Sharon Trotter RM BSc
Midwife, Breastfeeding Consultant and Neonatal Skincare Advisor
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Raising awareness amongst parents of treatments for tongue-tieThe full reference for this draft article is: Trotter S (2010). Midirs Midwifery Digest 2010 vol 20, number 1 page 83-5 | ||
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Pre-snip picture of tongue-tie
Post-snip picture of tongue tie |
Editor’s noteSharon Trotter is well known for her work on breastfeeding and neonatal skin care. She has a website (TIPS®) that involves parents in evaluating a range of commercial products for use with babies, and as part of this, she has also developed some information leaflets for parents. Over my time as editor of the Digest, one area that has really moved on in terms of clinical recognition and positive outcomes for breastfeeding is the management of a tongue-tie (Finigan 2009). Therefore, when I saw Sharon’s leaflet on this, I felt that it was important to make midwives aware of the accessibility of this for parents. The leaflet has been slightly adapted for reproduction in the Digest and the content is subject to copyright laws. It is written with parents in mind and therefore the style is based on plain English for a lay readership. In reproducing it here, in this format, it is hoped that this will raise awareness in health care professionals and advisors of what information appears to be needed by and will be of most use to parents. There is more information about Sharon and her website, following her advice on tongue-tie. References Finigan V (2009). ‘It’s on the tip of my tongue’: evaluation of a new frenulotomy service in Northern England. MIDIRS Midwifery Digest 19(3):395–400. TIPS Ltd (2009). Available at: www.tipslimited.com ‘TIPS’ Toolkit for tongue-tie Ankyloglossia (better known as tongue-tie) could be more common than you think. The toolkit covers the following:
What is tongue-tie? Tongue-tie is also called ankyloglossia. When a baby has tongue-tie, the membrane which holds the tongue in place at the floor of the mouth (the frenulum) is thicker or shorter than normal. This condition is graded from 1 to 4 (grade 1 being the most severe). Tongue-tie is thought to affect around 5% of babies and may or may not cause problems, but it can interfere with the successful establishment of breastfeeding. It can also sometimes affect speech, development of the mouth and jaw and even kissing in the long term.
How will I know if my baby has tongue-tie? You may notice that your baby’s tongue remains fixed or low at the bottom of their mouth. This is especially noticeable when your baby is crying. Their tongue may not move very much. You can see an example of tongue-tie in the pretreatment photograph. How is tongue-tie treated? Treatment is relatively simple: the tongue-tie is simply snipped (also known as a frenotomy). Your midwife, lactation consultant or health care professional will arrange treatment for you locally. This should only be carried out by a trained professional. Snipping the tongue-tie solves the problem instantly with few, if any, side-effects. Occasionally, the initial snip fails to cure the problem, and sometimes scar tissue can grow back making a second snip necessary.
Where can I go for treatment?(featuring examples of national and local centres of excellence)
How can I find out more?The following websites give excellent information on tongue-tie:
Book - Tongue tie – from confusion to clarity: ankyloglossia. 88 pages. £39.95 (pbk). ISBN: 0646352547, Bollarong Press, Fernando C (1998). — This is the first book to explore tongue-tie comprehensively. It explains that tongue-tie is real and proceeds to recommend an assessment method to judge the severity of the condition and to determine whether surgical intervention is warranted. The book includes:
This book provides very helpful information for those with a tongue-tie, the parents of children with a tongue-tie and the many health professionals involved in the treatment of this condition.
Podcast: MIDIRS podcast by Rachel Hillan, infant feeding advisor at North Bristol Trust. In this podcast, Rachel Hillan talks mainly about the effects of tongue-tie in relation to breastfeeding. She also talks about how tongue-tie is treated, and how the condition can also affect cup feeding and weaning. To listen or download go to:
About Sharon and TIPSI have worked with MIDIRS for a number of years. I am a midwife who is passionate about breastfeeding, alongside my other interest of looking into baby skin care and cord care. To this end I have spent years researching and writing about these subjects and have been published in professional journals. My proposed new guidelines on skin care are now policy in my local maternity unit with many other units following this lead. TIPS Ltd is now a stakeholder with the National Institute of Clinical Excellence whose recent postnatal care guidelines (NICE 2006) now recommend that cleansers and baby wipes no longer be used on newborn skin. My goal is to continue to spread the word to parents and health care professionals throughout the UK and beyond. In November 2008, I won the Dermatology award at the Nursing in Practice Inaugural Awards Ceremony in recognition for my work on baby skin care and especially the Baby care — back to basics™ leaflet which is now in its 6th edition. It was very encouraging to have such recognition as at the outset, getting attention for my work was not easy. My intention is to explore other subjects in the future with the aim that the outcomes from this will be easily accessible to parents and professionals. All my work is evidence-based and where possible fully referenced and I have a range of experts to call on when needed. All my work is available to read online at www.tipslimited.com and here, on my professional website www.sharontrotter.org.uk I decided something original and objective was needed to help parents find their way in the mass of commercial products available for baby care and infant feeding. I set up the TIPS Awards Scheme to mark out those products that parents considered met a high standard of ‘fitness-for-purpose’ as a product. The scheme was launched in 2007 to carry out independent market research into carefully sourced products within the baby and toddler market. While at first glance, it would seem such information is quite widely available, it is important to try to evaluate use and effectiveness based on independence of thought. The products are tested by highly motivated parent testers who have signed up voluntarily on the TIPS website.
The trials so far include:
Aquasolari bed pad, baby wipes, breast pads and treatments, baby skin care products, Bentley organic toy sanitizer, Dribblebuster bib, Ella’s Kitchen baby food, Miracle toys, TENS machines, open top cups, nursing bras and tops, Shampoo Rinse Cup, baby baths, cuddle towels, decongestants and thermometer soother. References [back to top |
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