A tongue tie is a band of tissue passing between the floor of the mouth and the underside of the tongue. This restricts the ability of the tongue to protrude and can produce a central groove or heart shape. A tongue tie may cause difficulties with breast feeding with poor latch and nipple pain/cracking for the mother. In a baby under 12 weeks of age a tongue tie can be divided in the clinic without anaesthesia if there are breast feeding problems. A rapid access clinic is available and contact arrangements are in the referral guideline section.
There is not convincing evidence that tongue tie causes difficulty with bottle feeding, introduction of solids or speech development. Many babies with tongue tie will breast feed without difficulty and so routine division of all tongue ties in the newborn period is not recommended.
Tongue tie division may be offered in older children for cosmetic reasons but as the tongue changes in appearance and shape in the first year of life this would not be recommended in infancy.
FM, LS, JB Sept 22
Who to refer:
- Babies under 8 weeks of age WITH breastfeeding problems – using the rapid access pathway
- Older children with a tongue tie whose parents wish to discuss division of the tongue tie on cosmetic grounds
- Children with speech problems in whom speech therapy assessment suggests the tongue tie is implicated
Who not to refer:
Infants with a tongue tie and no breast-feeding difficulties.
How to refer:
Rapid Access Tongue Tie Clinic
The rapid access tongue tie clinic can be accessed directly by midwives, health visitors, breast feeding advisors or GPs by emailing a completed form (see links below) to tonguetie.referral@nhslothian.scot.nhs.uk
Tongue tie referral form BLANK
Tongue tie referral form VISION
Alternatively a referral can be sent through SCI gateway but this will take longer to process.
Older Children referrals as outlined above
Referral should be via SCI Gateway
Referral Priority
- Breast feeding infants referred via the rapid access pathway will be seen urgently.
- Those referred for other reasons will be triaged to a routine appointment.
Surgical Priority
Tongue tie division in older children for cosmetic reasons is a non-urgent procedure.
