Tongue-tie service

We provide a midwife-led service for babies with feeding problems associated with a restrictive frenulum otherwise known as tongue-tie or ankyloglossia.

We accept referrals for babies from 5 – 28 days old. After 28 days, babies are referred directly to the Ear, Nose and Throat team.

What is tongue-tie?

Research suggests that approximately 1 in 10 babies may be born with some prominent membrane (frenulum) under the tongue. Only about half of those babies display significantly reduced tongue function, making breast or bottle feeding difficult.

Tongue-tie (ankyloglossia) is where the frenulum is shorter than usual which can restrict the tongue’s movement necessary to feed. The tongue is effectively tied to the floor of the mouth. The condition may be mild, or the restriction can be more pronounced. It is not possible to assess the severity of the tongue tie based on the appearance of the frenulum alone. A diagnosis of tongue-tie can only be made upon assessing how the tongue functions when the baby is feeding.

It can be treated by a safe fast procedure called tongue-tie division or frenulotomy.

What to do if you are having feeding difficulties?

Most breastfeeding problems are not caused by tongue tie and can be overcome with breastfeeding support. The infant feeding team see babies with feeding difficulties.

If your experiencing feeding problems which you think may be associated with tongue-tie please ask for help from a health care professional: your midwife, health visitor, infant feeding specialist or private lactation consultant.

Find further information on infant feeding support.

How do I get an appointment?

You will need to be referred to the clinic by a healthcare professional.

You will be offered an appointment by telephone, text message or letter. We aim to offer you an appointment within two weeks of receiving the referral form.

Before being referred to the tongue-tie service a health care professional will undertake an oral assessment and discuss the baby’s feeding with you. If you are breast feeding, you will be offered feeding support with positioning and attachment, managing your breastmilk, breast comfort and care alongside assessing your baby’s wellbeing.

If the oral assessment indicates the baby has a suspected tight frenulum you will be offered a consultation at the tongue-tie services for a diagnosis and you may be offered the frenulotomy procedure.

The appointments team will attempt to offer you an appointment within 14 days, but this cannot be guaranteed.

Prior to your appointment

Please bring your baby ready to feed. This is important if we offer you the option of tongue-tie division as the baby will need to feed immediately after the procedure.

Your baby must have also had a full dose of vitamin K.

What to expect at your tongue-tie clinic appointment

The appointment will involve a face-to-face consultation with a qualified tongue-tie practitioner who is qualified to undertake surgical division (cutting or ‘snipping’) of your baby’s suspected restrictive frenulum. The practitioner will assess if a tongue-tie division is recommended alongside an informed discussion regarding your options. All information given will be supported by a patient information leaflet.

Clinics will operate every week within the maternity unit at Watford General Hospital.

Useful information


Contact our infant feeding team.

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How to get help

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Refer yourself