Tongue Tie in babies, how it affects feeding and what you can do..

Julie Carden is Carmenta Life’s fully qualified Tongue Tie Practitioner, Lactation Consultant () and experienced midwife who has seen great results in fretful babies who have struggled to feed and have been unsettled. If you are anxious or worried about your babies weight gain, if you are struggling to feed your baby or if your baby is unsettled during or after a feed, then read on to find out about Tongue Tie and what you can do to help your baby.

Firstly – What is Tongue Tie?

Tongue tie is also called Ankyloglossia, which comes from the Greek for ‘crooked tongue’. It is a congenital condition where the membrane that attaches the tongue to the floor of the mouth (the frenulum) is shorter or tighter than usual. This may cause restriction of tongue movement, which can cause problems with breastfeeding.

Approximately 1 in 10 babies are affected, commonly more boys than girls, and there is often a family link. Many babies who have a tongue tie grow up with no problems and may not even be aware of it. However, some babies and their mothers suffer extreme breastfeeding difficulties if a restrictive tongue tie is left undiagnosed and untreated.

It all depends on the range of movement and how the tongue functions. If there is restriction of tongue movement, the baby may have problems maintaining a good latch on the breast, or may not manage a good suckling technique. This can lead to Mum experiencing sore nipples, poor milk drainage – which in turn may lead to blocked ducts, mastitis, reduced milk supply. Her baby may be unsettled on the breast, unsatisfied after feeds, want frequent feeds, have poor weight gain, suffer from colic or reflux.

With the correct help and support, a mild tongue tie may only be a challenge whilst mum and baby are learning to breastfeed. A posterior tongue tie might not be obvious to the untrained eye, yet these can cause distressing feeding problems.

If there are continuing issues, even after breastfeeding support and latch correction, a tongue tie might be suspected. A detailed history and assessment of tongue function is necessary to diagnose a tongue tie and it’s severity. If it is restricting the baby’s ability to feed well, it may be beneficial to simply snip the frenulum to aid better tongue movement. This is an easy, quick and safe procedure performed by a skilled and experienced health professional. Often there is immediate improvement with breastfeeding.

The potential side effects are minimal. There are hardly any nerves endings in that area of a young baby’s mouth, so there is little discomfort and the procedure lasts only a few seconds. There is usually only a tiny amount of bleeding and the risk of infection is 1 in 10,000. breastfeeding is encouraged straight away afterwards.

Julie Carden is a Tongue Tie Practitioner, Lactation Consultant (IBCLC), Registered Midwife and Registered General Nurse, experienced and skilled in working with mothers and babies with breastfeeding and tongue tie issues. She can offer the simple and safe procedure of tongue tie division for babies up to 6 months of age at Carmenta Life Wellbeing and Medical Centre in Berkhamsted

Also, within the free drop-in breastfeeding cafe on Thursdays 1-3pm, Julie can offer a free tongue tie assessment. This will involve discussing the breastfeeding history and examining the range of movement of the baby’s tongue, with clear information and discussion of each unique situation.

Some useful links regarding tongue tie in babies:-

Post Frenulotomy Information Sheet

After your baby has undergone the procedure of Frenulotomy, (division of tongue tie), he/she will immediately be picked up and cuddled and pressure applied under the tongue with gauze, should there be a tiny bit of bleeding.  Any crying stops quickly and babies have been known to sleep throughout the procedure!

You will be encouraged to feed your baby as soon as possible in the presence of your Lactation Consultant.  This soothes your baby and you can have help with your latch as needed.  You may experience instant improvement with nipple pain or suckling issues. Sometimes it takes a few days to notice a difference. Occasionally there is no difference.

It is a good idea to breastfeed frequently as your baby needs to, over the next couple of days.  This helps to strengthen the tongue muscle for more effective feeding, and reduce the risk of the frenulum reattaching.

Often a diamond shape, white area develops under the tongue after a couple of days.  This does not appear to be painful and lasts a few days while the area is healing.

There is a minimal risk of infection 1:10,000.  If pus is seen or your baby appears unwell, please contact your GP.  If bottle teats, nipple shields or pacifiers are used, extra care is needed with hand hygiene and sterilising.

Some older babies are a little unsettled following the procedure and Calpol as per instructions may help.

Some parents find Cranio-osteopathy helpful to facilitate optimal movement of the tongue area to improve suckling. This can be discussed.

It is recommended to have a follow up consultation or attend the drop in breastfeeding cafe on Thursdays 1-3pm, a week after the tongue tie division, or earlier if required.

If you have any questions or worries you may contact Julie Carden IBCLC and Tongue Tie Practitioner on 07702 669558 or email or