Reasons for Treating Tongue-tie

The treatment for tongue-tie is a simple procedure called a frenulotomy (sometimes called frenotomy or frenulectomy). Not all babies and children with tongue-tie need treatment, some may be fine without it. National guidance from the National Institute of Clinical Excellence (NICE guidelines)suggests that frenulotomy is usually safe for young babies and could help with breastfeeding problems. Frenulotomy may be recommended in babies up to 6 months of age if there are;

Difficulties with Breastfeeding for baby which may/may not include the following;
  • Poor weight gain
  • Prolonged jaundice
  • Fractured frequent feeds
  • Baby feeding ‘all the time’
  • Baby appearing unsatisfied after a feed
  • Agitation and frustration whilst feeding
  • Head-rocking or waving on approaching the breast for a feed
  • Noisy clicking or lip noise whilst feeding
  • Dribbling of milk during a feed
  • Falling asleep prematurely during a feed
  • Multiple attempts at latching or maintaining latch
  • Use of expressed breast milk or artificial milk supplements
Difficulties with Breastfeeding for Mother may include;
  • Distortion and or compression of the nipples resulting in pain, damage, loss of tissue
  • Incomplete milk transfer by baby resulting in engorgement and/or mastitis
  • Poor initiation and maintenance of maternal milk supply

The presence alone of a visible or anterior sub-mucosal (hidden/posterior tongue-tie) is not an indicator for treatment with frenulotomy. Tongue mobility is the critical factor that affects breast feeding.

In the UK, the National Institute for Clinical Excellence (NICE) operational guidance regulates our practice in the treatment of tongue-tie. NICE states that the procedure to divide a tongue-tie should be carried out only to assist mother and baby to breastfeed more effectively. Frenulotomy should not be undertaken as a procedure for concerns that parentsmay have about their baby’s future ability to speak, eat or for cosmetic reasons.

For more information about our Tongue-tie procedure, please read the Tongue-tie Assessment, Diagnosis and Treatment Guide.