Information and support about tongue-tie in babies

Congratulations on the birth of your baby.

You have been given this leaflet as you may:

• have been told your baby has a tongue-tie.

• be worried your baby has a tongue-tie.

• have worries about feeding your baby with a tongue-tie.

• want to find out where to get support for tongue-tie.

This leaflet provides parents with information on tongue-tie, and offers support where needed.

We hope this leaflet answers some of the questions you may have. If you have any further questions or concerns, please speak to the Infant Feeding Lead.

What is a tongue-tie?

There is a thin piece of skin under the tongue, called a frenulum. This attaches the tongue to the base of the mouth.

In some babies this skin is tight and short. This can stop the tongue from moving freely. This is called a tongue-tie.

About 1 in 10 babies will have a tongue-tie. Not all tongue-ties will affect how a baby can feed.

A tongue-tie can look different for each baby. Sometimes the frenulum is easy to see, but not always. It is important to feel how the tongue moves. The way the tongue moves can affect feeding.

Some babies may need to have the tongue-tie released. If your baby needs this, you will be referred to the hospital tongue-tie clinic in Kent.

Who can refer my baby to the hospital's tongue-tie clinic?

In Kent, referrals to the clinic are made by:

• lactation consultants; and

• breastfeeding counsellors.

These specialists work in:

• Kent Community Health Foundation Trust (KCHFT) Specialist Infant Feeding Service.

• voluntary and third sector drop-in’s and appointments.

• postnatal ward (not a full-time service).

They are trained to provide feeding support and plans. They use simple assessment tools to identify if a tongue-tie may be affecting the way your baby is feeding. 

Tongue-tie practitioners have in-depth training in tongue-tie. They will make a final assessment in the hospital clinic. They will help you decide if a procedure is right for your baby.

I'm having feeding problems and am worried about tongue-tie, what should I do?

Step 1

• Get feeding support from:

  • your midwife

  • an infant feeding support worker

  • your health visitor

  • your local drop-in group. For more information on breastfeeding support near you, please go to the #BesideYou web site.

• What can they do to help?

  • Breastfeeding

    • Support with how to position and attach your baby.

    • Support keeping up your milk supply. This might include borrowing a breast pump.  

  • Bottle feeding

    • Support with how to hold your baby for feeding.

    • Support with finding the right bottle and teat for your baby.

  • Mixed feeding

    • You will be supported with breast and bottle feeding.

• All babies

  If your feeding problems are not resolved with this support, you can be referred to the KCHFT Specialist Infant Feeding service. See Step 2 below. You will receive a telephone call. If needed, they will offer you a face-to-face appointment.

Step 2

At the KCHFT Specialist Infant Feeding service appointment, you will see an infant feeding specialist. They will assess your baby’s tongue and feeding. They will make a plan with you, which will involve a referral to the tongue-tie service, if it is felt that:

• the tongue-tie is the likely cause of your feeding problem; and

• releasing the tongue-tie is likely to help your feeding problems.

Common questions

• I am not having any feeding problems. Should my baby have their tongue-tie released in case of future problems?

  No. Every procedure has risks, such as bleeding or infection. A baby should only have a tongue-tie released to help a problem that is happening now.

  It is not possible to predict if speech will be affected, and whether treatment as a baby will prevent this.

• Why was my baby’s tongue-tie missed at birth?

  Sometimes a doctor or midwife may mention a tongue-tie at birth. Usually, a tongue-tie is not mentioned unless feeding problems occur.

  Not all tongue-ties can be clearly seen at birth. As your baby develops and grows, a tongue-tie may become more noticeable.

  In both cases, the pathway is the same as described in this leaflet.

• Why aren't all tongue-ties released in the hospital after birth?

  In the early days a baby is learning to feed. It often takes time to find a position to feed your baby and attach them to the breast. Baby is developing sucking skills, and the way their tongue moves is developing. You and your baby are learning together. Many problems may get better with time and feeding support. Feeding support should be given first, to see if things get better without a procedure.

  A surgical procedure should not happen unless necessary.

• Can a midwife or health visitor diagnose a tongue-tie?

  No, they have not received specialist training to diagnose a tongue-tie; but they:

  • are trained to give you feeding help and information.

  • can help identify feeding problems.   

  • can refer you to the specialist infant feeding services.

• I have been given conflicting information about whether my baby has a tongue-tie, what should I do?

  If you have no feeding problems, you will not be referred to the hospital tongue-tie clinic. You can speak to your midwife or health visitor. For information and support, please go to the KCHFT web page Feeding your baby: Kent family.

  If you are having feeding problems, please follow the steps in this leaflet.

• Will they release the tongue-tie if my baby is gaining weight well?

  Yes, if you are having other feeding problems. Some babies will gain weight well with a tongue-tie.

• Should I be worried about a lip-tie?

  There is no published evidence to support a link between breastfeeding and bottle feeding problems and lip-tie. If you are worried, please speak to your midwife or health visitor.

• My baby has already been referred to the tongue-tie clinic, what happens now?

  For more information, please read the Kent Tongue-Tie Service for Babies under 12 weeks leaflet.

Further information

• #BesideYou: breastfeeding in Kent

• East Kent Hospitals. Kent Tongue-Tie Service for Babies under 12 weeks.

• Kent Community Health NHS Foundation Trust. Feeding your baby: Kent family.

Contact details

Please email the Infant Feeding Lead if you have any queries.

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