Tongue Tie Assessments and Division Specialists
Liverpool, Wirral, Cheshire
At Zita Maria, we provide comprehensive tongue-tie assessments and division for babies where feeding difficulties are present. We understand how worrying and overwhelming feeding challenges can feel for families, and our role is to offer clear, honest guidance and expert clinical assessment.
All assessments are carried out by experienced tongue tie practitioners working within a CQC-registered service, taking a thorough, evidence-based approach.
Tongue-tie division is only recommended when it is clinically indicated and likely to improve feeding outcomes.
Appointments are unrushed and supportive, allowing time to fully assess your baby’s feeding, discuss findings, and answer your questions so you can make informed decisions with confidence.
WHAT IS A TONGUE TIE?
A tongue-tie (ankyloglossia) is a variation in the tissue (frenulum) that connects the underside of the tongue to the floor of the mouth. In some babies, this tissue can restrict tongue movement. Every baby is born with a frenulum, and its appearance can vary widely. The presence of a visible frenulum alone does not mean a tongue-tie requires treatment. Tongue-tie only becomes clinically relevant when restricted tongue movement is affecting feeding, comfort, or function. For this reason, assessment should always focus on how the tongue is working during feeding — not just how it looks. A thorough feeding assessment is essential to understand whether a tongue-tie is contributing to feeding difficulties.
HOW CAN A TONGUE TIE AFFECT FEEDING?
Effective feeding relies on the tongue having a full range of movement to create and maintain suction, coordinate swallowing and transfer milk efficiently. When tongue movement is restricted, some babies may struggle to feed effectively. This can affect babies differently, depending on how the tongue functions and how feeding is going. During breastfeeding, this may include: Difficulty achieving or maintaining a deep latch Prolonged or unsettled feeds Clicking sounds while feeding Maternal nipple pain or damage Poor milk transfer or slow weight gain During bottle feeding, this may include: Milk leaking from the sides of the mouth Clicking or noisy feeds Fatigue part-way through feeds Taking a long time to finish a bottle Wind or reflux-like symptoms These signs are not diagnostic on their own and can have multiple causes. A full feeding and oral assessment is essential to understand whether a tongue-tie is contributing to feeding difficulties.
Signs and Symptoms of Tongue-Tie
Feeding difficulties related to tongue function can present in different ways, and not all babies will show the same signs. Some babies may feed well despite a visible tongue-tie, while others may experience challenges even when the restriction is less obvious.
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Common signs that may be associated with tongue-tie include:
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Difficulty achieving or maintaining a deep latch
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Prolonged, unsettled or inefficient feeds
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Clicking sounds or milk leakage during feeding
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Parental nipple pain or damage during breastfeeding
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Excess wind, fussiness or fatigue during feeds
These signs can have multiple causes and are not diagnostic on their own. A thorough feeding and oral function assessment is essential to determine whether a tongue-tie is contributing to feeding difficulties and whether treatment is appropriate.
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More detailed information, including extended symptom lists and illustrations, can be found in our FAQs and Information section.
Our Assessment Approach
At Zita Maria, assessment always comes first.
Not every baby with a visible frenulum requires treatment, and feeding challenges can have more than one contributing factor.
Our assessments are are carried out by experienced tongue-tie practitioners, including International Board Certified Lactation Consultants (IBCLCs) and midwives with advanced training in infant feeding and tongue-tie.
We take a thorough, evidence-based approach, tailored to your baby, your feeding goals and your family.
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Every assessment includes:
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A full feeding history, including breastfeeding, bottle feeding or combination feeding
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Observation of feeding where appropriate
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Assessment of oral anatomy and tongue function - NOT appearance alone - using the Hazelbaker Assessment Tool for Lingual Frenulum Function™© (ATLFF™©)
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Consideration of birth history, medical background and infant behaviour
We take time to talk through our findings clearly and honestly, answering your questions and discussing whether a tongue-tie is likely to be contributing to feeding difficulties.
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If treatment is not clinically indicated, we will not recommend division.
Our priority is supporting feeding safely and effectively - whatever that looks like for your family.
The Procedure (Frenulotomy)
The tongue-tie procedure
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If, following a full assessment, tongue-tie division is recommended, this is carried out as a simple and quick procedure called a frenulotomy.
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The procedure itself usually takes just a few seconds. Your baby is comforted throughout, and feeding is encouraged immediately afterwards. We’ll talk you through everything on the day and ensure you feel fully informed before any decision is made.
We take time to explain:
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why treatment may or may not be beneficial
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what will happen on the day
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what to expect immediately afterwards
There is no obligation to proceed, and treatment is only recommended when it is clinically appropriate and in your baby’s best interests.
Safety and reassurance
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Tongue-tie division is a well-established procedure when carried out by appropriately trained professionals. At Zita Maria, procedures are performed within a CQC-registered service, following strict clinical governance and safety protocols.
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We ensure:
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careful assessment before any treatment
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appropriate pain relief and comfort measures
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clear aftercare guidance
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access to follow-up support
You will have the opportunity to ask questions and feel fully informed before making any decision.
Aftercare & Follow-up Support
Our care doesn’t end when your appointment finishes. We provide ongoing, personalised support to help you feel confident as feeding settles and your baby adjusts.
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Immediate feeding support
We observe a feed following assessment or division and offer tailored guidance for breastfeeding or bottle feeding, including support with winding and reflux-type symptoms. -
Clear aftercare information
You’ll receive a same-day follow-up email with personalised aftercare advice, recommended exercises (where appropriate), and links to written guidance and video resources. -
Routine follow-up
A routine follow-up call is offered around one week after your appointment, or, if preferred, a face-to-face follow-up in clinic to review feeding progress and answer any questions. -
Ongoing access to support
We offer WhatsApp and email support for 7–14 days following your appointment, and we are always happy to continue supporting families beyond this where needed. -
Joined-up care when required
If additional support would be helpful, we can signpost to trusted, appropriately trained osteopaths and chiropractors. Where concerns arise outside our scope, we refer promptly to GPs, paediatricians, or private paediatric ENT consultants to ensure safe, appropriate care.
Our aim is to ensure you feel supported, informed, and never rushed — with honest advice and compassionate care at every stage of your baby’s feeding journey.
Clinics and Home Visits
We offer tongue-tie assessments and, where clinically indicated, division appointments in carefully selected private clinic settings or in the comfort of your own home.
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Clinic Appointments
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Our clinics are chosen for their calm, clean environments and accessibility for new families. Each location has been selected to ensure a supportive, professional setting where parents can feel at ease during their visit. Complimentary on-site or nearby parking is available at many of our clinic locations to make your appointment as stress-free as possible.
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Home Visits
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For families who prefer care in their own space, we also offer home visits. This option can be particularly helpful in the early postnatal period, allowing feeding assessments and support to take place in a familiar, relaxed environment.
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Whether you choose a clinic appointment or a home visit, you can expect the same thorough assessment, unrushed care, and compassionate support - tailored to your baby’s individual needs and your family’s preferences.
Tongue-tie Assessment & Division Appointments
All tongue-tie appointments include a comprehensive feeding assessment, expert clinical judgement, and ongoing support. Treatment is only recommended when clinically appropriate.
What’s included in every appointment
✔Comprehensive medical and feeding history​
✔Full oral assessment - to include Appearance and Functional​
✔Tongue-tie division if clinically indicated​
✔Feeding support immediately after the procedure
✔Individualised feeding advice and guidance
✔Written aftercare information, exercises and video resources
✔Follow-up support and review
Clinic Appointment
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Tongue-tie Assessment ± Division (Clinic)
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Face-to-face appointment at one of our private clinics
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Feeding support and aftercare guidance provided on the day
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Follow-up call or clinic review included
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Ongoing WhatsApp/email support for up to 14 days
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From £130 – £230
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Home Visit
Tongue-tie Assessment ± Division (Home Based)
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Face-to-face appointment in your own home
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Feeding support and aftercare guidance provided on the day
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Follow-up call or clinic review included
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Ongoing WhatsApp/email support for up to 14 days
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From £220 – £320
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Additional follow-up & ongoing support
Further feeding support appointments can be arranged if required.
• £80 – 30-minute clinic follow-up
• £160 – 60-minute home visit (minimum)
** Please note **
If you can not find a suitable appointment date or time on our booking calendar, please get in touch and we will arrange a date and time to suit you.
Why Choose Zita Maria For your babies Tongue-tie Assessment
Expert, feeding-focused care — centred on your baby and family
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At Zita Maria, tongue-tie assessment is never just about what the tongue looks like. It’s about how your baby feeds, functions, and behaves - and how best to support you as a family.
What sets us apart:
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✔ Experienced tongue-tie practitioners & IBCLCs
Care is delivered by experienced tongue-tie practitioners, IBCLCs, and midwives with advanced training in infant feeding and tongue-tie. This ensures decisions are guided by function, not appearance alone.
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✔ Thorough, unrushed assessments
We take time to explore your baby’s full feeding history, observe feeding where possible, and assess oral function in detail — allowing space for questions, discussion, and reassurance.
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✔ Evidence-based, honest recommendations
Tongue-tie division is only recommended when clinically indicated. If treatment is unlikely to help, we will explain why and support you with alternative feeding strategies instead.
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✔ Immediate feeding support & continuity of care
Feeding is supported straight after assessment or division, with tailored advice provided on the day and followed up in writing. Ongoing support is available by phone, email, or follow-up appointment.
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✔ Strong clinical governance & referral pathways
Zita Maria is a CQC-registered service with robust governance. Where concerns arise beyond our scope, we work closely with GPs, paediatricians, and trusted specialist consultants to ensure your baby receives the right care.
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✔ Calm, carefully selected clinics — or care at home
Appointments are offered in carefully selected private clinics or in the comfort of your own home, depending on what best suits your family.
Support When You Need It
If you’re concerned about your baby’s feeding or wondering whether a tongue-tie assessment would be helpful,
we’re here to support you.
Booking an appointment gives you the opportunity for a thorough, unrushed assessment, honest guidance, and time to ask questions - with no pressure to proceed with treatment unless it’s clinically appropriate.
You can book online at a time that suits you, or get in touch if you’d like to arrange a home visit or just discuss your options first.
No referral required • Appointments available across Liverpool, Wirral & Cheshire • Honest advice,
even when treatment isn’t needed