Tongue Tie – Frequently Asked Questions (FAQs)

Will it be painful for our baby?

It’s thought that the frenulum does not have many nerve endings until babies are older. We believe that the procedure is not very painful for babies, however they can feel that something has been done and will often cry very briefly (as with a heel prick procedure, vaccinations etc).  The procedure itself usually takes around 3-4 seconds, and we will aim to feed immediately afterwards for baby’s comfort and to minimise any bleeding.

Some babies can be unsettled or fussy in the hours after the procedure.  They may wish to feed more frequently, or not feed as much for a while.  Skin to skin, lots of cuddles, calming measures, and relaxed feeding will all help if this is the case.  Babies over 8 weeks can have paracetamol if needed, but this is often not required.

Will there be bleeding?

There are often a few drops of blood collecting under the tongue after the release.  This generally stops very quickly with feeding.  Very occasionally, some babies may need a few minutes of pressure applied under the tongue if bleeding is not stopping with feeding.  Heavy bleeding is a recognised risk, although this is extremely rare.

What is the difference between ‘anterior’ and ‘posterior’ tongue tie?

Anterior tongue tie describes a prominent restrictive frenulum which can be seen more easily towards the front of the tongue.  Posterior tongue tie describes a restrictive frenulum that is further back underneath the tongue (although the exact definition of where can vary).  When assessing for any restriction, it is important to fully assess tongue movement and function, rather than judging on appearance alone.

What will it look like afterwards?

After tongue tie release, you will often see a diamond shape underneath baby’s tongue.  After a day or two, this will usually become a small white or yellowish ulcer, which is part of normal healing and nothing to be concerned about. If you don’t see an ulcer, this is also fine.

What are the risks?

Although complications are extremely rare, we will always talk through potential risks of the procedure before taking consent, and will discuss ways to minimise these risks.

• Bleeding: There are often a few drops of blood collecting under the tongue after the release.  This generally stops very quickly with feeding.  Very occasionally, some babies may need a few minutes of pressure applied under the tongue if bleeding is not stopping with feeding.  Heavy bleeding is a recognised risk, although this is extremely rare.
• Infection: Cases of infection are extremely rare (especially if giving breast milk as this has many protective factors), but it is good practice after the procedure to ensure that any bottles, dummies etc. are sterilised before use, and that infant formula is prepared safely with hot water (as per instructions on the tin) to ensure that there is no bacterial contamination.
• Reattachment: Reattachment is uncommon but can occur, although not all babies with some reattachment will require a second division.