The procedure
I will wrap your baby in one of your blankets to stop them wriggling. I will ask you to hold your baby's head for me and show you how to do this. I put my fingers in his mouth and gently lift his tongue. The frenulum is snipped with sterile scissors specifically made for this purpose. I will check the division and visualise the muscles at the back of the diamond shape we have created. When I’m satisfied all is as it should be I will apply pressure with a piece of sterile gauze under the tongue for a few seconds and bring the baby to you. The blanket is unwrapped and the baby brought to you to feed immediately, by either breast or bottle. The bleeding will have stopped prior to the end of the appointment. I will then tell you any findings I observed during the procedure and put a plan in place with you about any issues you have risen during our consultation. In the days following division, you may notice a small white blister under the tongue, which does not interfere with feeding.
"I so wish I’d had Lucas’ tongue tie done earlier….. really didn’t realise the difference it would make. No sheilds and I never thought I’d say this but actually enjoying breastfeeding now. Even attempted to feed in public yesterday! Thank you so much!"
Tongue Tie
I was a desperate Mummy with a son who was 100% tongue tied and not feeding. Erika came to our home on a Sunday evening. She really was fantastic and now my son is feeding perfectly.
Tongue Tie assessment with Erika
There are so many reasons a baby may have difficulties learning to feed. One of those is tongue tie. A tongue-tie is a fold of skin that connects the tongue to the floor of the mouth causing some restriction in the movement of the tongue. This leads to problems feeding from the breast or the bottle.
Research done in Southampton shows that over 10% of babies are born with tongue tie. Typical signs of a tongue tie are:
- Sore nipples, despite good latch and positioning technique, misshapen or blanched nipples following a feed
- Unable to sustain latch – coming on and off during the feed
- Dribbling out sides of a bottle
- ‘Clicking’ noise whilst feeding
- Frequent feeding, tiring easily
- Baby weight loss
- Unable to lift the tongue or move from side to side
- Heart-shaped tongue when poking out or lifting
- Mastitis
- Vasospasm
- colic/wind/fractious
- Reduction in milk supply
- Taking a long time to feed from the bottle
- Small gape
- Difficulty rhythmically sucking
The good news is tongue tie is easily treated and the vast majority of mothers find immediate relief and improvements in feeding from that moment. Others, notice an improvement over the next few weeks. The procedure is quick, does not require anesthetic and can be carried out in your home.
I have seen Erika twice in the last 2 years due to breast feeding issues with both of my babies. She is knowledgeable and efficient at getting to the root of the problem. She offers solutions and performs division of tongue tie if needed. I would definitely recommend her to other Mums having trouble establishing breastfeeding.
I so wish I’d had Lucas’ tongue tie done earlier….. really didn’t realise the difference it would make. No sheilds and I never thought I’d say this but actually enjoying breastfeeding now. Even attempted to feed in public yesterday! Thank you so much!
Common questions about feeding and tongue tie:
My baby can poke his tongue out so can’t have a tongue tie which causes an issue?
The tongue moves from front to back. Some babies can poke their tongue out but have restriction from side to side or up and down. Some babies can easily stick their tongues out but still have feeding issues
I’ve been told his tongue tie is not causing the issues because it’s ‘only a little one’.
The size of the tongue tie does not correlate to feeding difficulties. Some babies are 100% tongue tied and have no probems at all. Some have a tiny tongue tie behind the skin and have lots of feeding issues. We do know if there are feeding difficulties and the tie is divided, up to 97% will improve their feeding problems.
He doesn’t have a tongue tie – I cant see anything
It is a common misconception that you can check for tongue tie just by looking. Actually you should always feel for one. Any obstruction you feel may be a submucosal tongue tie. A tongue tie underneath the mucosa which is not easily seen.
My baby is a couple of months old, so why would the tongue tie be an issue now?
Sometimes, as the breasts soften the ejection reflex settles the baby has to work harder with their tongue tie. It is common to find they have more difficulties around 6-8 weeks for this reason.
My baby is a couple of months old so its too late for a tongue tie division.
I and all tongue tie practitioners are trained to divide ties up to 8 months old, although we are aware some local units do not do this, we can assure you it is safe and within our remit.
If you think your baby has a tongue tie which is interfereing with his or your comfort and feeding please contact me for a consultation. During the consultation visit we will discuss breastfeeding or bottle feeding advice and support and assess for tongue tie division. If the procedure is required we can do it then. After the visit you will have contact with me for any concerns following the procedure.
Cost : £200
Please call Erika on 07828719278
Please note, Erika works through Beautiful Births Ltd for her tongue tie procedures. Beautiful Births Ltd is registered with the CQC.
The risks
Frenulotomy is a low-risk procedure, however it is important you understand all the potential risks. I will go over these in detail during our consultation prior to the procedure. Please ask any questions you require.
Risk of excessive bleeding (Data collected by the Association of Tongue Tie Practitioners 2018 suggests the risk of bleeding needing intervention in hospital (adrenaline) is 1 in 7000 and cauterising or suturing 1 in 77,000). On some occasions the bleeding will start again a few hours or days afterwards. It is usually a little amount mixed with saliva of course. Please feed the baby. If bleeding continues apply pressure with a clean muslin. for 10 minutes, avoiding pressure under the chin. If the bleeding continues, reassess that you have applied pressure on the wound. You can contact me directly for advice and reassurance. You will have my number on your documentation after the procedure. You can call 999 and have a doctor’s review at this time. I want to reassure you that although excessive bleeding is a risk to be aware of, I have never had to admit a baby to hospital in the 15 years I have been doing this procedure.
Risk of Infection
This is also rare with an estimation of less that 1 in 12000 (Association of Tongue tie practitioners). However, I still recommend that anything entering the babies’ mouth is clean (Breast or finger) or sterilised (bottles, shields, dummies). If an infection was to occur you would see an ill baby, redness or swelling and pus from the wound, high temperature, high breathing rates. If this happens you should call your doctor or go to and e if concerned. Please also call me. Again I have never seen this in my practice of 15 years.
The procedure may not work 98% of the time we see an improvement leaving 2% no improvement at all. If this is the case, I would like you to keep in touch with me and we will work out the next steps. It is highly likely I will recommend chiropractic or osteopath support for your baby as no improvement confirms there is other fascia which is tight and causing this issue.
Regrowth or reattachment requiring redivision occurs approx. 3% of the time – but only a few of those will need a redivision. You may notice regression in your symptoms around day 5 to 10 which can be muscle fatigue. The full healing may take 4 to 6 weeks to get the full result however, if you are still not happy with your baby’s feeding after within the 4 weeks please contact me and we can discuss another consultation and possible redivision. I will always recommend this is in conjunction with some body work. I have anecdotally noticed that babies who see a chiropractor or osteopath trained and experienced in paediatrics and newborn, rarely need a redivision and have a lower reattachment rate.
Fractious or unsettled after the procedure for 24 – 48 hours (1%). If this happens, please call me for advice or reassurance. It is thought the babies cannot feel the division until around 4 months old however, they will feel the release through their whole body and so for some babies this is unsettling. If this is your baby, please give lots of skin to skin, reassurance and time.
Potential damage to other structures in the mouth. I have never experienced this in my career.
Increased saliva – the saliva glands are underneath where we divide and so the release can stimulate more dribbling. This is temporary and will settle.
Black or brown in the nappy or vomit if your baby has swallowed small amounts of blood.