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Better services needed for tongue-tie

Healthcare professionals are failing to pick up the condition, causing untold stress, and curbing infant growth, says the National Childbirth Trust

Caroline White

Tuesday, 18 February 2014

The National Childbirth Trust (NCT) has called for better services for the diagnosis and treatment of tongue-tie in the UK. This would save the NHS money and alleviate the stress and anxiety parents, and babies with the condition, experience, it says.

In a letter sent to health minister Dan Poulter MP, the parenting charity expresses its concern that a diagnosis of tongue-tie can often take weeks or even months to be made.

The problem is not being picked up by health professionals, causing babies to fail to to feed properly and preventing them from gaining weight in their crucial first weeks, it says.

More professionals need to be trained to recognise and deal with the problem as current NHS treatment is often patchy and sometimes non-existent, says NCT.
It says that NICE guidelines, issued in 2005, should be updated to ensure that tongue-tie services are commissioned across the UK.

Tongue-tie is thought to affect between 3% and 10% of babies, and Health and Social Care Information Centre figures show that more than 5000 babies in England underwent a procedure for tongue-tie in hospital last year.

An NCT spokesperson told OnMedica that a call to members about the issue had prompted a deluge of responses. “We’ve been aware of this issue for a long time, but we were overwhelmed by the responses we got, which prompted us to renew our energies on this,” he said.
“Tongue-tie can be very stressful for parents and prevent babies from gaining weight. It occurs in babies’ vital first weeks and can leave them desperately hungry, unhappy and frustrated. Parents are often sick with worry as a result,” comments Belinda Phipps, NCT chief executive.
“We want to see earlier treatment and diagnosis which would save a lot of misery for parents and babies and save the NHS money.”

Tongue-tie affects some babies when the frenulum— the piece of skin attaching the tongue to the floor of the mouth— is positioned too close to the tongue tip.

This means the tongue can’t extend very far, and may not be able to move up and down or side to side as it would otherwise do.

Treatment is usually quick and simple. Specially trained midwives or infant feeding specialists can snip straightforward ties with scissors. Babies often don’t even need an anaesthetic.
Treating the problem early is cheap whereas looking after babies who are underweight and mothers who are in pain is costly, says NCT.

Louise Silverton, director for midwifery at the Royal College of Midwives, said early identification was important, ideally before the mother leaves midwifery care.

“Essentially we need to identify tongue-tie as early as possible, monitor breastfeeding and if it is affected by tongue-tie or similar problems, refer the mother and baby to a paediatrician or lactation consultant to treat the tongue-tie,” she said.

We need to ensure that there are sufficient infant feeding specialist midwives so women can receive expert help and support when they need it, she said, adding that the College would like to see more midwife-led tongue-tie clinics so specialist treatment and attention would be available.

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