A Free Guide to Tongue Ties

The big question is what is a tongue tie?

A tongue-tie can be diagnosed if the membrane under the tongue, also known as a frenulum, is restrictive enough to cause reduced tongue movement and feeding problems. We all have a frenulum under our tongues when it does not permit the tongue to move freely, we can call it a tongue tie.

Some tongue-ties are relatively easy to spot, the frenulum is attached very close to the tip of the tongue and gum line. When a baby cries there is little lift of the tongue and often the tongue appears heart-shaped.

However, many tongue ties cannot be diagnosed by just looking in a baby’s mouth. If the frenulum is posterior, this means it is further back in the mouth, or submucosal, one cannot tell just by looking into the mouth. A full assessment needs to be made, as it is easy to miss a posterior tongue tie.

When assessing a tongue tie it is important to consider the impact that it has on feeding, the baby and Mum. Both posterior and anterior tongue ties can cause significant problems and affect both breast- and bottle-fed babies.

If in doubt always get a skilled practitioner to assess, rather than just accepting that there is or is not a tongue tie present.

Symptoms can include, but are not limited to the following:

• Difficulty latching

• Painful feeding

• Mis-shapen or blanched (pale/ white) nipples at the end of the feed

• Clicking

• Fussy unsettled behaviour

• Low milk supply

• Slipping down the nipple

• Coming on and off the breast

• Difficulty controlling the flow of milk

• Leaking lots of milk as the baby is unable to form a good seal

• around the breast or bottle

• Excessively long feeds OR very short frequent feeds

• Excessive weight loss by day 5 or poor/slow weight gain

• Clicking

Tongue-tie division, also known as frenotomy, can help to improve feeding and reduce pain for Mums. However, it is also extremely important to get good feeding support as early as possible if you are experiencing problems. You can watch good breastfeeding attachment here.

Myth: “It’s normal for you to feel pain until your nipples toughen up.”

Fact: This is an indication that something isn’t quite right. Get some skilled help as soon as possible ideally from an IBCLC lactation consultant, a practitioner who has undertaken additional extensive training to support breastfeeding.

Some NHS areas have fantastic infant feeding support so you may only need someone to divide the tongue tie and your midwife or health visitor can refer you to the NHS service or you can use a private practitioner if there is a delay.

There are many tongue tie dividers who are also lactation consultants who are more cost-effective if you go privately. You can find a register of tongue-tie practitioners here.

You can download a FREE shareable PDF of this and many other resources here.

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Regina is an independent midwife, IBCLC lactation consultant and tongue tie divider.

She visits her clients in their home rather than a clinic and offers services to families living in north, east, west, and central London and the London borders of Essex and Hertfordshire.

Regina provides one-off services for tongue-tie divisions AND additional breastfeeding support on a longer-term basis. You can find more information on her website here.