Tongue Tie and Oral Function Assessment
A visible frenulum does not necessarily mean that a baby has a feeding problem and feeding difficulties are not always caused by tongue-tie.
A meaningful tongue-tie assessment considers function: how your baby moves their tongue, how they feed, whether milk is transferred effectively and whether restriction appears to be contributing to the difficulties you are experiencing.
As a midwife, IBCLC and certified tongue-tie practitioner I bring feeding assessment and oral-function assessment together rather than considering the tongue in isolation.
When An Assessment May Be Helpful
You may wish to arrange an assessment if your baby:
- Struggles to attach or repeatedly slips from the breast
- Makes clicking noises or loses suction
- Feeds for very long periods without appearing satisfied
- Has difficulty managing milk flow
- Struggles with breast or bottle feeding
- Causes persistent nipple pain or damage
- Has weight gain or concerns about milk transfer
- Appears unable to lift, extend or move their tongue effectively
- Has already been told that they may or may not have a tongue-tie, but feeding remains difficult
These signs can have several causes. An assessment is intended to explore the full feeding picture rather than assume that tongue-tie is responsible.
What the assessment includes
A detailed pregnancy, birth and feeding history.
Discussion of your symptoms and concerns.
Observation of a complete feed where possible.
Assessment of attachment, sucking, swallowing and milk transfer.
A gentle oral examination with your consent.
Assessment of tongue movement and function.
Consideration of other factors that may affect feeding.
A clear explanation of my findings.
Immediate feeding support and strategies that may improve comfort and milk transfer.
Discussion of appropriate NHS or private referral options where necessary.
A personalized written and/or pdf plan
Important information
This service includes tongue-tie and oral-function assessment but does not include tongue-tie division.
An assessment does not guarantee that a restriction will be identified or that division will be recommended.
Where referral is appropriate, I can explain your options and provide relevant information, but I cannot guarantee acceptance, appointment times or treatment by another provider.
Photographs and videos can provide useful background information but cannot replace an in-person oral and feeding assessment.
After division or treatment
I can also support you before and after a tongue-tie procedure.
Division alone does not automatically resolve every feeding difficulty. Follow-up may involve reviewing attachment, milk transfer, maternal comfort, bottle feeding, milk supply and helping your baby adapt to feeding differently.