The Tongue Tie Clinic

Prior to your Consultation

  • Ensure your baby is hungry prior to your appointment, this is to encourage immediate breastfeeding after the procedure.

  • In babies older that eight-weeks it is recommended to give the age appropriate dose of paracetamol (Calpol™) 30 – 60 minutes prior to your scheduled appointment time.

  • Confirm your baby has had a Vitamin K injection.

  • Confirm your baby has been added to your medical insurance policy; otherwise you are liable for the private fees. Please bring your insurance policy details to the appointment.

  • Bring a bottle of expressed milk if you are combining this with breastfeeding
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    Consultation Appointment

  • Identifying tongue problems requires placing the baby into the correct examination position. Dr. O’Neill will sit knee-to-knee with the parent and the baby’s head will be positioned in her lap. This allows the parent to control the feet and hands while the baby is resting and stable. It also allows excellent visualisation of the entire oral cavity and its structures.

  • If your baby is a candidate for tongue tie release Dr. O’Neill will discuss the procedure with the parent, including the risks, benefits and expected outcomes. You will then be asked to sign a conscent form.

  • Dr. O’Neill and her nurse will then swaddle the baby, the tongue is retracted to expose the tie, and it is then divided using a sterile scissors. When division of the tongue-tie is performed in early infancy, it is usually performed without anaesthesia.

  • Baby is then unwrapped and returned to the parent for immediate breastfeeding.

  • Once baby has fed, the oral cavity will be reviewed before you are discharged.

  • After the surgical release of a tongue tie the majority of babies latch immediately, others may take a week to become good breastfeeding infants. A review appointment with a Lactation Consultant is recommended following the procedure to ensure the best possible outcome.
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    Contra-Indications to Treatment

    • Family history, or suspicion of a bleeding disorder

    • Babies who have not have a vitamin K injection

    • Active oral infection/disease

    Risks

  • Bleeding: A small amount of bleeding following the procedure is common. There is a 1:300 risk of a minor bleed, however, this commonly ceases following feeding. The oral cavity will be reviewed before you are discharged to ensure there is no excess bleeding.

  • Infection: The risk of infection following the procedure is rare, approximately 0.01% (1:10,000).

  • Pain: Post-surgical pain and discomfort will often depend on the type of attachment that was treated. A thick, wide surgical site will be more likely to cause discomfort than the release of a very thin membrane. Babies should be given age appropriate paracetamol (Calpol™) during the healing phase. For babies less than eight weeks old, the analgesic is the sucrose, and other sugars found in breast milk.

  • Reattachment/Recurrence: this is not due to the membrane growing back; it is due to scarring of the surgical site, and then the resultant scar contracting. It is estimated that there is a 5% incidence of scarring causing the tongue to tighten again following its release. This tends to be more common in babies who have a posterior tongue tie.

  • Post-Surgical Active Wound Management

  • It is important that the tongue is prevented from healing back to its original position; this is accomplished by keeping the two sites separate. This requires the parent to place two index fingers directly into the surgical area and firmly press towards the floor of the mouth. (Parents do not need to wear gloves, just wash hands.)

  • This should be preformed three times per day for two weeks.
  • The area under the tongue will initially turn into an ulcer and heal in approximately 7 – 10 days.

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