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What does the procedure involve?

Ideally your baby will have received the vitamin k injection at birth or had a minimum 2 doses of oral vitamin k.  If not you will need to sign a disclaimer that the potential increase in bleeding has been discussed with you 

You will be asked to bring your baby to the appointment ideally settled but willing to feed.  This is important so I can support you with feeding. 

I will call you prior to your appointment to discuss your booking form, what you need to bring and complete the relevant  paperwork.  You will have the opportunity to ask questions. 

The initial part of your appointment will be a thorough  oral assessment to confirm a tongue tie restriction.   Pre & post photographs of your baby’s mouth will be taken as they form part of the health record, 
For the procedure your baby will be swaddled in a blanket.   A parent or other support person will be asked to assist by holding baby’s head still whilst I divide the tongue tie.
To prevent the risks of infection I wear disposable gloves. The scissors used to divide the tongue tie are single use and sterile.  The procedure itself takes no more than a few seconds. Gauze is applied to the wound site to absorb the tiny amount of blood and your baby is brought straight to mum for feeding.  Feeding is important in soothing your baby and helps in assessing any immediate improvement to feeding.  Breastfeeding mothers will be supported with positioning and attachment.
I may also recommend additional support or treatments. (See below) Once your baby has completed a feed I will check their mouth to confirm bleeding has stopped before you are discharged home.
 
If there is no tongue tie the appointment will become a feeding support one as there are still feeding issues that you need support with, 

What symptoms might I see if my baby is tongue tied?

There are many signs and symptoms of a tongue tied baby. 
The most common problems for mum are sore/damaged nipples, pain during feeding which persists after the initial latch, a misshapen nipple (lipstick shape) post feed, reduced milk supply or repeated episodes of engorgement or mastitis.
Tongue tied babies can have difficulty latching resulting in nipple feeding or they may have trouble maintaining a latch so slip off the breast frequently.
Your baby may lose more weight than expected, have slow weight gain, static growth or continued weight loss, sometimes dropping percentiles.
Your baby may tire very quickly during feeding, spend a long time feeding & still be unsettled afterwards or want to constantly feed. Hiccups, and wind are very common in tongue tied babies.
 

If you are bottle feeding your baby may take a long time to complete a feed, dribble milk out the sides of their mouth, choke or splutter and be very noisy when feeding

I'm not sure if my baby is tongue tied

If you are experiencing any of the symptoms I have mentioned & you think your baby might be tongue tied despite being told otherwise, I recommend you book an appointment with me so that I can carry out a thorough oral assessment of your baby. I will then discuss appropriate treatment options with you.
 
Please visit the gallery where you will find photographs of babies with tongue tie and additional information.

Will it hurt my baby?

Parents who have brought their baby to me have themselves had a tongue tie division as an adult.  They felt it as nothing more than a sting similar to if you accidentally cut yourself for example.  The procedure takes just a few seconds. Feeding and closeness with a parent is a wonderful way to soothe your baby both immediately after the division and in the couple of days afterwards.   If you are breastfeeding your baby will receive pain relief naturally,  Older babies may benefit from paracetamol. Ensure you follow guidance from the manufacturers.

What additional support or treatments might you suggest?

Tongue tie division should not be seen as a stand alone procedure or miracle cure. Whilst it’s benefits are widely evidenced babies need time to adapt to the increased mobility of their tongue. On going breastfeeding support is hugely beneficial during this time. This can be provided by midwives, health visitors or local breastfeeding support groups. If you would like 1:1 support you can arrange a follow up with myself for a small additional fee.
If there is concern about reduced milk supply I may recommend that you express for a few days to increase your supply. .
I might also suggest you seek treatment for some body work from an Osteopath or Chiropractor.   My rationale would be based around the position your baby was lying during your pregnancy, your birth experience or the type of delivery you had. It is entirely your decision as to whether you seek this as a follow on treatment.

What is the recovery time after the procedure?

All babies are unique. Your baby will need time to figure out how to use their tongue more efficiently after the restriction has been released.  They may also have a small ulcer under their tongue where the division took place that can be a little sore. In general babies are a little unsettled for approximately 48hrs.
It can take at least two weeks, sometimes longer for everything to settle down, the wound to heal and feeding to get established.

What follow up support do you provide?

Parents can contact me Monday to Saturday 8am – 6pm if they have questions or concerns.  I follow up all parents by text 2-3 days after their appointment. Depending on the situation I may continue to follow up parents for as long as is necessary. Sometimes up to 4 weeks after the procedure. For parents who would like a 1:1 follow up with me, I offer support for a small additional charge.

Do you divide lip ties?

Currently in the U.K. there is no solid evidence to support such a thing as a lip tie let alone the need to divide one.  It is incorrect to suggest that the upper lip needs to flange out during breastfeeding. The upper lip remains in a neutral position during breastfeeding and serves to stabilise the breast in the baby’s mouth. If it was to flange out the baby wouldn’t have a good seal around the breast resulting in a shallow latch and nipple feeding.  Sometimes a tongue tied baby might flange out their top lip as a compensatory mechanism because they can’t use their tongue correctly. The issue can be resolved once the tongue tie is divided.
 
For more information on lip ties please visit the Association of Tongue Tie Practitioners website.

What are the benefits of a private tongue tie division service?

Choosing a private practitioner gives you a greater choice of location and appointment times  Most appointments can be made within a few days.

All appointments are individualised as we recognise that no two mums & babies are the same.

All services and pricing are on the website. There are no hidden extras.

I am a registered midwife and lactation consultant so you have access to skilled feeding support after the division. Your appointment will last around an hour. I will take a full feeding history from you, discuss tongue tie in greater detail, and you will be given the opportunity to ask questions. You will be supported with feeding immediately post division and together we will develop a feeding plan.

All parents receive telephone follow up after a couple of days. I am available 5 days a week so you can contact me for support and to discuss any questions or concerns you might have. I also provide a follow appointment service for ongoing feeding support or possible further division.   Please note that telephone calls, text messages or emails will not be responded to out of office hours, during times of illness or annual leave or during public holidays.  If you have concerns about your baby during these times you are advised to see your GP or ring 111.