University Hospital Southampton NHS Foundation Trust


A tongue-tie is a fold of membrane that connects the tongue to the floor of the mouth. Sometimes the membrane can be shorter than normal causing some restriction in the movement of the tongue.

Some tongue-ties are easy to see and others are less obvious. About half of babies with a tongue-tie have someone else in the family who also has one. It is more common in boys. Research done in Southampton shows that over 10% of babies are born with this. 

Some medical experts say that having a tongue-tie will not affect the way your baby feeds, but we have found that a number of babies who have tongue-tie may find feeding more difficult (see our patient information sheet for more details).

If you have concerns about your baby's feeding or tongue-tie, you should speak to your midwife, feeding specialist, health visitor or GP.


For babies under 8 months old this is a simple procedure, which takes a few seconds and does not need an anaesthetic. We do not think the treatment hurts newborn babies, as it was shown in one study that a small number of babies slept through the procedure. Older babies and certainly those over the age of 9 months will need a general anaesthetic.

We take the baby to a quiet room nearby. Babies are wrapped tightly in a blanket to stop them wriggling. As soon as the tongue-tie has been snipped using sterile scissors - this takes about 2 seconds - pressure is applied with a piece of sterile gauze under the tongue for a few seconds. Usually there are only a few drops of blood. The blanket is then unwrapped and the baby is fed immediately, by either breast or bottle.

Following division, you may notice a small white blister under the tongue, which does not interfere with feeding. 

For more information you can read our tongue-tie patient information.

The tongue-tie service at UHS is led by Mr Nigel Hall, consultant paediatric and neonatal surgeon, with Jayne Threlfall, midwife and lactation consultant.

Health professionals can find information on referring a baby for tongue-tie division here.

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Page comments

Thank you for your comment. We are currently looking into how we can best provide training and will post details once available.
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Nigel Hall (21/09/2015 10:47:27)
Dear Dr Hall, we are also looking to train some staff in frenulotomy and we are finding this very difficult to source, if you do decide to offer this training in the near future please could you let us know in Somerset
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Anonymous (17/09/2015 15:56:48)
Thanks for this message. Some children with tongue ties do indeed have problems with speech but it is difficult, in fact usually impossible, to say whether these will get better if the tongue tie is divided. The ‘snake’ appearance of his tongue you describe suggests that he may well have a tongue tie. I would be very happy to see him. Please ask your GP to refer him to me if you would like to proceed. Best wishes. Nigel Hall
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Nigel Hall (14/07/2015 10:06:12)
dear dr hall
my son is soon to be 5 and has just had a visit to school to which his teacher has asked if he has speech therapy. when he was born midwives/doctors umed an ared as to wether to cut his tongue or not an decided against it. he had feeding issues, I got maistitus an in the end expressed milk into bottles as he fed well this way. ive always worried about his speech and we went for a consultation, they said he was bright and had the vocab of a much older child but needed to slow down an practice his sounds. we were discharged but a year on his speech has now been mentioned again and im keen to get this resolved, as his teacher commented it will affect him socially as he gets older. the more I look into this an view images theres no doubt in my mind that he has tongue tie, if he sticks his tongue out it pulls in the middle an resembles a snakes tongue! I cant find any info regarding older children with this issue. please can you help me?
many thanks
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suzie (07/07/2015 14:43:43)
We are currently looking at how to best provide training for health professionals in frenulotomy and will publish details soon.
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Nigel Hall (01/05/2015 16:33:05)
Do the Southampton team stil provide training for health professionals? We are wanting to set up an All Wales Frenulotomy service for neonatal feeding problems but our managers want staff to attend an accredited training session/sessions for clinical governance reasons. I was trained well by Carolyn Westacott and provide a Frenulotomy service in Cardiff, but managers want additional staff to be trained/assessed by an accredited source.
Many thanks- the training I received in Southampton has resulted in many well fed babies and happy mothers.
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Anonymous (01/05/2015 14:31:42)
The tongue-tie service is led by Mr Nigel Hall, consultant paediatric and neonatal surgeon. The majority of referrals are assessed by Jayne Threlfall, midwife and lactation consultant. If division of the tongue tie is indicated then Jayne will perform it in a safe environment.
We are unable to comment on the service provided by other professionals.
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Nigel Hall (29/04/2015 10:59:18)
What are the trade-offs with getting a tongue-tie division done by a local private midwife or going to Southampton Hospital. Is the hospital likely to be safer and higher standards? Who will do the division at the Hospital
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Anonymous (24/04/2015 17:04:34)
Thank you for this perceptive comment (09/12/2014 12:03:25).

There is nothing for age 15. This is because the site was invented for babies and infants and I never thought to add anything for age 15, for which I apologise.

I have seen five patients with a tongue-tie aged between 12 and 15 over 25 years. Two had problems with saliva/dribble and did not seem to be able to move it easily from the front to the back of the mouth, so they had to actively and sometimes noisily suck it into the back of the mouth. Both were helped by division. The other three sat beside their mothers and said that they could not kiss their boy/girlfriend properly. I think they deserve the Victoria Cross for bravery as I would never have said that in front of MY mother. I never asked if this improved after division, but assumed it did.
At this age a speech problem is unlikely to improve following division.

At age 15 you do have a choice of how to get it divided. I divide them under a general anaesthetic, i.e. you are asleep. However, there are dentists who will divide them under a local anaesthetic i.e. you are awake and the area is numbed by a local anaesthetic injection. I don’t (can’t) do that. You may need to ask your dentist who does it in your area, as not every dentist does it.

I hope that helps, but if you have a different underlying question, please feel free to ask it more specifically.

Thank you again,

Best wishes
Mervyn Griffiths
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Mervyn Griffiths (18/12/2014 09:14:46)
there is not much information for age 15
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Anonymous (09/12/2014 12:03:25)
Thank you for your query (15/11/2014 21:47:10).

I will be honest and say that this is not a question I’ve been asked before. I’ve discussed it with an orthodontic colleague and she agreed that this is very unlikely to be related to the division, as the tongue will have been freed up to its normal extent, but not to an abnormal extent.

This website seems to have a balanced view, i.e. it is almost certainly a normal variant and your child enjoys doing it, but if there are any associated problems, then it might be worth seeing someone about it. Very few babies require any treatment, though.

Best wishes
Mervyn Griffiths
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Mervyn Griffiths (24/11/2014 14:19:44)
Just wanted to check if a constant tongue protrusion(not whilst asleep) is a normal side effect after a tongue-tie cut is performed(for 6 months after the cut), and how can it be fixed.
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Anonymous (15/11/2014 21:47:10)
Thank you for your query (01/09/2014 10:11:10).

You have a baby who is not feeding efficiently and who has a 25% tongue-tie.
You cannot look at a tongue-tie and say “That will cause you trouble” or “That isn’t a problem”. There are babies with 100% tongue-ties who can breastfeed for England, and babies with 25% tongue-ties who feed dreadfully, often because there is a tight band you can’t see, but will be easy to feel, which is limiting the tongue’s movement. The critical thing is not the appearance of the tongue-tie, but the function of you and your baby’s tongue when feeding. My advice would be to get it divided.

Thank you again.

Best wishes
Mervyn Griffiths
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Mervyn Griffiths (22/09/2014 10:10:40)
Dear Catherine,

Thank you for your query.

It is normal for some babies to be unsettled, especially after posterior Tongue-tie division. However, there are often other potential causes, and it can be really difficult to be certain what is causing the unsettled-ness. Oral aversion is something we talk about a lot, but only see very rarely.

I think you should talk to the ICBLC who divided the tongue-tie as well as going for the cranio-sacral therapy.

Thank you again.

Best wishes
Mervyn Griffiths
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Mervyn Griffiths (22/09/2014 10:06:35)
Thank you for your query (11/07/2014 23:43:24).

Different hospitals have different upper age limits for when they will divide a tongue-tie without a General Anaesthetic. Six months is common, but some people ,like me for example, will keep dividing tongues until the baby has teeth top and bottom and I will get bitten!

There has to be a risk from an anaesthetic at any age, but it is very small. For most babies, the real risk of the procedure is the drive from home to the hospital as the chance of a car crash is far higher than the chance of a problem during the procedure. However, normal mothers will never be really happy until the baby is in Recovery afterwards. The anaesthetic time is about 10 minutes, and the procedure takes less than a minute. The potential advantages of division far outweigh the tiny risk of the procedure.

Thank you again.

Best wishes
Mervyn Griffiths
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Mervyn Griffiths (22/09/2014 10:02:19)
My baby is now 16 weeks old and although hasn't lost weight, his weight gain is slow, having dropped from the 75th centile at birth, now to below the 25th. He feeds every 2, 3 or sometimes 4 hours, including through the night, this has increased through the night since birth. It is harder now than when he was a newborn, as then he was going for 5 hour stretches through the night. I went to see a breastfeeding adviser and she said she thought he had 25% posterior tongue tie. How likely is it that this is affecting his feeding? He is latching on ok and it is not painful but I often feel that I don't seem to have enough milk for him and he can get frustrated. I want to continue breastfeeding but I'm not sure what to do for the best, particularly as this may be affecting his weight gain.

Thank you for your time, any advice would really be appreciated.
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Anonymous (01/09/2014 10:11:10)
My son had his posterior tongue tie snipped last week by an ibclc at 14 weeks. He's been very unsettled all week and will only go onto the breast for a few minutes before pulling off and is refusing a bottle completely. Is this normal? We're really worried about getting him to eat again and are worried we maybe caused some oral aversion. We are giving him nurofen and will try cst this week.
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Catherine (11/08/2014 13:09:51)
Thank you for your query.

Your question happens to be very similar to one posted on 17/03/2014 at 21:33:54. Please refer to my answer that I gave on 24/03/2014 at 10:35:07.

Best wishes
Mervyn Griffiths
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Mervyn Griffiths (28/07/2014 11:31:23)
Hello, I have a one year old boy who was diagnosed with tongue-tie at birth. His doctor told us to wait until he is 2 or 3 years old, when he will be speaking and we will know whether his speech has been affected or not, to decide whether to have surgery to correct it. Now I'm not sure if it is wise to wait that long because if his speech has been affected will he have to then 're-learn' how to talk with his ''freed' tongue? Also will the surgery be more distressing to a child of that age??
His tongue does protrude slightly beyond his lips but it definitely has the 'heart' appearance when it does protrude. He isn't making the usual baby sounds very much either and I worry that this could be an effect of the tongue-tie.
Your advice would be very much appreciated.
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Anonymous (23/07/2014 21:31:41)
Thank you for your query.

You do not say if feeding improved after the division.

I appreciate that there are a lot of variables here: sometimes, but not always, heart-shaped; breastfeeding painless, but breast not emptied; sometimes bottle feeds well but swallows a lot of air.

The critical thing to do is to get your baby re-examined by your lactation consultant. There are some babies who have a long thin anterior portion which divides easily, but the important part is the thick posterior bit, which may not have been divided, or if it was, it may have re-attached.
If there is nothing to feel, then the tongue-tie was completely divided initially and is not the problem. If there is a persistent posterior portion, then it would be worth (re-)dividing that.

So, "Does a heart-shaped tongue always require revision?" - Not always, only sometimes.

Best wishes
Mervyn Griffiths
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Mervyn Griffiths (22/07/2014 15:43:59)
I have an 8 week old daughter who had a 90% tie divided at 5 days by a lactation consultant. Since then I've noticed that the tip of her tongue is sometimes heart shaped when crying. I have a low supply due to previous breast surgery and am also bottle feeding so it's hard to know whether this is causing feeding problems, I have no nipple pain but she doesn't drain the breast very well. She does seem to have issues coordinating sucking and swallowing from a bottle frequently and gulps a lot of air but feeds well often enough from the bottle to gain weight very well. Does a heart shaped tip always require revision? I don't want her to have problems in the future with eating and speech but equally don't want further procedures if not neccasary. Would love to know your thoughts.
Many thanks
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Anonymous (19/07/2014 10:12:05)
Dear Carl,

Thank you for your query, and I'm sorry for the delay in replying, but I've been on holiday.

It is obvious that any doctor/accountant/architect/plumber should only do work that they feel competent and confident to do. The vast majority of tongue-tie dividers in the UK do not divide any tongue-ties in babies over there months. A few will go up to six months. A very few people, including me, will divide TT in older babies without a general anaesthetic, in my case up to 10 months, but only providing there are no teeth (about one a year).
The actual risk of a GA in a child of eight months is so small it is essentially impossible to measure, and definitely less than the risk of driving in to the hospital from home, which is usually easy to measure. However, humans find risk assessment very hard, and no mother will believe this, until their child is in recovery and doing fine! This is normal.

So, if the team at Oldham feel that your baby would benefit from tongue-tie division, then, in 2014, you have a choice. Do nothing, or go ahead with the operation, which will be fine for her, or ask for a second opinion from someone who is possibly prepared to divide a TT in eight month old babies without an anaesthetic, which may be difficult to find. This will cause further delay, and if she has teeth, is probably impossible.

The hospital team will have had your daughter's welfare uppermost when they made their recommendation - you should discuss it with them.

Best wishes
Mervyn Griffiths
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Mervyn Griffiths (18/07/2014 14:38:43)
Dear Karlie,

Thank you for your query.

I am delighted that you managed to get a posterior tongue-tie divided at five days as this is not easy. I'm not sure why there is a new problem now, but at nine months, with teeth, there is no easy fix. Once there are obvious teeth, then it is impossible to do anything without a general anaesthetic, and few parents think that is something they even want to consider, unless they really have to.

Most tongues with posterior tongue-ties are "short", not long pointy, I-can-lick-the-tip-of-my-nose type tongues. So not being able to poke it out now is "normal". The front part of the tongue will grow with time and "poke and lick" should improve. Similarly, speech is not assessable until three and a half years old, as some two year olds make very odd noises. If there is a problem then, it would be worth getting a speech therapist to see her, but there is no point before then. I don't think we've redone any previous posterior tongue-ties at three to four years old for speech problems, but anything can exist in medicine…

I hope that helps.

Best wishes
Mervyn Griffiths
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Mervyn Griffiths (17/07/2014 12:10:29)

I have 9 month old Daughter who had a posterior tongue tie which was divided at day 5 as it was causing problems with breast feeding. There was an instant improvement and we have continued breast feeding. Over the past few weeks I have noticed that when she is breast feeding she keeps coming off the breast after a few sucks like in the early days, also that she has never stuck her tongue out or blown a raspberry. I have tried to entice her with food to stick her tongue out, but she can't get to to beyond her teeth. When she cries her tongue remains down so hard to see if the tongue tie is still there but I feel that it is.

What are my options, as would hate for her speech to be affected and miss out on the enjoyment of licking an ice cream when he's older.

Kind regards
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Karlie owen (16/07/2014 12:59:25)
Hi I have a 6 month old baby who is tongue tied. We have an appointment for her operation for it to be corrected. She is being put to sleep for the procedure which I am very nervous about! I have read the information above which states that babies under 8 months old needn't have anaesthetic! Is this only certain consultants or across the board? What is the likelyhood of something going wrong putting my daughter under general anaesthetic?
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Anonymous (11/07/2014 23:43:24)
why does Oldham hospital say they anaesthetic babies older than 6 months and Southampton say 8 months. My daughter had hers done at 3 months and its reattached and she is just about to turn 6 months and my mrs doesn't want to use anaesthetic but Oldham wont allow it.
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Carl Petch (08/07/2014 13:55:18)
Dear Meena,

I’m sorry to hear that you are having such a traumatic time. The hospital missing a posterior tongue-tie initially is actually normal as no hospital has enough people to pick these up initially, and I doubt that there ever will be. It is excellent that you had someone pick it up at 10 days, as many mothers struggle for much longer.

This type of feeding problem can be very difficult to elucidate. The problem is that not all the babies with a posterior tongue-tie have a feeding problem which is due to the tongue-tie. They all have short, square-ended tongues and many have associated muscular problems which you are already addressing. You need to get a second opinion from another lactation consultant who has seen many posterior tongue-ties, and find out if there is actually anything there. If so, then you will have to decide if re-division, or further division is actually worth while, as if she didn’t improve the first time, there is a strong possibility that she won’t improve after a second division. If it was felt that the initial division was incomplete, then a second division is easier to justify.

There are a group of babies with short tongues whose major problem is not anything under the tongue, but the tongue itself or the muscles of the throat and neck. These babies do not benefit from multiple division, but can be helped by the cranial osteopath team.

So, get a second opinion, discuss if further division is necessary, and be prepared to continue with the osteopathy.

Best wishes
Mervyn Griffiths
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Mervyn Griffiths (04/07/2014 10:58:24)
I’m sorry, but the short answer is “No”, I don’t know who to send you to.

I’m not sure from your message if there are problems with your three year old now, or whether this potential posterior tongue-tie is just something you can feel? I would be very unkeen on treating something you can feel, unless there were quite specific symptoms or problems that could be improved. I treat problems with tongue function, not simply the presence of something under the tongue.

As any treatment at this age will require a General Anaesthetic, there is an even greater need to be able to justify any action.

Whereabouts in the NW are you? Would you go to Newcastle or Manchester or Birmingham?

Best Wishes
Mervyn Griffiths
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Mervyn Griffiths (04/07/2014 10:53:15)
Dear Mervyn, I hope you'll be able to help me as I'm at my wits end. I have a 7 week old baby whose posterior tongue tie was missed by the hospital when she was born even though she wasn't feeding well. I breastfed my previous daughter for 7 months with no problems so knew what to expect. We had to pay a private consultant to fix baby's tongue tie when she was 10 days but I'm not convinced it's gone; I'm exhausting myself expressing and she constantly clicks when at the bottle, is full of wind, has an incredibly shallow latch when I attempt breastfeeding and all other tongue tie symptoms.

The problems that I am having is that health visitors, breast feeding support workers and midwives do not think that she has a tongue tie, I am positive that the problem remains, perhaps not as obviously as before but there is something.

I just want the problem fixed, I took baby for cranial osteopathy today and the practitioner thinks that there is a problem; baby is able to extend her tongue fully when she's relaxed but when sucking, her tongue only extends halfway before snapping back.

Any advice would be much appreciated, I did ring the lactation consultant that performed the frenetomy but she couldn't be less interested, I'm desperate and just want my baby to be able to feed without it being a traumatic experience for us both.
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Meena Puaar (03/07/2014 01:29:22)
I believe my almost 3 yr old has a posterior tongue tie that was missed when she had her anterior tongue tie treated as a baby. She couldn't breast feed, struggled to drink from bottles and finds solid food very difficult to eat. My youngest daughter has had her tongue tie revised 4 times and we have been seeing a lactation consultant and osteopath privately, so I'm aware that not all NHS doctors are aware of tongue ties or how to revise them properly. I'm in the North West of England and was wondering do you know of anybody who knows about tongue ties that I could ask my GP or dentist to refer her to? I'd prefer to be able to name who I would like a referral to, rather than risking being told that there isn't a tongue tie by someone who doesn't know enough about it.
Thank you so much.
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Anonymous (02/07/2014 15:55:18)
Thank you for your comment.

There is no question that tongue-ties can cause symptoms in adults, but only some of yours. The mouth symptoms could be related, but not the breathing problems or the clicky noise inside your head.

It sounds as though you have a narrow nasal airway, but that is not treatable, though it may have been related to the tongue-tie when you were tiny. Leave it alone.

Some, but not all, dentists will divide tongue-ties in adults under local anaesthetic, on or off the NHS. You may need to ring round, but ask your own dentist first.

Best wishes
Mervyn Griffiths
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Mervyn Griffiths (27/06/2014 10:05:04)
Hi, I'm 25 and tongue tied. I've just been to see my GP, and although she was very nice, I got the distinct impression that she only knew a little bit about tongue tie in babies and next to nothing about its possible effects on an adult. She said that even if she referred me, there's no clinical indication to get it cut on the NHS.

My symptoms are as follows (obviously, I cannot say for certain that these are all due to tongue tie):

Last time I tried to swallow a pill, I nearly choked.
When I'm eating something that needs serious chewing, I have to sneak the corner of my mouth open so that I can still breathe.
Breathing through my nose is the next best thing to holding my breath. It requires concentration.
Excessive wind- could this be due to swallowing too much air?
When I run or jump, I can sometimes hear a clicky noise inside my head- sometimes accompanied by a headache.
My tongue comes out fat and stubby, and I can't kiss my husband properly. Again, kissing and breathing at the same time can be tricky.

The tie is very obvious, and goes almost all the way to the tip of my tongue, but it's also loose enough to allow me to talk fairly normally. If I open my mouth wide and try to put the tip of my tongue behind my top teeth, it will only go about half way.

Is there a chance of getting it done on the NHS, or would I have to go private?
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Anonymous (26/06/2014 11:16:48)
Dear Joanne (post from 09/06/2014)

Hogan M, Westcott C, Griffiths DM. A randomised controlled trial of division of tongue-tie in infants with problems breastfeeding. J Paed Child Health 2005; 41: (5-6) 246-250

Best wishes
Mervyn Griffiths
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Mervyn Griffiths (25/06/2014 13:28:23)
I'm sorry that I've not replied sooner, but I've been on holiday.

If the speech therapist thinks the speech problem is coming from the front of the mouth/tongue, then there is good evidence that division now will improve his speech. He will need to do exercises too, obviously.

If you leave division later, then fewer children improve, possibly the source of the "He's too old" comment.

Best wishes
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Mervyn Griffiths (25/06/2014 13:22:26)
My son is coming up for 3, he is tongue tried, was not cut at birth as i did not breast feed.
He is having trouble with his speech, wear he can say words like snake, he cant say rabbit.I have noticed that its r, k, q that he has trouble with. My gp says he is too old to get it snipped, he will have to learn live with it.Speech and language say hes speech might get better in years to come.
please give me some help on this
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Anonymous (09/06/2014 14:51:18)
I would like to read about the study that suggests that "over 1 in 10 babies are born with tongue tie" (quoted on this webpage). Pleae could you tell me where it is published? Thank you.

Joanne Johnson
NCT Breastfeeding Counsellor
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Joanne Johnson (09/06/2014 10:29:03)
Dear Jade (post from 26/03/2014)

The short answer is "No".

When you come to see someone at an appointment, you come for their professional opinion. This will be what they think would be the right action for you. To try to force them to do something they think is wrong is not a good idea, if you think about it, as you wouldn't really want someone to do something to you they thought was incorrect. However, you are entitled to a second opinion, and your GP could refer you to someone else.

Your 2-year-old child is different.
The Children's Act makes it an offence to do something to a child which is thought not to be in the child's best interest, so persuading someone to do something they disagree with is potentially illegal.

However, in this case, it sounds as though your child has significant problems eating and dribbling. These are perfectly reasonable grounds for many people to agree to do something, e.g. divide a tongue-tie, which can cause these sorts of problems. Division will require a General Anaesthetic, which some mothers think is too great a risk, but which I would regard as essential. Hence it is likely that it will be straightforward to find someone to divide your child's tongue-tie under a GA.

(Speech is impossible to assess in two-year-olds, as many speak poorly , but are fine by the age of 3.5 years.)

Does that help?

Best wishes
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Mervyn Griffiths (23/04/2014 10:47:12)
Thank You Doc for reverting on my query and thank you NHS for posting the same.

This really helped me and I will go with what you have advised. If he does have speech issues administering GA at 3 yrs + would still be better than when hes 1.

A million thanks.

A CBI Mom with lots of questions:-):-)
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Anonymous (21/04/2014 13:57:14)
Thank you for your long list of questions!

I note that you have a 10 month old son with no problems breastfeeding, but a tongue-tie which is visible. My basic view is: "If it isn't broken, don't fix it". So, as it is asymptomatic, leave it alone.

It may indeed stretch or even rupture by itself, or when poked with a toy.
At 10 months he is too old to allow division without a GA, as, if it bleeds, it will be impossible to press on it to stop the bleeding, because the person pressing will get badly bitten and will have to stop!
You will not know it there is a problem with speech till he is 3 and a half years old. If he has a problem with "l", "t","s", "th" and sounds muffled, then he needs it dividing under a GA, which is not a problem by that age. However, if his tongue is mobile enough to breastfeed well, it is likely to be able to pronounce sounds normally. Treatment at 3.5 yrs will allow full resolution of any problems. If you wait till he is 7 or 8, then it is less likely to be successful. Following a division , if he needs one, he will be able to poke his tongue around by himself and will not need massage. (There is no evidence for massage being helpful at any age.)

I don't have the right weight charts for India, but in the UK, the average weight of a 12/12 baby is 10 kg, so he doesn't sound too small.

Does that help?
Best wishes
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Mervyn Griffiths (16/04/2014 15:03:07)
Unfortunately in India Paeds dont really acknowledge TT to be a major issue that needs correction. My boy Reyansh who is now almost 10 months old has a TT (anterior class 3) which got detected by a LC when he was 2 months old. I had no issues in BF whatsoever so I did not clip the same.I visited the LC as I thought I had supply issues which were more due to my psychological issues that I cannot bf him and that my supply is low and not the TT per se. I have successfully breastfed him till date. But I am now posed with a few questions which I need answers to. Please can you help me answer the same.

Reyansh has an anterior tie and a short frenelum. I showed him to a paed surgeon when he was 5 months who said that his tongue mvmt is not restricted and he can move it beyond the below incissors. Hence immediate clipping is not required. He does not forsee any challenge in the future and has told me to go back to him when he is a year old. He would want to wait for his oral cavity to develop and then take a call. If required they would clip it by giving GA.

My queries as below

- I fear that Reyansh will have speech issues as his tongue is kind of flat.
- If I dont clip it and let nature take its course and then realise he has speech issue and then clip it, will the speech issue reverse.
- You have mentioned that the tissue can tear off naturally with say a spoon while feeding solids or a toy. Does a TT correct on its own. As I have seen a better movement and protusion of his tongue offlate. However when he removes his tongue out to grab the spoon it forms a slight heart shape(seen offlate again)
- I plan to snip the tie once he's 1-1.5 yr odl. (before his speech commences). Would GA be safe for a 1 year old? Should I do it without GA? We have a dentist in Mumbai who does it without GA. My LC is completely against GA. However I am not confident of putting my big boy through it now. - Are any massages required post the procedure and if not are there any chances of the tie reattaching itself.
- Also his weight gain is less inspite of solids and feeding. Could TT be the reason for the same. BW was 3 kg and now he weights 8.1. (at 10 months)

Really look forward to your support and help me take a decision for my boy.

Look forward to your inputs please.
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Anonymous (14/04/2014 07:39:46)
Can i demand to have my 2 year olds tongue tie snipped??? as it was not noticed at birth but now has a lot of difficulty speaking,eating slavering ECT he has a referral appointment 29th of April to see a specialist if they don't agree to snip it can i demand it???
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Jade (26/03/2014 15:00:24)
Thank you for your enquiry. I can understand your concerns, but will try to explain why your ENT surgeon has given you this advice.

There are two reasons for this advice:
Firstly, a visible tongue-tie does not mean that there will be always be problems with feeding or speech. There are babies with visible tongue-ties who breastfeed perfectly and have no problems with speech, so division in these babies would be unnecessary. My speech and language team (SALT) tell me that some 2 year olds make very strange noises, and that real problems will not be apparent until the age of 3.5 years. Then the problems will be with the front of mouth sounds, “l”,”t”,”s”,”sh”. Reassuringly, division then will allow the child to develop normal speech. Division at an older age makes it much more difficult, so being aware of prompt action at this age is important. If the problem is with “g” or “k”, for example, then, as these are back of mouth sounds, it is unlikely that division will make any difference.

Secondly, babies under 6 months of age can all have their tongue-ties divided without an anaesthetic. However, in order to be kind to the baby and to be safe and able to stop any excessive bleeding, should it occur, division at 12 months of age requires a short general anaesthetic (GA). This is also true at 3.5 years. (It requires a 5 minute anaesthetic and a 45 second operation). Quite rightly, most mothers do not want an unnecessary anaesthetic, but will accept one if there is definite evidence of a speech problem at 3.5 years.

To my knowledge, there is no-one in the South of England who is willing to do a tongue-tie division on a 12 month old who has no problems now.

A private GA will be at least £1500, as it requires a day case admission, theatre time, surgeon and anaesthetists fees etc...

My advice would be that as your son has no problems now, then it is quite safe to wait and see if any develop and are present at 3.5 years old. If so, then get him assessed promptly by your local SALT, and if they feel that the problem is at the front of the mouth, then division under a short GA is the sensible way forward.

I hope that has helped.
Best wishes
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Mervyn Griffiths (24/03/2014 10:35:07)
Thank you for your very reasonable question.

Fifteen years ago, almost everyone knew that tongue-ties never caused a problem, so they weren’t routinely divided, even if you had problems breastfeeding. In 2014, most problem tongue-ties are divided early on, so problems like your son’s ones are getting rarer.

When his speech problems improved, there will have been resistance to giving him a general anaesthetic (GA) if he could now speak normally, even if the tongue-tie was clearly visible, as there are adults with visible tongue-ties which don’t cause them any problems.

However, despite all this, he has obviously had dental problems and is getting food stuck. (Some paediatric dentists would have said that at birth and would have used this reason to divide all babies’ tongue-ties, whether they have problems feeding initially or not). Some other boys of this age have problems with their saliva, and have to consciously suck it to the back of their mouths or they will dribble. Others will be brave enough to say that they cannot kiss their girlfriends properly, which I think deserves a medal…

As he is having problems with solids getting stuck, I would definitely consider that he should have this divided on the NHS. He is old enough to say if he would like it done under a general anaesthetic (asleep) or under local anesthetic. If he wants a GA, then he needs a referral from your GP to your local ENT/maxillo-facial/paediatric surgical unit. If he wants a local anaesthetic, then ask your dentist first, and if they won’t do it, they should know a dentist who will.

I hope this helps,
Best wishes
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Mervyn Griffiths (24/03/2014 10:32:04)
My son is 12 months old he has been diagnosed with a tongue tie by my local nhs ENT! However the ENT has said he will not divide the tongue tie unless it causes problems with his speech and will only see him again when he is two years old if this is the case! I fear that if I wait until then that any damage done to his speech could already be done! Is there anywhere that will cut a tongue tie privately for a 12 month old?
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Anonymous (17/03/2014 21:33:54)
My son is almost 15 years old. He has a large tongue tie (which reaches the end of his tongue/up to his lower gum). As a baby we had lots of breast feeding problems which resulted in changing to bottle feeding at a few weeks. He also needed speech therapy aged 3 - 5, it was only then a tongue tie was diagnosed. As his speech developed with therapy they said nothing needed to be done about the tongue tie and I accepted this. It has only been in the past couple of years I have become concerned about his tongue tie. He has poor dental hygiene and has needed several fillings and finds it hard to get pieces of food out of the mouth/trapped in teeth using his tongue. When eating food he is unable to effectively chew his food unless he eats with his mouth open and at times can feel the tongue tie tugging when he chews food. Quite often lately when he talks a clicking sound comes from his mouth. I am worried over how the above could impact on him as he gets older, particularly confidence in social situations and relationships also. Do you think he would be able to have the tongue tie divided on the NHS? And if so what steps do I need to take to start the process?
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Anonymous (15/03/2014 00:12:46)
I agree that sometimes mothers with unwell children need to be persistent. We are seeing her this month. Best wishes
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Mervyn Griffiths (14/03/2014 16:55:55)
Thank you for your very topical question.

The reason that you have had difficulty finding any information about upper lip ties, is that there is very little in existence, and that is mostly about older children.

From 1950 to 1990 it was said that tongue-ties never caused a problem. We now know that was untrue and many babies feed better if the tongue-tie is completely divided.

Similarly, almost no-one thinks that the upper lip tie is important in breastfeeding in the vast majority of babies. The only upper lip ties that anyone thinks might be important are the ones which reach round the gum (called a type 4). If the baby feeds well from birth, they are obviously not a problem. If feeding is a problem but following tongue-tie division the baby feeds well, then the upper lip tie is not important then either. That is almost all babies.

Inevitably, there will be a few babies in whom there are feeding problems despite the tongue-tie being completely divided. In this small group, many have peculiar tongues or other problems. Many of these babies are definitely helped by cranio-sacral therapy, as the problem is muscular, in a way I don't understand. However, I have heard of two women who fought for upper lip tie division and said it helped, but there is absolutely no published evidence for this.

In 7 year old, an upper lip tie that encroaches on the gum can sometimes cause separation of the upper teeth, but this is impossible to diagnose until then (just because there is a problem with the milk teeth does not mean there will be a problem with the permanent teeth). The thick portion between the teeth needs removal under a general anaesthetic as a day case.

So, initially I would be keen to ensure that your baby's tongue-tie is completely divided or hasn't recurred. Then I would be keen to suggest some cranio-sacral therapy. Only when all this had failed would I think it reasonable to even consider the significance of the upper lip. I know of no-one who is dividing these on the NHS in babies.

I would like to re-iterate that there is no convincing evidence that upper lip tie division is successful if all else has failed. Does that help? Best wishes
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Mervyn Griffiths (14/03/2014 16:54:44)
After battling for 4.5m my daughter has finally been diagnosed with a posterior tongue tie and upper lip tie. I have several breast feeding qualifications and she is the 6th child I have breastfed yet I was not listened to. We have finally been referred to mr griffiths at southampton so am hoping we can finally have both ties snipped.
Symptoms we have are...
Blanching of nipples
Low milk supply
Slow weight gain (3weeks to birth weight and 4lb gain total since birth)
Clicking when feeding
Sliding off the nipple
Shallow latch
Top lip curling inwards
Constant feeding blisters on babys lip for the first 6 weeks
Choking on milk even at end of feed or when given a bottle

These are all symptoms that I noticed myself. Yet because my daughter was able to feed with a good latch occasionally I was told it wasn't possible for her to have a tongue tie.

Since being diagnosed I have also been told that her tongue humps rather than forms a gulley when sucking... Another sign.

If you think there's something wrong then seek a second/third opinion!
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Sam robertson (11/03/2014 10:24:34)
My little boy was born 21.11.13 at St Marys Hosp IOW. After a week of excruciating breast feeding the midwife noticed he was tongue tied and quickly arranged for this to be corrected. However the feeding continued to be painful and only possible with the use of shields. Despite visits to the health visitor, lactation consultant and GP no one could help but I persevered. Yesterday I read about upper lip tie and after checking his mouth and discussing with the health visitor she has today confirmed that he also has this. I don't understand why this wasn't checked earlier, especially when his TT was corrected. Why is there no information available on discharge from hospital, who can I address this with? Are you also able to advise me of the way forward please, can / should his ULT be corrected?
Thank you.
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Ruth Williams (10/03/2014 14:55:19)
My 5 month daughter has tongue tie. I went to my GP when she was 2 months. I was in a lot of pain feeding with blisters but my doctor said she did not have tongue tie. I carried on BF but would still get sore every so often. She still feeds every 1 to 2 hours & feeds 5 times in the night. I went back to the doctors for a second option & it has now finally been confirmed she has tongue tie. I am now waiting for a referral from Kingston Hospital but the doc could not tell me how long it would take & was even rushing me out the door! I'm seeing my health visitor on Monday to make her aware too. I'm hoping it's soon.
So, go with your instincts & if you think you have been given wrong information, go & get a second opinion. Doctors don't always get it right first time.
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Georgie (07/03/2014 12:10:38)
You have had a dreadful time for far too long. I agree that the symptoms of speech problems and dribbling would fit with a tongue-tie. There are several ways forward:
You could go back to your GP and request a second opinion from another nearby hospital with either a maxillo-facial or an ENT surgeon. There is no reason why this shouldn't be on the NHS, but I'm sure they will all do them privately as well. A private operation will cost in excess of £1000.

If your GP will pay for it, you could be referred further from home, again either NHS or privately.

There is no point in a speech and language referral at this age, as if there is going to be any improvement following division, it needs to be divided sooner rather than later. Older children tend not to improve as much following division as three year olds.

You can complain again to Croydon. The habit of postponing elective surgery and non-cancer OPD is very common as hospitals ensure they are hitting the right targets. The SALT will not be causing the delays. They must have "breached" by now which gives you rights too…

Hang in there, it is worth continuing to get it divided. Best wishes
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Mervyn Griffiths (04/03/2014 15:12:07)
Thank you for your query. You could well be right.

You need to see a lactation consultant who is used to diagnosing tongue-ties and knows what to do. If your baby has teeth, then any treatment will probably need a general anaesthetic. Many lactation consultants won't treat a baby of this age at all, but they should be able to get you a decision as to whether there is a tongue-tie present. Try or Best wishes
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Mervyn Griffiths (04/03/2014 11:30:52)
I am having a nightmare trying to get my nearly 4 year old's tongue tie cut with Croydon University Hospital - it was pointed out when he was a baby but he breast fed for 6 months okay (albeit all the time) - I went back at 18 months as he was spitting, drooling etc, told to come back when he could speak - went back when he was 3 - he has a lisp, spits, poor speech and dribbles so much he's top is soaking wet it has to be changed. I managed to complain and finally thought I was getting somewhere but the pre-op appointment was postponed on 3 occasions. Complained again bumped back to place I started - bumped back to speech therapy where I had to make an appointment for an appointment for an appointment!! I had to insist on a formal assessment for speech therapy but the lady already said her 'gut' is its not the tongue tie and he is forgetting to swallow?!! I have complained again and am insisting it is done. The only way they can tell if its the tongue tie is if they cut the tongue tie. It has probably cost them more money with all of this nonsense. Essentially its down to money - they have never wanted to do it when he was a baby, a toddler or noe a pre-schooler. I am at my wits end. So any help much appreciated. Can it be done privately if so how much in the local area. I am so angry about this. I have had enough of patronising staff. I don't believe there is any speech therapist who will say the tongue tie is the reason they are just set to a default mode of its not a problem.
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natasha alexander (27/02/2014 15:12:00)
Hello. Please please may you offer sone advice. My little girl since day one has had feeding problems. Breast fed for 6 weeks combo fed for 4 more then formula. At 13 weeks diagnosed with reflux put on omeprazole and diagnosed with cows milk protein allergy. Her screaming in pain stopped. Now she's 7 months still failure to thrive, had so many prescription formulas with no imprivement. refuses feeds all day long, refuses a spoon, finger food she picks up puts in her mouth hold for a few minutes then either spits out/it falls out or she swallows it. She can take up to 2 hours to feed as little as 2 ounces of milk, slips of the bottle, clicks, can almost hear wind in her tummy if that's even possible, other close family members have tried with no luck, Only test that's been done is listen to hear chest, feel tummy, lolly pop stick on her tongue to check for thrush. Yesterday I noticed sonething, sid research and she has a top lip tie and it looks to be class 3 or 4 this I am 100% certain of. But now I am looking for a tongue tie, she can stick out her tongue if her mouth is closed and the tongue points downward. I have tried to look carefully but can't lift her tongue up enough and she can't lift it herself, I've never actually see her tongue above the floor of her mouth. And noticed when she cries the sides curl up slightly. Her dad and I are so very desperate to find an answer for our girl and I think this could be it. Could you offer advice or your own option we would be so very grateful. She's to and from the docs, many appointments and admissions to hospital, seeing pediatrician, dietician, soon to be seeing a SALT. Any info would be so much appreciated. Thank you
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Amy (26/02/2014 23:21:35)
Certainly. I see about three teenagers a year (and about 300 babies). I'm sure many others are not referred to me.

You have two options:
Firstly, you can go to your GP and ask to be referred to a paediatric surgeon, or a maxillo-facial surgeon or an ENT surgeon. There are different regional referral patterns, but all three types of surgeon would be equally good at dividing it. They would all expect to do this under a general anaesthetic, as a day case, i.e. with you asleep and no overnight stay in hospital. The division can be done with special cautery scissors, or high-tech with a laser, or simply cut and stitched with dissolving stitches which don't need to be removed. They all work very well and the chance of a complication like infection or bleeding is very low.

Secondly, you might prefer to avoid the general anaesthetic, and in that case I'd recommend you ask your dentist if they would do it under a local anaesthetic. They may refer you to a different dentist, as not all dentists divide tongue-ties. This will require numbing the tongue-tie with local anaesthetic and then dividing it.
Best wishes
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Mervyn Griffiths (26/02/2014 14:08:05)
I'm 13 and my tounge is tied is there any way I can get it cut at this age??
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Anonymous (25/02/2014 22:27:27)
I was delighted to see that the tongue-tie was divided so early after delivery - that is very difficult to achieve across the country. However, I note that it did not make any real difference to her feeding, either initially or now. The problems with solids could easily be due to a tongue-tie.

So, either the whole tongue-tie was not fully divided initially, which is possible – a thin anterior portion is divided successfully, but the important thicker posterior part may not have been divided, and so the symptoms remain. Or, any tongue-tie is irrelevant, as the problem lies with the tongue itself or muscular inco-ordination from some other cause.

Someone needs to feel under the tongue and sweep from side to side and feel if there is any posterior part of the tongue-tie remaining. Assuming that she hasn’t got teeth top and bottom, then it would still be possible to divide any remaining tongue-tie without a general anaesthetic. Your breastfeeding team may be happy to do this, or they can refer you to us in Southampton. Best wishes
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Mervyn Griffiths (25/02/2014 12:55:39)
My daughter was born at 38/40 with a severe tongue tie - which my husband noticed immediately and was released at dorchester jospital on day 0. She had a terrible time breastfeeding with poor latch on and poor weight gain despite lactation consultant support. She was combination fed as a result of this. Shes now 8 months and was weaned at 5months. Despite nearly 3 months on solids she has a terrible trouble with anything thats not completely pureed, chokes/gags and vomits up whole feed. Could it be the tongue tie causing this? She is far behind all others her age with finger food etc. Thanks.
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Mercedes Mills (24/02/2014 10:30:29)
Still feeding 9 months on thanks to the marvellous Mr Griffiths. Made all the difference in the world, and what a wonderful man.
Thank you is simply not enough.
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Charlie Briar (08/02/2014 20:40:35)
Thank you very much. In contrast to the almost daily media coverage of real lapses in care, the vast majority of the staff in the NHS are simply trying all the time to help as many people as possible to the best of their ability. Sometimes we do not do so well - see the comment from 29 December - but often we can help you and your child with simple things like immunisations and tongue-tie division. However, we would all agree that sometimes being a "pushy parent" is something for you to be proud of, too. Well done!
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Mervyn Griffiths (21/01/2014 14:02:24)
Just wanted to thank you for the Incredible service you are offering. My daughter had a major tongue tie, both back and forward, which was released by your team in 2009. Immediate dramatic improvement. Noticeable on the feed given seconds after the surgery. A very happy baby emerged, who grew to be a wonderful happy child. She successfully breast fed exclusively until 18 months, had perfect speech development and has just made a very confident, chatty, start at school. We could not have imagined that such a simple, un distressing procedure would have such liberating, far reaching consequences for our child. A literal overnight improvement from those first miserable, exhausting weeks of her life, both of us fighting a losing battle against the tongue tie, which midwives consistently misdiagnosed as 'poor feeding position by mother'. We are certain that our child's outcomes would have been very different had the tongue tie not been released. My husband has exactly the same major tie but left unreleased. As a child he suffered major feeding issues, speech problems and years of speech therapy, naturally impacting his confidence and academic attainment.

My wish is that there was more widespread recognition of tongue tie and availability of care / release service. I only located and managed to get an appointment with the wonderful Southampton team through making it my personal quest and becoming a 'pushy parent' through sheer desperation. Thank goodness they took pity on us! Our local midwives and NHS Hospital Stoke Mandeville did not even recognise that our daughter had a tongue tie, let alone have any resources to release it! A quick check for tongue tie should be part of the standard paediatric checks on release of mum and baby from hospital, and in the training of all obstetric staff, surely?

THANKYOU doesn't even begin it cover our gratitude. But I hope you know how important your work is, affecting long term improvements to the lives of ordinary parents and children all over the UK.
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Lucy (19/01/2014 22:05:17)
Thank you for your enquiry. I agree that at least some of his issues are almost certainly related to this tongue-tie: the feeding problems, the dribbling, the messy eating, possibly the gagging and the speech, depending on what exactly the speech problem is.
The horrendous reflux and snoring are unrelated. I cannot control any desire to run round in circles... (this is common in 4 year olds, after all).
You have a right to be referred for a second opinion, and, at that age, most paediatric or ENT or maxillo-facial surgeons would be happy to divide it under a short general anaesthetic as a day case.
I suggest you ask your GP for a second opinion. Best wishes,
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Mervyn Griffiths (13/01/2014 10:22:55)
My little boy who is now 4, is sufering from a very tight, thick tie which comes about a CM from the end of his tongue. He can stick his tongue out partly, but it is squared with a dimple in. I also feel that if he didn't have a gap between his teeth then it would be even further restricted. He also can't lift it unto his mouth. He suffers a lot with dribbling, and is a messy eater and snores in his sleep. He has had issues since birth, problems feeding and gaining weight, horrendous reflux, problems gagging, speech therapy. Having recently been back to the GP about the drooling issue, we have been referred back to speech therapy, I feel like we are running around in circles. I'm 99% sure his tie is the cause of his issues, but having trouble being listened to. I don't want him to start another course of therapy when the last lot clearly hasn't worked?
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Emelie (10/01/2014 11:08:41)
Thank you for your comment. I sympathise with your concerns about anything which might make your baby less well.
I think that a poor latch on the teat allowing considerable dribbling is usually combined with excessive air swallowing - milk out leads to air in... this can make any baby miserable. Whether this is in any way affected by, or causing a problem with, the cyst, I don’t know. It is quite possible that the cyst is completely unrelated to the bowel, for example an ovarian cyst, or simply a collection of fluid inside the tummy. Even if is a duplication cyst, it is unlikely to be affected by the swallowed air.
Regardless of the cyst, I see no reason why the symptomatic tongue-tie should not be divided by your local team. If you live in an area which will not divide tongue-ties in bottle-fed babies, then you need to do two things, firstly complain to the local management team and secondly ask for a referral to us. Best wishes.
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Mervyn Griffiths (06/01/2014 09:14:15)

Our 4 week old daughter is tongue tied, she is having difficulty feeding, dribbling a lot of her milk from the right side which then means she doesn't manage to take all her feed which then results in her wanting another about an hour later, as she is feeding so often either too little or too much it has resulted in her having very painful trapped wind possibly colic.

She also has a cyst in her abdomen (possible bowel duplication cyst, which she is being scanned for at Southampton in January and then to be seen by Dr Wheeler at the start of February) She was admitted to Southampton neonatal with a possible bowel twist after having green vomit but this was confirmed to not be the case, I would hate to think that her not feeding properly would cause her any pain to her abdomen due to the tongue tie/trapped wind

She is bottle fed and know they aren't usually cut if bottle fed but would like to to know if it is possible due to the circumstance?

Many thanks

Liz Carter
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Liz Carter (30/12/2013 15:12:35)
Thank you for your comment. As I’m sure you are aware, there is always going to be a chance of a tongue-tie recurring after division. However, the chance of this varies a lot depending on the type of tongue-tie your daughter had initially. Clearly visible, anterior tongue-ties only rarely recur, as there is sufficient tongue movement to keep the raw edges apart while healing. On the other hand, posterior tongue-ties seem to recur quite often, and re-recur if re-divided too. In the first instance you need to be seen by your local team and get it re-assessed. If it has recurred you will then have to decide if you want to put her through re-division, or accept that her feeding efficiency is perfectly adequate, especially as you will be introducing solids soon. Not all local teams are prepared to do re-divisions, but they can certainly advise you on whether the tongue-tie has actually recurred. Best wishes.
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Mervyn Griffiths (30/12/2013 14:00:00)
My 5 month old daughter had her tongue tie divided 4 weeks ago at our nearest service and we saw huge improvement in her feeding. However, in the last 7 days we have noticed that her gape seems smaller with a shallow latch, and she is dribbling milk and 'clicking' when bottle feeding again, causing her wind and discomfort. Could it be possible that her tie has reattached?
Would I recommend this service: Yes
Anonymous (30/12/2013 13:38:01)
Like you, I am very upset that you and your baby have had to wait so long. We have tried for the last 15 years to see breastfeeding babies within 3 weeks and often managed it in less than that.
However, last year I retired at the end of August and returned to work later, part-time. During that time we experienced a huge surge in referrals and were essentially overwhelmed. I think the comment at the beginning of November was, in retrospect, a bit hopeful, and for that I apologise too.

We have managed to get the wait down to 4 weeks again but this is still not what I would like to see, as I am very mindful of the other centres which I have criticised over the years with long waiting times, as we know that mothers are in pain and will, quite reasonably, give up breastfeeding if they are not seen soon. You have done very well to keep going all this time.
However, I hope you and your baby will continue to benefit from today's division.

Once again, my apologies,
Best wishes
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Mervyn Griffiths (29/12/2013 15:31:20)
Unfortunately, I can not share my experience with tongue-tie division, but can share my experience with waiting time. My baby was diagnosed with posterior tongue-tie on 8/10/13 and was referred to Southampton. After few weeks I have chased the referral and was assured on 5/11/13 that the referral is in progress and I should receive invitation any time soon. I got a phone call on 23rd December to be given appointment on 16/1/14!
Very long 3 months wait and struggle with breastfeeding! At the date of appointment my baby will be 5 and half months old. I am combination feeding as my little one, who was born at 35weeks weighing 1,9kg, wasn't gaining any weight. Despite seeking breastfeeding advice and following up on feeding routine I had to start using formula, which wasn't my intention, however I had no choice. So if you don't want to give up on breastfeeding and even a week feels too long, than I recommend to seek help privately. I was originally told 2 - 4 weeks waiting time and reassured that the referral is in progress several times. Finally waiting for 3 months! I am very disappointed about the whole experience so far. Let's see what impact the division will have.....
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Anonymous (28/12/2013 18:30:32)
Thank you for asking for our waiting time for tongue-tie division.
Although we have tried over the years to treat all babies within a fortnight, we have been overwhelmed by posterior tongue-ties and re-do divisions and we are currently slower than "within a fortnight". In addition, the Christmas period is on us, and this is causing a further delay.
I'm starting to do extra sessions in the New Year, but I must be honest and advice you that we are looking at about 4 weeks, which is far too long, but is due to the increase in referrals.
There are some, but not all, private lactation consultants who will divide posterior tongue-ties.
My apologies.
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Mr Mervyn Griffiths (23/12/2013 11:07:15)
How long it takes from referral to appointment? My son has been diagnosed with posterior tongue tie and our local lactation expert has refer us to Southampton hospital for confirmation and treatment. Breastfeeding is very painful and often takes hours but I don't want to give up! Thanks
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Anonymous (21/12/2013 09:25:01)
My daughter Lara struggled from birth to breast feed without falling asleep or latch on properly, and lost a lot of weight. After a painful couple of weeks we were referred to the clinic. Carolyn was so kind, diagnosed Lara with a posterior tongue tie and carried out the division, which was over very quickly, with very little distress to the baby. Unfortunately my daughter lost more weight that week, so I contacted the clinic, and Carolyn agree to see us again that day, despite the clinic being full. Lara was really quite poorly by the time we got to the clinic through not being able to feed well. Carolyn confirmed that her tongue tie had reattached and carried out another division, then stayed with us while the paediatrician checked my daughter, and arranged for my local hospital to help us with a feeding plan for Lara. She couldn't have been more sympathetic and helpful at what was a very stressful time. Thankfully, the second division made all the difference, and we're still breast feeding 6 months on-I couldn't be more pleased, and we definitely wouldn't still be feeding if it weren't for the tongue tie division. A huge thank you!!
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Victoria Elms (08/09/2013 20:00:57)
My son had his strong TT divided at the clinic in April 2012 (I commented here 23/04/12 on the immediate results)...I just wanted to make a few comments on the longer term results for him.
He was a smudge under 10lbs at birth & on 98th centile & his weight dropped to 60th centile at the point of our visit at 4 months. After the treatment his feeding improved significantly to see him reach 85th centile by 6months & further progress back to the 98th centile once weaned. In his "red book" the point of the TT division is blatantly clear from the graph...something which has proved a point to the HVs that repeated told me his TT wasn't hindering feeding.
He started to speak at 13-14m old and has an astounding vocabulary for his at 19m he speaks in 3-4 word sentences...the most common comment from friends, family, nursery & health professionals has been how clear his speech is! I cannot tell you just how heartwarming that is after the battle to get his TT treated...he's clearly an advanced speaker & I wouldn't like to think too much about how frustrated my boy would be if that TT was still there to the tip of his tongue...but I'm pretty sure his speech could not have become so clear & encouraged him to try so many new words & sounds.
Anecdotal as my comments on speech may be I am ever thankful for the vital work you do for so many babies in my sons situation.
Thank you just doesn't seem a big enough phrase to express how grateful I am to have been finally referred to your clinic...
Would I recommend this service: Yes
Anonymous (20/07/2013 15:59:12)
Dear Dr Griffiths,

I would like to thank you for all you and your team do in the field of tongue tie problematic.

It is a great relief to find help and understanding when pretty much everybody tells you that your difficulties will pass with time and they dont.

I am especially glad that you pass your knowledge on other health care professionals.

Best wishes

Would I recommend this service: Yes
Ivana H. (17/07/2013 21:34:57)
Thank you for your query. As I understand you, feeding has improved since the division, but is not as good as you think it ought to be, given that you are an experienced mother.
There is no question that there could well be a posterior portion of the tongue-tie which was not divided initially or which has regrown. If you or your lactation consultant/infant feeding advisor put a finger under your baby's tongue, and slide it from side-to-side under the tongue, there should not be any obstruction. But if there is a lump or bump or "Sleeping policeman", then division of the posterior remnant may well help.
However, the tongue may just be very short and although there is no longer any tongue-tie, the tongue still does not work quite right. If you are local, and there appears to be something there, you just need to get someone to refer you in to us.
Would I recommend this service: Yes
Mr Mervyn Griffiths, consultant paediatric surgeon (19/06/2013 12:16:19)
Hi, my 2 week old had anterior tongue tie snipped a week ago. Feeding is no longer painful for me, but he still struggles to latch. His tongue gets nowhere near his lower lip when he latches and feeds and he seems to rely on a very strong suck instead, often breaking the weak seal his lips have made. He takes in air so much and gets very tired quickly. He is gaining weight well with plenty of wet and dirty nappies and I have spent the whole two weeks working on positioning and attachment. I successfully fed my 4 year old for a long time and can tell that this little one's feeding isn't 'right'.could this be due to posterior tongue tie? Thank you.
Would I recommend this service: Yes
Leigh (19/06/2013 09:11:26)
You need to be referred by your GP to the service, following which I would be very pleased to see you.
Would I recommend this service: Yes
Mr Mervyn Griffiths, consultant paediatric surgeon (31/05/2013 10:22:26)
Hello, I think my son 3.5years may be short tongued as he has unclear speech. He's been seen by SALT and he's a more confident speaker and now at his local nursery after a small stint at ICAN! I think he has a problem with his tongue as he can't stick it out fully or lift it! Also hes vocab is great. ...he's just not clear! Sometimes spit gathers in his mouth. As a baby he dribbled lots! Please can we come and see you Mr Griffiths?
Would I recommend this service: I have no view
Benedicta Moxon (30/05/2013 09:56:57)
You need to be referred to your local breastfeeding team. Your midwife or health visitor or GP can do this. If you have already seen them and they agree with you that your baby has a posterior tongue-tie, then any professional can refer him on to us here for our opinion. They need to write to Mr DM Griffiths, Room EG 240, Southampton General Hospital, SO16 6YD with all your details and your GP's details and their details. We can then ring you up and make an appointment to see you both.
Would I recommend this service: Yes
Mr Mervyn Griffiths, consultant paediatric surgeon (28/04/2013)
We think my son has a posterior tongue tie as he doesn't obviously have a tongue tie but he can't lift his tongue very hie in his mouth and when he crys it lifts and curls slightly. I bf him and its painful for me and he has serious reflux (which I have read can be related). If he sticks his tongue out it comes into the right side of his lip rather than out of the middle. Can you offer me any advice?
Would I recommend this service: I have no view
Madeline (27/04/2013 20:14:26)
Thank you for your comment. You are both having a rough time. In this sort of situation, it is likely that the tongue-tie is not the only problem and to continue to divide it seems unfair on your baby and you.

Have you had him seen by a cranial osteopath or a cranio-sacral therapist, trained to work with babies? I think that might be a sensible way forward.
Would I recommend this service: Yes
Mr Mervyn Griffiths, consultant paediatric surgeon (27/04/2013)
I have an 18 week old , he was 6 weeks premature, I am breastfeeding him and had wonderful support but unfortunately had every thrown at us he has had his tongue tie cut 4 times so far and everytime it grows back thick. I have had nipple thrush on going ductual thrush, , mastitis , cracked, bruised nipples , many of you are probably asking why haven't I given up yet and the only reason he won't take a bottle, cup, spoon and hates formula so I have just continued:( he's had it cut twice in poole once in salsbury and once in Southampton, I have been told by Southampton that if it grew back they wouldn't cut again as it wouldn't be worth it for him as it will always come back. but he continues to feed every hour to two hours all during the day and night, there must be someone that can help me as he is never satisfied and always tired :'(
Would I recommend this service: I have no view
Anonymous (26/04/2013 22:55:32)
I'm delighted that we have been able to help you and your baby. Thank you for leaving your thanks and comment on the website.

Tongue-ties and bottle-feeding is a longstanding problem. There are many paediatricians who can cope with the concept of tongue-ties causing a problem with breastfeeding and permit their division soon after birth, but there are a large number who would regard division for bottle-feeding as wrong. Personally, I know that some babies with a visible tongue-tie are not tied at all and can breast or bottle-feed perfectly, but some can't, and these ones need division, however they are feeding. I will send your comment on to the neonatologist in charge of the Princess Anne. Thank you again.
Would I recommend this service: Yes
Mr Mervyn Griffiths, consultant paediatric surgeon (26/04/2013)
after being told at princess anne at 1 day old my daughter was tongue tied and would not recieve the treatment as i was not breast feeding and that if when she got to the age of 3 and had a speech problem they would then do it i thought it must not of been that bad until we got home we had problems with her feeding from bottles, problems with dummies and then at 4 months problems latching onto a spoon i knew something was not right! 2 weeks from the dr referring us we got an appointment with dr griffiths' team i can not thank them enough for helping my daughter already 3 hours on she is a completly different baby! i will be making a complaint against princess anne as my daughter was 100% tongue tied and any baby should not be left like this and waiting to a child is 3 is digusting and also wasting money the nhs doesnt have a simple snip at a day old would of prevented my daughter going through this today. thank you again
Would I recommend this service: Yes
hannah rogers (25/04/2013 14:44:07)
Also the consultant I saw when my son had his tongue cut said,

' I've been doing these procedures for 30 plus years and my advice is do it young that way stops more problems as child gets older. But I really wish I could educate midwives and HV because no child with tongue tie would be able to breast feed!'

Would I recommend this service: I have no view
Anonymous (26/03/2013 10:20:59)
My son weighed 7Ib exactly born. On hs 24 hr old doctors check they informed me he had tongue tie. My HV explained the lil op to me and at the time I refused it. By the time my son was 2 weeks old he had dropped right down to 6ib. Breast feeding was impossible he just would not feed at all. He was taking only 6ml a feed had that took us an hour to get that down him. William was then referred to hospital because of his weight lost they fed him through a tube through his nose into his tummy he was in hospital for 4 days. We then made the decision to have his tongue cut! He was 4 weeks old they wrapped him up in blanket I got a bottle at the ready and it was done in seconds bled for a bit and within two days it was fully healed. Since then he put on weight and what normally took us an hour he was done feeding within 30mins and came on leaps and bonds. The weight gain and feed was just brill I honestly couldn't recommended the surgery highly enough! My advice is if your child won't Breast or bottle feed, is loosing weight and not thriving do it! For sake of 2 seconds this could stop your chil having speech problems and going through this later in life when they no more. They won't remember it! Please don't hesitate! My boy is 19 months old now he's bigger than all his friends his age and is happy and healthy little boy. I wouldn't look back I feel my decision was right for him! If your baby has tongue tie and can feed well and is gaining weight d leave it but if not do it do it do it!
Would I recommend this service: Yes
Nat (26/03/2013 10:16:00)
It was a while ago that we had this treatment for my son and I have been meaning to email a thank-you for a long time! From birth he couldn't breastfeed at all but we continued to try. We were given different opinions on whether his tongue tie was causing a problem. Finally we were referred to Southampton when he was nearly 7 weeks old. A week later he was treated and we were made to feel very comfortable during something that could be very distressing. Unfortunately there was no immediate change to his ability to breastfeed but within a week we were breastfeeding successfully and no longer needed to express. Thank-you so much.
Would I recommend this service: Yes
H Moores (09/01/2013 12:11:36)
I am very concerned and sorry that you and your son have had such a poor experience.

As you rightly say, we have shown that about a half of all babies with a tongue-tie do not need anything doing, so we leave them alone. "If it ain't broke, don't fix it". Some paediatric dentists disagree and would divide them all, but there is no real evidence for this view. So, we do not usually divide a tongue-tie in a baby who is feeding perfectly. There is no correlation between a visible tongue-tie and speech, even though common sense says there ought to be, so we don't divide them for potential speech problems in 3 years time, unless the family has had speech problems before and are very keen on division, so they don't worry for the next 3 years.

In babies of 3 weeks, we know that the average time between division and quiet breast/bottle feeding is about 15 seconds, as feeding, the smell of mum and being cuddled, are much more important than pain-killers. Local anaesthetics taste revolting, so we avoid using them. A general anaesthetic is a very big deal for all parents and quite unnecessary for small babies. In babies over 3 months, I give paracetamol, but am not at all sure if it is more important than the feed and cuddle afterwards, as some babies cry anyway and others that have not been given paracetamol do not cry. However, all babies over about 9 months have to have a general anaesthetic as they are able to bite and we routinely anaesthetise toddlers.

Following division, smaller babies seem to be oblivious and are no different from babies who have not had a tongue-tie division, but older babies are often unsettled for a day or two and we suggest that they can have more paracetamol if required.

Over the past 14 years we have divided about 10,000 tongue-ties in Southampton and have developed our own view about how best to treat them, but we are always on the lookout for a better way. We have recently reconsidered the use of Sucrose solution, which is suggested for the Guthrie Heel-prick and immunisations, but milk seemed more logical.
The vast majority of these babies have done well, many brilliantly, though some do not improve if the feeding problem is due to the tongue itself, for example, rather than the tongue-tie. I do not know of any that have fed worse in the long term, though some of the older babies (>3 months) are worse temporarily.

Obviously, I would be very pleased to meet and discuss this further with you, if you would like.
Would I recommend this service: Yes
Mr Mervyn Griffiths, consultant paediatric surgeon (20/11/2012 17:01:34)
My son had his tongue tie snipped and I now think the procedure is brutal and unnecessary, how you can subject babies to this I will never know, anesthetic should be used! Half the time surgery is not required as it causes no problems for babies, I was completely mis-lead by my HV! Had I known the full extent to all of this I would never have given consent for this to take place, to all other mums out not let your child go through this!
Would I recommend this service: No
Anonymous (17/11/2012 07:28:05)
Please could you tell me if there is a private clinic for this procedure as I do not want to wait for a referral appointment? My son is four and a half months old and we have just moved back to Reading from Germany where professionals keep insisting he doesn't need it cutting despite poor latch on, 3 lots of mastitis, poor weight gain, and extreme wind and discomfort. I really can't let him suffer another 6-8 weeks for a referral. We arrive in Reading next week and will then have to register with a GP, and then get a referral. I am at the point of thinking of giving up breastfeeding as I don't think it's doing either of us any good, I don't want t as I breastfed my two other children for a year. Please advise.
Would I recommend this service: I have no view
Anonymous (08/11/2012 07:17:57)
I would like to find out some information please regarding tongue tie division training with Mr Mervyn Griffiths.


Dr Paula Brennan
Would I recommend this service: I have no view
Anonymous (23/08/2012 00:40:34)
What a wonderful service. They took my concerns seriously (even on the second visit) and were so pleasant and reassuring. After the second division by daughter now breastfeeds beautifully. A complete turn around from having to give up breastfeeding when she was 10 days old.
Would I recommend this service: Yes
Hayley Cousins (03/07/2012 16:43:35)
I would just like to say what a fantastic service you provide. I was referred on the Monday and my daughter had the procedure carried out on the Thursday. When you have a child with feeding issues time is of the essence. The hospital staff were lovely and very informative. Thank you all very much.
Would I recommend this service: Yes
A Thomson (27/04/2012 16:55:18)
My 4 month old son had a strong tongue-tie to the tip of his tongue, which was also thick and caused the classic heart-shaped appearance.
I found it an incredibly difficult decision to visit Mr Griffiths clinic and undertake a procedure for my son which was not for a life-threatening or painful condition, especially following numerous medical professionals advising a "wait & see" approach.
However, having been referred to the clinic,I am so grateful to Mr Griffiths & his team for their belief in the importance of dividing TTs and the way they approach this condition. Carolyn and Joanne who carried out the procedure were amazing, so empathetic and sensitive, taking great time to reassure me both before and after it was completed.
So...what did it do for us?
My son appeared to have no significant pain following the procedure and was his usual vocal, smiley self leaving the hospital.
We have much improved son latches on so well now and much stronger than before. His frustration at the breast has evaporated, with less crying and no back arching..he just gets on with it! This has also meant feeds are less stressful and not painful for me, now I am used to the stronger latching sensation.
He feeds for longer and is much less sleepy, frequently unlatching himself to end a feed rather than falling asleep and just slipping off.
We have breast-fed in public for the first time as he settles quickly, is less noisy and I do not have to manually hold his head and my breast towards eachother to help him stay latched on.
In the last few days, I have heard him make brand new squealing and "th" sounds and watched him suck his bottom lip in as he delights in discovering the new movements and shapes he can make with his new tongue!It has been so heart-warming to see and given me much relief with regards to his developing early speech.
A huge thank you to the team, it feels as though my sons true spirit has been released.
Would I recommend this service: Yes
Anonymous (23/04/2012 23:25:22)
My daughter recently had her tongue tie snipped at 7 weeks, and it has completely revolutionised feeding - we no longer suffer hourly feeds, a constantly hungry baby, huge amounts of wind and general grumpiness. It's such a delight to be able to finally enjoy my happy baby.

We were referred rather grudgingly by the Royal Berks as the midwives at the BF clinic there couldn't agree if she had a TT or not (it was only my insistence that something wasn't right that led to the referral as they wouldn't snip it themselves). Luckily as soon as we got to Southampton I was told that there definitely was a thick posterior TT, exactly as I had suspected. The procedure was quick and everyone was very kind and knowledgeable, and explained everything that was going to happen in detail.

Thank you so much for making breastfeeding so much easier for us.
Would I recommend this service: Yes
Helen Bligh (15/04/2012 12:09:21)
I want to thank Mervyn and Carolyn so much for allowing us to travel from NHS Highland to be taught how to snip tongue ties. This service is invaluable and now both Janet and myself are providing a service for our local mothers. Thank you both for providing us with the skills and knowledge to preform this in our own area.
Would I recommend this service: Yes
Karen Mackay (12/04/2012 13:58:03)
My daughter Sophie had a posterior tongue tie which had previously been divided by two different midwives. There was a small ulcer and a big thick band of tough fibrous tissue which was really resistant.
After each tongue tie division there was a small improvement in her ability to take a bottle, but Sophie still had extreme difficulty with breastfeeding. We were therefore referred to Mr Griffiths at Southampton Hospital.

Having already allowed two midwives to cut our daughter's tongue we were understandably apprehensive about a third procedure. However, Mr Griffiths' experience and professionalism was reassuring and the results of the procedure are fantastic. Although Sophie was a little bit upset at first she quickly recovered and is now breastfeeding successfully for the first time at 6 weeks old.

Overall, a very successful end to a difficult 6 weeks. Thank you
Would I recommend this service: Yes
Alex Rabbitt (08/04/2012 20:46:02)
My son who is 13weeks, had his tongue tie snipped this afternoon by two lovely ladies! He was 100% tongue tied & the procedure was quick & easy. I would highly recommend this procedure. We were warmly welcomed & the whole procedure was explained in detail & really put my mind at rest. The ladies also stayed for a long time & explained what had been done & to check the small bleed, along with checking his feeding. fantastic service highly recommended!!
Would I recommend this service: Yes
Rachel Davies (29/03/2012 20:12:20)
My son had his tongue tie divided by Mr Griffiths when he was 5 weeks old. The procedure was very quick. He was asleep when he was taken to another room to have it done and still sleeping when he was returned. Breast feeding was extremely painful before the procedure but I have noticed a difference immediately (only had it done yesterday). I would recommend anyone to have this done and wish that more midwives were of the same opinion.
Would I recommend this service: Yes
Sarah Howard (16/03/2012 18:30:52)
we arrived to a lovely childrens area

greated by name and escorted to a different room, it had a great view

i talked about what had been happening and i was given a leaflet and learnt so much

my son went with her for a few minutes and came back for a much longer feed we
left when we were ready Thank you
Would I recommend this service: Yes
victoria tapson (24/02/2012 21:51:50)
My son was very badly tongue-tied and the consultant couldnt believe i had managed to breast feed him at all, he was 4 months when we got it done. Even though they had to double clip him as the tongue tie was so bad he only cried for a short time and was comforted by consultant until i started breast feeding him which he took to straight away. The service was fantastic and everyone was lovely and supportive. I am so happy that we got it done as my son is breast feeding so well now, even better then he did before.
Thank you so much
Would I recommend this service: Yes
Sarah Edmonds (02/02/2012 14:37:59)
My daughter was 70% tongue tied and I had to get referred by my GP as the midwifes at the Royal Berkshire Hospital did not believe this procedure was necessary even though I was in severe pain breast feeding and my daughter was struggling to feed, so much so that I eventually gave up breast feeding and went on to formula.
Thankfully my health visitor mentioned Dr Griffith's to me so I was able to get us referred.

My daughter was crying when she returned from the procedure but she instantly took a bottle and slept lots over the rest of the day, no further distress was seen and since her mini op we have had no further issues, I just wish more midwifes had the same opinion as Dr Griffith's as it would save a lot of hassle for distressed babies and parents.

Thank you so much
Would I recommend this service: Yes
Helen Fisher (15/01/2012 19:47:40)
My daughter had this done at 3 months and I am so pleased we had it done, she feeds alot better and finishes her bottles. The staff were amazing and did it with such care.
Would I recommend this service: Yes
Kirsty Niziolek (05/01/2012 21:27:17)
Our daughter was referred for a tongue tie procedure following her continued weight loss after birth (she is now nearly 3 weeks old) and I'm so glad she had it done, we can already tell a difference in her feeding, she seems able to latch onto the breast a lot easier and does not fall asleep so quickly during feeding.

The procedure was incredibly quick and she seemed to suffer no discomfort at all, in fact she was fast asleep when she was brought back in! The staff were very thorough with their information and I wouldnt hesititate in recommending this procedure to anyone in the same situation.
Would I recommend this service: Yes
Anonymous (22/12/2011 22:26:11)
My daughter was seen at Southampton General at 5 1/2 months of age.
We were told after her birth she had a tongue-tie but even though she has a little heart shaped tongue, it was not significant enough to have it cut. My son had his snipped the day he was born. So we trusted our midwife and went home. Breast feeding was a disaster. She just could not latch properly and with a toddler at home I was not mad keen to persevere so moved quickly to formula.
For the last 5 months she has fought the bottle, crying and trying to turn her head away. She would never finish a bottle, only taking small amounts at each feed, which was then followed by crying. We thought something must be wrong and mentioned it to our health visitor who mentioned reflux. She was never really sick after feeds but seemed to be in pain and was very unhappy. Each feed would take around an hour and would involve a lot of crying. I could only feed her if I was walking around &/or bouncing. Matters were complicated further when at 16 weeks after passing blood in her nappy she was diagnosed with a cows milk allergy and was put on a hydrolysed formula. She has been seen by numerous specialists and has been on a few reflux drugs none of which seem to be working. After changing drugs we finally thought we had got to the bottom of things and at 5 months she started drinking some bottles without crying, but would still only drink 100ml at a time.
We introduced solid at around 5 months and now I can see that she also struggled eating.
A physio friend saw her feed and asked if she had a tongue-tie and suggested we get it looked at. Out of desperation to try anything, our health visitor got us referred to your clinic where we were told she had an 80% tongue-tie and had it cut. The description you gave of the behavioural and feeding habits of a baby with tongue-tie fitted my daughter exactly. She did not seem to be in any distress following the procedure. Within a few days she was drinking a greater volume per bottle than ever before. For most feeds she does not fight the bottle at the start of each feed and drinks enthusiastically. She does not seem to be in any distress. She looks now as if she really enjoys her solids. After 2 weeks of our new happy baby, I am doing a little experiment to see if I can reduce her reflux medication, so far so good.
Watching her eat solids, smiling & laughing during the day I cannot believe how much she moves her tongue, or how little she could move it before.
I just wish we could have had an earlier diagnosis as we could have saved our daughter 5 months of feeding distress.
Thank you for a fast, efficient, great service and for bringing some calm to our household!!
Would I recommend this service: I have no view
Sarah Tidey (06/12/2011 08:32:38)
My son James had his tongue tie divided by Mr Griffiths when he was 3 months of age - he was taken to a separate room and then brought back to me - it only took a minute or two. I think James was more stressed about being held tight than the procedure itself - he fell asleep straight after (he was due a sleep) and did not seem in any discomfort at all afterwards - in fact he was all smiles as soon as he woke. The wound healed really well, there was a white blister under his tongue for a few days but he did not seem bothered about it at all. So (even as a hyper-sensitive mother who hates to hear her darling-baby cry) I must agree that surprisingly, tongue tie division does not seem to cause discomfort to the baby. It is such a pleasure to see James having a good time moving his tongue freely and I am very happy to have had it done. A big THANK YOU to Mr Griffiths for his professional yet very human approach and for taking the time to help me decide what was right for my baby (it took me a while). I could not recommend him more.
Would I recommend this service: I have no view
Beata Bique (19/10/2011 08:33:24)
My daughter was treated while we were still in the Princess Anne. It was quick and successful. Would recommend other parents to get it done.
Would I recommend this service: Yes
Gail Bell (05/10/2011 16:49:27)
My son treated at princess Anne by breast feeding babes. Simple procedure and immediately he was able to feed properly.
Would I recommend this service: Yes
teri pragnell (12/07/2011 15:42:21)