This leaflet answers common questions about your baby’s tongue tie appointment at the Royal Free Hospital. If you would like further information, or have any worries, please do not hesitate to ask your nurse or doctor.

In all cases, a specialist midwife will explain the appointment to you and answer any questions you may have. We allow two parents or guardians to attend the appointment. Please expect to spend up to one hour with us.

What is a tongue tie?

A tongue tie is when the small piece of skin connected to the underside of a baby’s tongue and the floor of the mouth (sometimes the lower gum) is restricting the tongue’s function and movement. Tongue ties are formed when the fetus is growing and visible when the baby is born.

Babies need good tongue function to feed effectively, and a tongue tie can impact this – however, it is not always problematic.

What can be done about a baby’s tongue tie?

A frenulotomy, the procedure to separate a baby’s tongue tie, can be performed to release the tightness under the tongue. This allows more movement of the tongue and enables the baby to feed more effectively.

What will happen during your baby’s tongue tie appointment?

The process to release your baby’s tongue is very quick, with the whole procedure taking only a minute or two.

We place a finger underneath the tongue to get a good view of the tongue tie. The skin connected to the baby’s tongue and floor of the mouth is divided with specialist scissors, to release the tongue tie. Some babies will sleep through the procedure, and some will cry. However, those babies that cry usually stop crying very quickly, recover well and start feeding immediately. No anaesthetic is needed for the procedure.  

Before your baby’s procedure

Please do not feed your baby in the two hours before your appointment time. This helps your baby to feed after the procedure.

Please ensure your baby has been given a Vitamin K injection or at least one dose of oral Vitamin K before the procedure. Babies are born with limited Vitamin K in their bodies, so an injection is offered to all babies at birth to help clot their blood.

As there is a bleeding risk with this procedure, your baby needs to have had a Vitamin K dose before attending this appointment.   

After your baby’s procedure

Once your baby’s tongue tie has been released, you will then be asked to feed your baby. Feeding is a natural pain relief and can help your baby after the procedure. Feeding your baby directly after the procedure will help to stop the bleeding and calm your baby. It also allows us to observe your baby feeding.

Risks and side-effects

As with all procedures, there are several potential risks with releasing a baby’s tongue tie:

  • There is a one in 10,000 risk of significant bleeding. There is also a one in 70 risk of bleeding more than we would like, but this is managed in clinic and does not require emergency services. Feeding your baby following the procedure usually stops the bleeding within a few minutes.
  • There is a one in 10,000 risk of infection. Symptoms of an infection include a high temperature above 37.5 degrees or a bright red, angry-looking wound. If you are worried your baby may have an infection after the procedure, you should attend your nearest A&E department.

There is a risk that the tongue tie will regrow. We will discuss these risks with you during your baby’s appointment and will only proceed when you give consent.