Feeding & Tongue-Tie Information | FAQs
We believe parents deserve clear, evidence-based information. Below you’ll find answers to common questions about breastfeeding, bottle feeding, reflux, tongue-tie assessment and division, appointments and policies.
Tongue Tie Assessment & Division – Frequently Asked Questions
What is tongue tie? Tongue tie, or ankyloglossia, is a condition where the thin tissue (lingual frenulum) that connects the underside of the tongue to the floor of the mouth is shorter or tighter than usual. This can restrict the movement of the tongue, potentially causing breastfeeding difficulties or other related issues. Not all lingual frenulum cause problems. We only recommend treatment if feeding function is affected.
Some common signs include: - Painful or shallow latch - Clicking, gulping or leaking milk during feeds - Prolonged or very frequent feeding - Poor weight gain - Reflux-like symptoms or excess wind - Nipple damage or recurrent blocked ducts - Difficulty staying latched However, these symptoms can have more than one cause. A full feeding and oral function assessment is essential before diagnosing a tongue tie.
What does a tongue tie assessment involve? Our assessment is comprehensive and feeding-focused. It includes: A detailed history taking - Pregnancy, labour and birth, feeding, weight issues, any maternal health issues and much more Observation of a breast and/or bottle feed A comprehensive oral assessment Assessment of tongue function and appearance Discussion of findings and treatment options We assess function - not just appearance - as this helps us determine whether treatment is indicated.
What happens during a tongue tie division? If clinically indicated and you choose to proceed, a tongue tie division (frenulotomy) is a quick procedure where the tight frenulum is carefully released. The procedure itself takes only a few seconds. Babies are gently swaddled, and their head is supported throughout. Your baby’s mouth is carefully opened and the tongue lifted. Sterile, single-use, round-edged scissors are used to make a small incision in the frenulum to release the restriction. A small piece of sterile gauze is applied briefly to manage the small amount of bleeding. Your baby is returned to you immediately for comfort and feeding. Most babies feed straight away after the procedure. We observe a full feed before you leave and provide written aftercare guidance, exercises (where appropriate), and ongoing support.
Will it hurt my baby? The procedure is very quick. Babies often cry briefly due to being held still rather than pain itself. Feeding immediately afterwards is both comforting and helps settle them. Most babies feed calmly straight after.
Is there bleeding? A small amount of bleeding is normal and usually stops within minutes with feeding and gentle pressure. Significant bleeding is rare. We screen carefully before treatment to ensure it is safe to proceed.
How long does it take to heal? Healing is usually very quick. As the area heals, you may notice a white patch forming under the tongue. This can sometimes have a yellow or slightly green tinge and may look similar to a mouth ulcer. This is a normal part of the healing process. The white patch typically appears within 24–48 hours and gradually fades over 7-10 days. As healing progresses, the edges of the wound may look slightly raised, and in some babies the area can appear dark red or orange. This is also normal and does not indicate infection. If you ever have concerns about healing, bleeding, feeding changes or signs of infection, we encourage you to contact us for advice.
Do I need to do exercises afterwards? We provide tailored aftercare advice and an Exercise Factsheet. Gentle facial and oral exercises are recommended to support mobility and reduce reattachment risk - the best exercise is feeding! We guide you carefully and ensure you feel confident before leaving clinic.
Can older babies be treated? We routinely treat babies up to 6 months old. For babies aged between 6-12 months we make a judgement based on the size and temperament of the baby and how many teeth they have. For more complex cases, we will refer to a paediatric ENT consultant if treatment is more appropriate in a hospital setting.
What if my baby is bottle fed? Tongue ties can affect bottle feeding too. Symptoms may include: Clicking Dribbling Coughing or spluttering Reflux symptoms Poor weight gain Assessment is functional and relevant for all feeding methods - breastfeeding, bottle feeding, or combination feeding.
What are the risks? Tongue tie division (frenulotomy) is considered a low-risk procedure when carried out by appropriately trained and experienced practitioners in a regulated setting. However, as with any procedure, there are potential risks. These may include: Bleeding – usually minor and stops quickly with gentle pressure. In very rare cases, bleeding can be more significant and may require further medical assessment or hospital admission. Temporary discomfort or fussiness – some babies may be unsettled for a short period after the procedure. Risk of re-attachment – scar tissue can occasionally reform, particularly if oral movement remains restricted. Infection – very rare in the mouth due to its rich blood supply, but possible. Damage to surrounding structures – extremely rare, but includes potential injury to nearby tissue such as salivary ducts. No improvement in feeding – while many families see benefit, outcomes can vary depending on underlying factors. We carry out a full assessment before recommending treatment, discuss all risks and benefits in detail, and only proceed where it is clinically appropriate and in your baby’s best interests.
What follow-up is provided? We: Observe a full feed after the procedure Provide personalised written aftercare and exercises and recommendations Offer WhatsApp/email support Arrange a routine follow-up call Offer face-to-face review if preferred Feeding support continues beyond the procedure - because division alone does not solve feeding without skilled support.
Mothers may experience:
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Pain and/or nipple damage resulting from a shallow latch
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Prolonged feeds or short and frequent feeds
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Blocked ducts/mastitis from incomplete breast drainage
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Decreased milk production due to inefficient feeds (and top-ups)
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Exhaustion from frequent/constant feeding
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Distress from 'failing' to establish breastfeeding
Babies/toddlers may exhibit:
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Consistent clicking noise during feeds, indicating a repeated loss of suction
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Inefficient, long feeds resulting in exhaustion and frustration
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Leaking of milk from sides of mouth from a poor latch
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Air intake due to a disrupted seal leading to reflux/colic symptoms and gas pain
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Coughing or gagging during feeds from suboptimal coordination patterns
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Snoring, mouth breathing and/or wakeful sleep patterns due to low resting tongue posture
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Difficulty in chewing/swallowing or managing foods/liquids/saliva
Early treatment of tongue tie can significantly improve breastfeeding outcomes. Breast milk is widely recognised as the healthiest way to nourish your baby, offering a range of benefits including enhanced immune protection and the ability to adapt to your baby's evolving needs. While breastfeeding may be the preferred choice for many new mothers, it can present unexpected difficulties.
Information:
Common Problems
Associated with Feeding
Infant feeding can come with its challenges. We are well-versed in addressing common issues in both breast and bottle fed babies, such as - latching difficulties which can impede babies ability to feed effectively, leading to frequent and prolonged feeding, fussiness, weight issues and excessive air swallowing (aerophagia), leading to reflux, wind, and flatulence, all resulting in an unsettled baby, which can be extremely worrying and exhausting.
For mothers, breastfeeding problems can lead to sore or cracked nipples from improper latch, causing pain, or poor milk drainage that may lead to engorgement, blocked ducts, or mastitis - an infection causing inflammation and discomfort - potentially reducing milk supply.
We're committed to helping you navigate these challenges with expert care.
