Tongue tie (frenulotomy)

What is Tongue Tie?

Tongue tie occurs when the frenulum, a stringy piece of connective tissue under the tongue, is too short. It is there from birth, but may only be identified due to difficulties caused with breastfeeding your baby. If the frenulum is too short, then the baby cannot extend it’s tongue easily. This results in it being difficult for the baby to suck effectively on the breast.
The required vacuum for effective breastfeeding is not achieved and often a clicking sound is heard during feeding. The baby is unable to suck effectively which will mean that the milk production will not be properly stimulated. This can mean the baby becomes frustrated and unsettled. If the milk production is not effectively stimulated, then the baby may not receive enough milk or grow properly. Also, your nipples may become cracked and sore due to an incorrect sucking technique. Even if your baby drinks formula milk from a bottle, there may be difficulties with feeding as the vacuum required for sucking is also important with a bottle. If this vacuum is not effective, then the baby may take in air with the feed which can cause stomach cramps. 

Tongue tie can be easily remedied. The usual method is to use a special pair of scissors to release the tight frenulum. This takes about 0-5 seconds. Your midwife can do this procedure at home.

Tongue tie release will happen as follows:

1. The baby will be placed on the changing table or safe surface with it’s head towards the midwife;
2. The midwife will lift the baby’s tongue using her forefinger and thumb or a special ‘spoon’; 
3. Using a small sterile pair of scissors, she will cut the frenulum close to the tongue to avoid damage to the glands under the tongue;
4. If the frenulum is very tight, it may be necessary to make 2 or 3 small cuts to ensure it is released.

There is usually a small amount of bleeding afterwards. Pain relief and antibiotics are not necessary. Following the release of the tongue tie you will usually see immediate result. It can take a little time for the baby to re-learn sucking with the increased mobility of the tongue. You can feed your baby immediately after the procedure. 

If you are experiencing feeding problems, we can assess the baby’s tongue to see if there is a case of tongue tie and whether it is necessary and/or possible to release the tongue tie. Contact us or ask us during a home visit if you suspect tongue tie.