Babies who have Tongue-tie – Assessment & Treatment Options in Cambridge
Tongue-tie is caused by a tight frenulum (skin under the tongue) which restricts the mobility and function of the tongue and may affect the baby’s ability to breast/bottle feed effectively. It’s also called Restrictive Lingual Frenulum.
All practitioners should inform you about the benefits and small risks of tongue-tie release, enabling you to make an informed decision about the treatment options.
For NHS treatment, parents see the baby’s GP, Health Visitor (HV), or midwife first. They can refer to the providers below. The Infant Feeding team at the Rosie Hospital can refer babies, if the Community Midwife contacts them.
NHS in Cambs & Peterborough will fund tongue-tie assessments and treatments for babies up to 16 weeks, if causing problems for baby or mother. NHS assessment and treatment is free.
This information must be included in the referral email or form:
Baby’s full name, date of birth, NHS number (and hospital number if available).
Mother’s full name, home address and contact phone number, and the baby’s GP’s full name and address. A brief reason for referral (for example, breastfeeding difficulties not resolved after help with positioning and attachment.) NNU require further information as on their referral form.
Oral Surgeon Mr Simpson and his team are trained to release all types of tongue-tie.
Mr. Simpson, Dept. of Oral Surgery, Bedford Hospital, Kempston Rd., Bedford MK42 9DJ
For babies up to 18 weeks
NHS referral is needed, by Community Midwife, Health Visitor or GP, preferably with documented observation of tongue-tie from a breastfeeding drop-in and a referral letter. NHS staff send referral letter to: firstname.lastname@example.org
The paediatric surgery department takes referrals, which must be sent to the Booking Co-ordinator. An appointment will then be given to see a paediatric surgeon in an available outpatient clinic slot. There is no set clinic specifically for this procedure so appointment times may vary.
They will see babies up to 12 weeks. They do not usually divide posterior tongue-ties.
Referrals should be sent by E-Referral. Contact: Natalie Thurston, Booking Co-ordinator for Clinic 6: Tel 01223 254987
Norfolk & Norwich Hospital (NNU)
Contact: Mr Ashish Minocha, Consultant Paediatric and Neonatal Surgeon,
Tel: 01603 286356 – Mrs Penny Slaughter (secretary). Email email@example.com.
Fax: 01603 287584 (Check if procedure is available on the NHS or as a private patient.)
NNU takes referrals from GPs, HVs, and midwives, including Community Midwives, using the NNU referral form. NHS staff send the form by email to: Nnufirstname.lastname@example.org
Private treatment – Lactation Consultants
This website lists International Board Certified Lactation Consultants (IBCLC) with specialist training in breastfeeding support and tongue-tie release, who are also registered health professionals:
Association of Tongue-tie Practitioners: www.tongue-tie.org.uk Click on the page ‘Find a tongue-tie divider.’
A private practitioner will be able to see you at home or in a clinic setting to assess and release the tongue-tie if appropriate and with your informed consent. The procedure costs approx £175. Discuss aftercare with her when booking: some practitioners include repeat visits (if needed) or phone calls in their package; some cost these separately.
About the procedure
Both NHS and private health care providers will assess your baby/feeding and advise if they think that tongue-tie division would help with feeding. If it is needed, it can be done there and then, if you agree. The procedure takes about 40 seconds. It is done without anaesthetic for young babies, because the procedure is considered less invasive than anaesthetic. The baby is then handed back to the mother to feed immediately.
Continuing support needed
Improvement may be noticeable immediately or it may take two to four weeks for feeding to improve. Support with techniques that help improve tongue function is advised after release of the tie. This is available from the free breastfeeding drop-ins clinics in the Cambridge area, or discuss with your private practitioner.
Hand expression/pumping and breast compressions can support your supply and milk transfer to your baby while tongue function improves:
You may need to express milk for your baby before he/she can feed well, perhaps after the tongue-tie is divided as well as before. Please see the Rosie Hospital information pages: http://www.cuh.org.uk/pregnancy-labour-and-birth/after-birth/postnatal-care/feeding-your-baby/community-support
for a list of electric pump agents in this area. Hand expression works well for many mothers, see ‘Off to the Best Start’ leaflet.
Breast compression can help milk transfer and supply for these babies: compress your breast while your baby is sucking to deliver more creamy milk and release when he pauses. See: www.breastfeedinginc.ca for helpful video.
Websites for parents and health professionals:
www.lcgb.org (Lactation Consultants Great Britain)
www.nice.org.uk (national guidelines)
www.cwgenna.com (images of tongue-tie, parent-friendly website)
www.breastfeedinginc.ca (pumping, supplemental feeding, breast compression)
http://newborns.stanford.edu/Breastfeeding/MaxProduction.html (increasing pumping effectiveness)
www.mobimotherhood.org (supply issues)
www.ncbi.nlm.nih.gov/pubmed/15953322?dopt=Abstract (randomised controlled trial research)
http://thebirthhub.co.uk/talks/about/feeding-your-baby/tongue-tie-stories/ (mothers’ experiences)