I come across a lot of babies with tongue-tie. In my area, we don’t have any local private lactation consultants and NHS services leave a lot to be desired, so there have been quite a few mums who learn that their babies symptoms tally with tongue-tie for the first time from me.
As a doula and breastfeeding supporter, it is not a part of my role to diagnose (or rule out) tongue tie and I always signpost to specialist services. However, many mums want to know if it’s a real possibility before either paying out or travelling to get a full assessment.
A tongue-tie is a frenulum that restricts the function of the tongue. Assessing the function of the tongue is really something for an experienced lactation consultant. Currently only International Board Certified Lactation Consultants (IBCLCs) and hospital clinic staff are usually trained in carrying out a Hazelbaker Assessment of Tongue Function.
Fortunately, checking for a lingual frenulum that protrudes from the tongue (the physical bit of a tongue-tie) is simple for a parent to do.
Checking for a frenulum
The easy check is to sweep your finger (obviously make sure it’s clean and short-nailed first!) from side to side under baby’s tongue. You should not feel a barrier, whether this feels like a “guitar string” you could almost twang (a sign of an anterior frenulum), a speed bump or a tree trunk (signs of a restrictive posterior frenulum).
If your baby has an anterior frenulum, these are generally visible if you can see under the tongue. But if the tongue tie is severe, baby may not be able to move their tongue out of the way for you to look!
A posterior frenulum is further back on the tongue and cannot be diagnosed (or ruled out) by appearances. You can make a posterior frenulum visible by applying gentle pressure either side with your fingers. First, lie baby on your lap with their head towards you. Then slide your index fingers into baby’s mouth and under the tongue. Apply gentle pressure either side of the midline. A posterior frenulum can then “pop up” between your fingers.
Dr Kotlow (a American paediatric dentist who treats tongue-tie) has demonstrated this in the video below.
To find someone who can help you with full assessment, diagnosis and treatment of a tongue tie, see: