Demo page for boxes, columns and icons
About division of a tongue-tie
This procedure involves the division of the piece of tissue which attaches the underside of the tongue to the floor of the mouth. This piece of tissue is left over from early development in the womb.
What to expect after the procedure
- After the procedure, you will notice a few drops of blood at the wound site under the tongue. This bleeding usually settles down quickly after the procedure and rarely causes concern.
- If your baby has swallowed any blood, you may see some brown staining if they vomit up a small amount of milk during the first 24 hours after the procedure. This is nothing to be worried about.
- Occasionally, a small amount of fresh bleeding can be seen in the wound. This is easily settled by feeding your baby. The action of suckling compresses the small blood vessels under the tongue.
- Most babies settle quickly after the procedure and some even sleep through it.
- Older babies (more than 3 to 4 weeks of age) can be more unsettled. They may need more comforting and extra feeds in the first few days after the procedure.
How to know your baby is healing well
A diamond shaped wound will be visible under your baby’s tongue immediately after the procedure. This will look like a yellow ulcer within the first 24 hours. Over the next 14 to 21 days, this will change colour from yellow to white, as the tissue heals. This change is normal.
The incision made to divide the tongue tie should heal over quickly with no problems. This is because of the antiseptic quality of saliva. If your baby is breastfeeding, this will also aid healing due to the large number of protective and healing properties of breastmilk.
Caring for your baby after the procedure
- Avoid using dummies for 24 hours after the procedure.
- Always sterilize bottles, teats and any nipple shields before use.
- Make sure your hands are cleaned well with soap and water before handling any feeding equipment that you use.
- Make sure your hands are cleaned well with soap and water if you put your fingers in your baby’s mouth.
- Avoid touching the wound site directly under the tongue in the first 24 hours after the procedure. Feeding and exercises (see box below) do not involve touching the wound directly so they should continue as advised.
- Feed your baby regularly in the first 72 hours after the procedure. Feeding encourages your baby to use their tongue and reduces the risk of the tongue-tie reattaching. This is particularly important for breastfed babies.
Doing these exercises may help to prevent the tongue-tie reattaching:
|
Wash your hands well with soap and water before you start the exercises. Do them when your baby is awake and alert, several times a day until the wound is healed. |
Use a clean finger and run it around your baby’s bottom gum. This will make them try to follow your finger with their tongue. With a clean finger, tickle your baby’s top and bottom lip. This will make them try to poke their tongue out, up and down to ‘catch’ your finger. Sit your baby facing you, supporting their head and back. Poke your tongue out at them. They should try to copy you by poking their tongue out. With a clean finger, gently touch your baby’s palate (the roof of their mouth) and your baby will suck on your finger.Once they are sucking, gently pull your finger out. Your baby will stretch their tongue to try and hang on.Repeat the process, but as you gently touch your baby’s palate, twist your finger slightly to the left and right and gently withdraw it. |
When to seek help about your baby's progress
Most babies recover quickly.
Important
Make an urgent GP appointment or go to your nearest Emergency Department (A&E) if you notice any of the following:
- Your baby has a high temperature (more than 37.6 degrees centigrade).
- Your baby is excessively irritable or is making a high-pitched crying sound.
- Yellow or green fluid (pus) is oozing from their tongue-tie wound.
- Your baby is excessively sleepy or is difficult to wake for feeds.
- Your baby is not settling after a feed.
- Your baby has bleeding at the wound site that does not stop after feeding or sucking on a clean finger for 2 minutes.
Feeding after the procedure
If you breast feed
For the first 72 hours after procedure, offer a breastfeed at least every three hours.
If you formula feed
Offer your baby a feed when they show signs of being hungry. You will see feeding cues such as moving their head around looking for food, or sucking on their fingers or hands.
Reestablishing your baby’s feeding technique
Some babies establish a poor sucking pattern when they first breastfeed, to compensate for their tongue tie. After the procedure, these babies must learn to suck with a tongue that is fully mobile.
You can help them establish a good sucking pattern by following this advice:
- If your baby becomes uncomfortable, unlatch them and reposition them.
- Do not pull them away from the nipple. (If you breastfeed, this can be painful and damage your nipple.)
- Use a clean little finger and gently place it between your baby’s gums to release their latch.
- Reposition and latch again.
Signs of effective feeding
Signs of effective feeding are:
- regular wet nappies
- regular bowel movements
- your baby settles well after feeds
- your baby gains weight.
Ask your midwife or health visitor about local feeding drop-ins if you are worried. These are a good place to meet other mums and access specialist feeding support.
More information
Further NHS information on tongue-tie
Further information on infant feeding, including local clinics
National Breastfeeding Helpline (9:30 am to 9:30 pm)
Contact information
Kingston Hospital Infant Feeding Team
or
Kingston Hospital Tongue-Tie Team (email: khft.
Telephone:
Kingston Hospital Infant Feeding Team: 020 8934 2848