What's a Tongue-Tie?
It’s a very short or tight frenulum forming a tight string under the tongue. The tongue-tie can tether the tongue to the floor of the mouth and limit its free movement. This can often contribute to feeding problems, particularly with breast feeding. Moreover, it can also cause problems with weaning and later, oral hygiene. Some tongue-tied infants will not have any feeding problems apparent and so may not require treatment.
Tongue-tie division (Frenulotomy) is a quick, simple and safe procedure when performed on babies less than six months old. It involves swaddling the baby in a blanket, holding the baby still and cutting/releasing the tongue-tie. The baby needs to feed from the breast or bottle straight afterwards, as this stops any bleeding and comforts baby.
It’s therefore important your baby has not fed for one to two hours before my visit. There may be rare instances when, using clinical judgement, I decline to carry out the procedure.
My full name’s Gillian Bird, but I prefer Gill. I’m an experienced qualified midwife, trained in tongue-tie division at University Hospital Southampton. I carry out tongue-tie assessment and division in a private capacity in your own home and have insurance cover, CQC registration, ICO registration and NMC registration to permit me to do this work. I’m also a full member of the Association of Tongue-tie Practitioners and attend clinical updates. I do a high number of tongue-tie assessments and divisions, including at an NHS hospital.
I only see and treat infants under six months old.
How much does it cost?
You can make payment by cash, credit/debit card, contactless Apple Pay or Google Pay at the end of my visit.
The parent/legal guardian will need to sign and return an examination/treatment consent form. I will retain this completed consent form but you may request a copy.
Immediately after a tongue-tie division, the baby needs to be put to the breast or bottle which settles bleeding and gives comfort. That’s why it’s so important that the baby is not fed for one to two hours before my visit.
The area under the tongue will be viewed after a feed and an aftercare leaflet and sticker given for baby’s red book.
I’ll call you seven days after my visit to check how your baby is getting on.
This includes a full assessment and the tongue-tie division procedure itself.
The full assessment includes a feeding and medical history, and physical examination to determine if a-tongue tie is present and its type.
Mileage over 10 miles away from me will carry a supplement of £10 – more if you are over 20 miles away.
No anaesthetic is used so the baby has maximum use of the tongue immediately afterwards to feed. The first feed settles bleeding. Fortunately, there are few nerve endings under the tongue, so it’s not thought to be very painful for the baby, maybe like a scratch. Babies generally seem to settle as soon as they feed. Babies over eight weeks old might need a dose of Calpol sometime after.
The wound can ooze blood for longer so a piece of gauze may need to be pressed on the wound. Much nicer to have a feed, which is why your baby should be hungry before the exam/procedure.
There’s about 2-4% chance of a scar forming that can create another tightness where it had been released. A frenulum string itself is unlikely to reform. Wound massage is popular in the US and at a few UK hospitals. However, it’s uncomfortable for baby, invasive to do, carries a risk of infection and isn’t backed up by research to have any positive effect. Simple tongue exercises will be taught.
What if anyone in the household develops COVID-19 symptoms and tests positive soon after the home visit?
You’ll need to contact your tongue-tie practitioner so that isolation measures can be taken. Likewise, your tongue-tie practitioner will alert you if she is symptomatic or has a COVID-19 positive swab. Screening for symptoms, wearing of PPE, minimising contact time and minimising people present are some of the measures that have been incorporated to reduce risk, which can never be fully eliminated.