Neonatal and infant tongue tie

What is a tongue tie?

The frenulum is a piece of tissue that attaches the underside of the tongue to the bottom of the mouth. A tongue tie is where the frenulum is too short or too tight.

How common are tongue ties?

Tongue ties happen in about 1 in 20 babies.

What problems do tongue ties cause?

Most babies with a tongue tie will have no problems at all. Some babies with tongue ties can breastfeed perfectly. Some babies can have problems with breastfeeding and a few have difficulty bottle-feeding. Many parents worry that tongue ties will cause problems with speech later on in life but this is very rare.

Should my baby have their tongue tie treated?

If you are worried that a tongue tie might be affecting your baby’s breastfeeding then you should see your midwife, health visitor or infant feeding specialist for information and support.

Most babies with a tongue tie do not need any treatment. If you are experiencing problems with breastfeeding then dividing the tongue tie may help. Problems could be difficulty latching on, nipple pain or discomfort.

Not all babies with a tongue tie and problems breastfeeding will benefit from having the tongue tie divided. About 80 percent of mothers will feel that breastfeeding has improved after the tongue tie has been divided.

What are the alternatives to dividing the tongue tie?

You can continue to breastfeed with support from your health professional, breastfeeding peer supporter or continue to give your baby your own breast milk by expressing and giving it to your baby by cup, spoon or bottle. You will be given support and help to do this.

What does dividing a tongue tie involve?

In babies up to 6 months of age, it is possible to divide the tongue tie in the outpatient clinic in hospital. You will be seen by the doctor who will ask about your baby and the tongue tie. They will explain about the procedure.

Your baby will be carefully wrapped and held. The tongue tie is divided using sterile scissors. It only takes a few seconds and your baby will be able to feed straight away.

What are the risks?

Potential risks are very low but can include:

• bleeding
• infection
• an ulcer on the underside of their tongue
• pain
• damage to their tongue
• damage to their salivary ducts
• the tongue tie reforming

What happens after division of the tongue tie?

You will be able to breastfeed straight away if you want to. You can ask for a private area to breastfeed in the clinic but sometimes the clinics are very busy and there may be a wait for this.

You will be allowed home with your baby once the doctor in clinic is happy there has been no bleeding or other complication.

Many mothers feel that it takes a few days to get used to breastfeeding after the tongue tie has been divided.

You can contact your midwife, health visitor or peer support worker via your nearest family centre for further support. You can also contact you local Children’s Centre who can put you in touch with a local Breastfeeding Peer Supporter.