?
Following the procedure, you will be given guidance on how to care for your baby and support feeding. This includes advice on caring for the wound, gentle exercises for your baby (with a video to guide you), responsive feeding, and where to find ongoing support. Some parents notice an immediate improvement after a tongue-tie release. However, because the tongue is a complex muscle, it can take up to four weeks for a baby to learn to feed effectively. During this time, we encourage you to continue accessing local breastfeeding support for ongoing help and reassurance.
How will I know I have an appointment?
You will be notified about your appointment, by letter, email and or telephone call with instructions on what to bring and how to prepare for your baby’s appointment. It is very important that you follow the guidance in preparation for your appointment as it may impact on the practitioner ability to carry the assessment and procedure.

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