Tongue tie Division - Frenulotomy

Why Divide Tongue ties?

Some babies with tongue ties can breastfeed perfectly, others have difficuly breastfeeding and a few have difficulty bottlefeeding. Research has shown that 44% of babies with ANY degree of tongue tie have difficulty feeding.

For breastfeeding babies, the difficulty is because the tongue tie prevents the baby from attaching efficiently to the breast, and therefore milk removal is not effective.
This can lead to baby feeding very frequently, (more frequently than normal for a breastfed baby!) not sleeping for any length of time, and weight gain can be slow, or indeed weight loss.
A tongue tie can cause a combination of the baby not being able to open his mouth wide enough; a tongue that does not cover the lower gum and disordered movements of the tongue, each resulting in poor attachment to the breast. However, not all of the above have to occur in order to have poor attachment, a baby might be able to poke his tongue out, but that does not mean that the tongue tie is not causing problems - the restriction in lateral movement of the tongue can be the cause of poor attachment.
As a result of poor attachment, the baby slips off the breast, chomps on the end of the nipple with both gums and this is excruciatingly painful for the mother. Nipple trauma combined with the hormonal changes in pregnancy can mean that there is also a risk of developing thrush (again very painful for the mother)
The poor attachment to the breast, leads to inefficient milk removal from the breast. This can also cause problems for the mother such as mastitis (due to milk stasis – milk just ‘sitting there’ not being removed) and also a low milk supply as a result.

For bottle feeding babies, the difficulty is that the tongue tie prevents a good seal around the teat. The suck is inefficient, and the feed takes two to three times longer than a non tongue tied baby. As the seal is leaky, babies dribble milk in varying amounts and may need a bib or muslin (or change of clothes!) after a feed.
A few babies are so inefficient that they squirt (not just dribble!) the milk out of the sides of their mouths. As the milk leaks out, air gets in and is swallowed. This can make baby very windy with the possibility of increased colic and irritability. Many parents try multiple types of teats, or have to hold the bottle in a precise way for optimum feeding efficiency.

Dividing a baby’s tongue tie doesn’t need a general anaesthetic, as long as he is under eight months old.
The procedure only takes a minute or two, a trained health professional will swaddle baby in a towel, divide the tie quickly with sterile scissors and bring your baby back to you quickly so that he can be fed.

Tongue tie release with Sarah March RM, IBCLC :

How is a Tongue tie divided?

How is the Tongue tie divided?

•An assessment is made of the degree of tongue tie
•The baby is taken to the treatment room, swaddled and supported at the shoulders to stabilise the head
•Sharp, blunt ended scissors are used to divide the frenulum. The tongue is not harmed.
•Blood loss is minimal and stops quickly.
•The baby is returned to the mother and immediately offered a feed.
•The frenulotomy itself is a simple procedure, and the baby is back with the mother/father within a couple of minutes.

Does it Hurt the baby?