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Tongue Tie Release

What is tongue tie?

Tongue tie is when the membrane under the tongue (frenulum) is short or tight. Depending on the degree of tongue tie it can affect feeding with either the breast or the bottle.

What is the effect of tongue tie on the breastfeeding relationship?

To effectively suck and remove milk from the breast, a baby needs to have full movement of the tongue. If the baby does not it will cause problems for both the mother and her baby;

Signs and symptoms for Mother

  • Pain
  • Damaged nipples
  • Ineffective breast drainage (leading to blocked ducts +/- mastitis)
  • Reduction in milk supply
  • Exhaustion from the constant/prolonged feeds
  • Early weaning

Signs and symptoms for Baby

  • Inefficient milk transfer due to restricted tongue movement
  • Tires quickly or may feed adequately only during “let down”
  • Loses the latch frequently (coming off the breast)
  • Unsettled behaviour during feeds
  • Frequent or very long feeds
  • Clicking noises and/or dribbling during feeds
  • Colic, wind, hiccoughs
  • Reflux
  • Failure to thrive
  • Poor sucking habit may be difficult to correct
  • Premature weaning

Infant oral assessment

If indicated I can perform an infant oral assessment on the baby. This involves inspecting the oral cavity and digital assessment of the palate, gums and tongue. It also involves checking for normal tongue movement (elevation, lateralisation and extension) and function by observing a feed and having the baby suck on a gloved finger.

Tongue tie release

I am able to perform tongue tie release surgery if indicated following infant oral assessment.

This involves dividing the membrane under the tongue to allow the tongue to move freely.

Babies in general tolerate the procedure very well.

Aftercare

It is important to work with your baby and encourage them to move the tongue in all directions. The main way of doing this is by having your baby feed regularly after division. I have updated my practice following the guidelines where I trained (Russell’s Hall Hospital, Dudley) in the UK. There they do not advocate wound massage as they noted that this increased reformation rates as you are traumatising a wound and increasing the probability of scar tissue forming. They have a recurrence rate of less than 1% with this method. And I have not had a recurrence to date.

Fee

The fee for assessment and tongue tie division surgery is €200

Tongue tie:

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