Tongue-Tie

Tongue-Tie is when either, there is a piece of skin under the tongue (anterior) which being too tight stops the baby from latching onto the breast correctly, or under the tongue at the back is very thick (posterior).

With anterior the tongue cannot reach the top of the mouth so the suction is not strong enough to hold the nipple in the mouth, so baby latches then slips off, causing damage to nipples, therefore pain for mum and exhaustion for baby as they cannot get enough milk, they then become tired so fall asleep only to wake a short time later for more milk and so it goes on. This is more obvious in the early days.

With posterior, the tongue action pushes the nipple out of the mouth rather than pull the nipple in. Also baby may make a 'click' when feeding with excessive dribbling as the suction is lost. This tends to show itself as the baby gets a little older.

The symptoms for tongue-tie: for mum are usually nipple pain, maybe mastitis from not having the breast emptied of milk fully, for baby failing to gain weight, not being satisfied, also lack of sleep being caused by being continually hungry.

More explanation and pictures can be found on the following:-

Lactation Consultants of Great Britain - Tongue-Tie Leaflet

NICE: Tongue Tie Guideline

 

Why do I divide Tongue-Ties?

In my Independent practice I have found more and more tongue-ties, which I used to have to get a lactation consultant to agree that it was there. Then the parent had to get a referral from the GP so the baby could be put on the list to be seen by an NHS consultant, this could take weeks if not months! So I looked into being able to divide them myself, I was seeing first hand how awful it was for mum, being in pain, and dad being completely at a loss as to what to do. Babies usually losing, or not gaining weight. Then going on to formula, and how sad this was for a mum so determined to Breast feed. Now being qualified I can do the cut quickly so to minimise any disruption to BF.

 
How do I divide Tongue-Ties?

I use the same technique as used in hospitals. Dividing your baby's tongue-tie does not need a general anaesthetic. It only takes a minute or so, I simply wrap them up with a towel, divide the tongue-tie with a pair of sterile blunt-ended scissors. Then hand them back to you quickly so that you can feed them.

 
Are there any potential problems?

Not really, a number of small babies are asleep when I start, asleep when I do it, and asleep afterwards. Older babies do not like being wrapped up so they usually cry out, and it can sometimes be really quite difficult to know whether or not dividing their tongue-tie is actually painful, as they are already complaining at being wrapped up. I accept that some babies will cry for up to 60 seconds but on average its 15 seconds. I would emphasise that there are some babies who remain asleep. So although common sense says that it ought to hurt, there are some babies in whom it does not hurt at all and in the rest it does not hurt very much.

A few drops of blood are normal, but this always stops and is never a problem.

There will be a wound that you may feel needs something done about. The inside of the mouth heals much faster than other areas of the body. It is normal for the lining of the mouth to continually be worn away and renewed. This happens even quicker in babies, so there is no need for any form of wound management, merely breast or bottle-feeding. Often there is a white patch under the tongue which takes 24 - 48 hours to heal.

 
Finally .....

I will be very happy to divide your baby's tongue-tie, especially if they have a feeding problem. There is a standard fee of £120, within 10 miles of Bexleyheath. If over 10 miles mileage is chargeable. All you will need is your child's Red Book (Parent Held Record) so that l can record relevant details.

Rene Bozier: Tongue-Tie PDF Info Leaflet

There is somewhere on my Info Leaflet where you can write down any questions that you may have, so that when we meet you will be able to ask about anything that worries you.


Some feedback from some of the Mum's.....

Rachel & baby Will ...... Our son Freddie (3wks old) was diagnosed with tongue tie last Thursday. I spent 4 days agonising over whether or not to have anything done about it - I knew he needed it done (he was gaining weight, but suffering badly with wind and clearly frustrated while trying to feed), the thought of inviting someone into our home to cause him pain was horrific!

I finally called Rene yesterday morning, and she came to see us the same day. I can honestly say that the whole experience was overwhelmingly positive. Rene was so kind, gentle and calm, and explained the process step by step. As promised, it was over within seconds. With a tiny spot of blood and barely any crying, Fred was placed straight on my breast and happily latched on.

Rene's confidence and experience was very soothing for all of us, and we're so happy we had it done. Fred is learning how to use his wriggly new tongue, and we're already seeing a difference in how he settles at the breast.

Thank you! Rachel & Will x

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Holly ...... 'The process of tongue tie division is a daunting prospect as a parent. We knew it had to be done but we wanted our precious little bundle to be in as little discomfort as possible so to be in the privacy, comfort & familiarity of our own home was wonderful & Rene was so calm, thoughtful & caring it made a world of difference to us both. I wouldn't hesitate to recommend Rene she's worth her weight in gold! She was fantastic before, during & after the procedure, without a doubt head & shoulders above waiting for a referral & having to undergo the ordeal of hospitals & overworked staff.'

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'Hearing the words 'Your baby has tongue tie' can be very daunting. What is it? Did I cause it? Will it effect my little one long term? How is it
treated?

These are just some of the questions I asked myself but all my fears and concerns were eased when I was put in touch with Rene through the
Independent Midwife network.'

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Nicki ...... 'I was committed to breastfeeding Charlie, but he was having difficulty latching on and then with effective milk transfer. Our midwife put us in touch with Rene who discussed everything with me over the phone before we arranged an appointment for her to come and assess and treat Charlie.

Rene is a friendly, professional, knowledgeable midwife who put me at ease from the moment we spoke on the phone and when she arrived for Charlie's consultation
I knew straight away that he was in safe hands. The procedure was explained to me and my initial reaction was fear, as I worried the procedure would hurt
my precious little boy.

Although there is not 100% certainty against any pain, I can assure you Charlie's biggest cry came from being swaddled tightly (he hates his arms being held down!)
and not from the procedure itself. The procedure lasts a matter of seconds and there really was less blood than a paper cut. I was encouraged to put Charlie to breast straight after and Rene assisted with initial feeding to ensure all was well. It was such a relief to see my little boy latched on feeding, although patience is required as he had to re-learn how to suck using his newly 'freed' tongue muscle.

It turns out I have tongue tie, but diagnosis was not common 37 years ago! I'm so pleased that I've been able to give my little one the best start in life by helping him to breast feed effectively.

I highly recommend this procedure to any mum who is apprehensive about it. Thanks' - Nicki x & Charlie x'

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