tongue tie release in a baby

Tongue Tie in Babies and Infants

Information for Parents

tongue tie

    Dr. Reynolds is an experienced Consultant Paediatrician based in Surrey, UK. He has dual certification on the GMC Specialist register, with subspecialist registration as Neonatal Consultant, so he particularly specialises in conditions affecting babies and infants.

    He is available for private newborn examinations, to deal with tongue tie in newborns using a local anaesthetic, and to manage problems such as lumps (including treatment for "strawberry" birthmarks), vomiting and reflux, colic and feeding issues as well as growth and developmental concerns. To contact his secretary phone 07564 184 010

    The information below on tongue ties has been written by Dr. Reynolds and is based on his UK practice.

    If you would like an appointment for your baby or infant for any problem or a check up, or to see Dr Reynolds for prompt treatment of your baby's tongue tie, which can be treated under local anaesthetic up to 6 months age then further details are at the bottom of this page

    What is a tongue tie? A tongue tie is a membrane that extends from the underside of the tongue, in the middle, to the bottom of the inside of the mouth. The pictures at the top of this page show the membrane under the tongue, with a cotton bud used to gently lift the baby's tongue upwards.

    The picture on the left, below shows a more severe tongue tie with the membrane extending right to the tip of the tongue. The picture on the right shows an apparently milder tongue tie.


    tongue tie in baby              tongue tie in baby

    How common is it? Estimates vary, but a commonly quoted figure is that 1 in 20 babies has some sort of tongue tie (some people think its even more common). It's commoner in boys and there may be other members of the family who have also had a tongue tie.

    Many tongue ties are minor and do not require treatment. However a tongue tie that is interfering with breast feeding may require assessment with a view to possible treatment (frenotomy). Some bottle fed babies will also benefit from tongue tie release. The assessment should be carried out by someone with experience in this field.

    Can my baby breast feed with a tongue tie? Some can, some manage OK, some find it difficult, and some can't. Some babies also have trouble bottle feeding and may dribble excessively, or swallow too much wind. The difficulties a baby is having do not always depend on the visual appearance of the tongue tie.

    What are the symptoms of a tongue tied baby? Sometimes mothers will experience painful feeding, grazing or damage to the areola or nipple, or even mastitis. Babies may latch on poorly, require several attempts to latch and become frustrated. They may make a clicking noise when feeding. Feeding may be prolonged, and the baby may still be hungry and be irritable, or be ready to feed again within an hour or two. Some babies have problems with excessive wind and may be in pain or suffer from vomiting as a result of swallowing wind. Sometimes babies can be diagnosed with reflux which may improve after treatment of the tongue tie. These are some of the more common symptoms of a tongue tie.

    The baby who had the tongue tie in the image above on the left was not having as many problems feeding as the baby with the tongue tie on the right. Both improved with their feeding after division was performed. So a tongue tie may not look dramatic but may still be causing significant restriction of tongue movement.

    Will it affect my baby's speech later on? Again it depends, but most tongue ties won't affect speech. However since they are much simpler to treat when a baby is young, it may be better to have treatment if, for example, there is a family history of speech difficulties related to tongue tie

    Who can treat it? The procedure, which is called a frenotomy, is safe in the hands of those who are trained and are able to administer pain relief and deal with any unexpected issues. A medical assessment by a paediatrician is an important part of the check-up, as parents may also wish to discuss other health concerns and feeding issues about their baby.

    Why do some doctors and midwives think tongue ties are not important? Nowadays we aim to promote breastfeeding much more strongly than in the past, because of the health benefits to the baby and to the mother. Our knowledge on what makes babies breastfeed successfully has also increased. As a result there is more evidence that the presence of a tongue tie can interfere with feeding. The National Institute for Health and Clinical Excellence have stated that division of tongue tie may be beneficial, and there is a parent information sheet to read. **

    How is it treated? Firstly the parents should understand the chances of improvement in symptoms after tongue tie division. Division is painful unless a local anaesthetic is used. Tongue tie treatment is carried out by carefully cutting the tongue tie under the tongue. It is a quick procedure and your baby will be able to feed afterwards. Sometimes there may be a small amount of bleeding, but this stops after a minute or so in most cases. Babies can be fed straight afterwards, and there is no special after-care needed.

    Treatment decisions should not be based solely on the information in these pages.


    Tongue Tie Specialist

    Dr. Peter Reynolds, a Consultant Neonatal Paediatrician (this means that he specialises in looking after newborn babies) has a particular specialist interest in the assessment and treatment of tongue tie in babies and infants. He has helped hundreds of babies with this condition to feed more successfully having collected substantial feedback from parents over the years of the positive effects of a tongue tie release on feeding. So you can be reassured that your baby's tongue tie release will be quick, safe and painless.

    Your baby will be treated in the outpatient clinic, so Dr. Reynolds will see you to answer any questions that you have, and will then carry out the procedure at the same visit. No need for hospital admission or further consultations. Your baby will be medically examined, to rule out any likely problems with division and also to rule out any other reasons why breast feeding is problematic.

    Will it be painful? Dr. Reynolds uses a combination of pain-relievers including a local anaesthetic to ensure that the division is not painful for your baby. No needles/injections are used. He does not believe that any baby should have a surgical procedure, however "minor", without pain relief. Some babies even sleep during the procedure!

    Do I have to hold my baby whilst it is carried out? No. This is a frequently asked question, and is one of the reasons that a Paediatric Nurse assists with the procedure.

    Is it safe?Yes - you have the reassurance of carrying out the procedure in a fully equipped hospital, and for it being performed under local anaesthetic by an experienced Consultant. Dr. Reynolds has been treating tongue ties in babies and infants for many years.

    How can I get an appointment?

    Dr Reynolds has a Private Practice at the Princess Margaret Hospital, Osborne Road, Windsor, SL4 3SJ where babies with tongue tie can be seen and treated (if needed at short notice) usually on a Tuesday. Dr Reynolds is registered with BUPA, Aviva, AXA-PPP, Cigna, Simply Health, Standard Life etc. Insurers may require a GP letter, and your policy number and authorisation code will be needed. Sometimes there is an excess payable, please check the policy carefully.

    What if I don't have private health insurance?You don't need to have private health insurance to be seen, and you can book and pay for a private consultation directly. A single appointment is all that is usually required to examine and treat your baby's tongue tie. Contact Elspeth (Secretary) on 07564 184 010 - leave a message and she will get back to you promptly, to book a private appointment. You can also email his secretary at

     

     

    Links

    NICE Guidance on Division of Ankyloglossia (Tongue Tie)

     

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    Legal Disclaimer: All information on this webpage is subject to change without notice and no liability or responsibility is claimed or accepted for any of the information presented herein. No claims of treatment are intended or given. If you are worried about yourself or any member of your family you should see a doctor or responsible health professional.