tongue tie assessment clinic awareness

Suspected Tongue-tie
Assessment Clinic

Management and referrals

Jas Garcha Tongue Tie Practitioner Midwife

Tongue-tie assessment team

 Sue Wallen Tongue-tie  Jas Garcha Tongue-tie  Jo Forward Tongue-tie
Support Worker Practitioner Midwife Support Worker

“I am looking forward to being a "I'm looking forward to “I'm excited to be joining this
part of a new team, supporting supporting parents with their team to support parents with
parents and their babies in feeding difficulties and to be a feeding and building their
feeding support and being able to part of this new service. confidence around feeding. I feel
help them on their journey” Supporting families to feed with it's really important for parents to
confidence and empowering get the support they need with
them through parent education is feeding which also helps with
key to the care I provide" their emotional/mental wellbeing
and good attachment with baby.
I'm looking forward to meeting
new families.”

Tongue-tie symptoms Inability to lift the tongue
• Inefficient feeding – long feeds,
Inability to extend tongue over
bottom lip frequent feeds, slow weight gain,
• Nipple pain/ damage
• Inability to latch weight loss
• Difficulty sustaining the latch, • Flow regulation issues – coughing

slips down or off the breast and choking at the breast, tiring

at the breast, wind and reflux

Inability to keep the Inability to cup the breast
tongue forward • Difficulty forming a seal
• Clicking sounds during
(dribbling during feeds)
feeding • Wind and reflux
• Slipping off • Slipping off
• Clicking
Inability to form a peristalsis
• Inefficient feeding due to insufficient

vacuum to transfer milk –tiring, long or
frequent feeds, weight issues

Conservative management
when a tongue tie is suspected

Conservative management
when a tongue tie is suspected

 Consider specialist referral e.g. Infant feeding specialist Midwife – Juliana Glaser /
Paediatric Infant Specialist Nurse – Claire Wise / Paediatric Speech and Language
Therapist - Vicky Palmer-Gee / Neonatal Infant Feeding Specialist Nurse -
Francesca Brewer

 Community peer support e.g. Coventry Infant feeding team / boobie buddies
breastfeeding support group

 Complete referral form at 3-4 days onwards to minimize intervention reminding
parents the appointment is for a tongue tie assessment – not for a frenulotomy,
other issues impacting feeding may be diagnosed

 The tongue tie assessment clinic is not a clinic for breast feeding support for
babies and mothers who do not have tongue tie symptoms

 If needing advice please contact the tongue tie assessment team at
[email protected]

Simple ways to boost breast milk supply

What to tell parents expecting a
consultation

 Avoid feeding baby an hour before the appointment
 Frenulotomy will not be performed if Vitamin K has not been given
 Bring your red book and a blanket to wrap the baby in
 If having top ups bring some EBM or ready-made formula and a bottle
 A detailed medical history for mother and baby, birth history and feeding history

(a feed will be observed)
 Assessment of tongue function/appearance and discussion of findings
 Discussion of strategies which may be more appropriate than tongue tie division to

improve feeding e.g. boosting milk supply etc.
 If appropriate, a discussion of procedure and risks of procedure – consent form
 Frenulotomy
 Observe a feed and support
 Feeding plan

Anterior tongue-tie

Referral
Form

 Send completed
referrals to
tonguetieassessmentcl
[email protected]

 Send referrals after
3-4 days, contact the
Infant feeding
specialist midwife or
nurse with referrals or
concerns before this
timeframe

Around 50% of tongue-tied babies will
successfully feed with support and
management plans put in place by you ☺



Any questions or queries please contact via
email
[email protected]
Jas Garcha