An article on Tongue-tie services in the UK has just been published in the June edition of MIDIRS Digest .

This paper reviews the evidence surrounding tongue-tie division (frenotomy) and reports on the findings of a national survey to map the provision of UK NHS tongue-tie services.  The findings emphasise the variability of service provision across NHS Trusts, and the limitations within the evidence base relating to assessment tools and intervention. There is a need for equitable access to skilled assessment and services to prevent both under- and over-diagnosis, and a need for all women to receive appropriate and timely breastfeeding support.

As a parents’ charity, to help address the variability and improve care for families, NCT recommends:

1. All Trusts/boards have an infant feeding coordinator/team and are working towards achieving or maintaining Baby Friendly status, to provide at least the minimum level of skilled support with breastfeeding.
2. Identifying priorities and securing funding for further research on tongue-tie, including longer term follow up, research into women’s experiences and identifying standardised diagnostic criteria and assessment tools.
3. Development of evidence-based good practice protocols by NICE or as part of the Baby Friendly Initiative to include

• commissioning of services, skilled assessment of feeding and clear criteria for referral for possible division,
• skilled support with feeding immediately after division, follow up, with ongoing support readily available, regular audit and reviewing the training process.

1. Easy access for all parents to a tongue-tie service, if needed, preferably provided by the local NHS Trust/board but, if not, with a clear referral route to a neighbouring Trust/board.
2. Services to have sufficient capacity, in order to minimise waiting times.
3. Recognition that mothers may have painful and upsetting experiences of tongue-tie and should have their concerns taken seriously.