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COVID-19 - Tongue Tie

A tongue tie is when the membrane of skin that connects the tongue to the bottom of the mouth is short and/or tight.

Most babies with a tongue tie have no problems. For some babies it might cause problems with feeding, this is more common when establishing breast feeding.

During the COVID-19 outbreak there is still support and advice available for you, if you think this may be something affecting your baby.

Please see below for advice on the way this service is currently being offered.

It can be hard to tell the difference between problems caused by a tongue tie and those caused by much more common feeding problems.

Often a feeding problem can be solved with support on attachment and feeding technique. Even babies with a tongue tie are often helped a lot by this. There is a lot of online support and advice that can help you improve your babies feeding techniques too. You can find some recommended links below.

If your baby needs further assessment following this support, we will be able to explain next steps. During the COVID-19 outbreak, to reduce the risks to babies, parents and staff, there have had to be temporary changes to the tongue tie service. 

 

Support Available 

Your midwife and /or health visitor can give you advice if you think tongue tie may be affecting your baby. These are the numbers to call if you need advice:

Norfolk & Norwich University Hospital - If your baby is under 28 days old please call Medicom on 01603 481 222 and you will be allocated a call back from a Community Midwife.

Queen Elizabeth Hospital – If your baby is under 28 days old please call your community midwife OR call the Infant Feeding Team on 01553 613710 or 01553 613950 (9-5 pm 7 days a week.) 

James Paget University Hospital If your baby is under 28 days old please call your community midwife on 01493 452011 OR  Infant Feeding Co-ordinator Kay Horn on 01493  453076. You can also leave a private message for Kay through the JPUH Bumps to Breastfeeding Facebook page *here*

 

If your baby is 28 days or older please call Just One Number on 0300 300 0123 and you can speak to a Health Visitor or Infant Feeding Champion.

  • Currently referrals for hospital assessment of tongue tie will only be when a health professional has assessed the baby as being ‘critically affected’. This criteria applies to all 3 hospitals in Norfolk. This would mean;

    • Baby is unable to gain weight, (at the minimum of around 25g a day), even when they are having additional top up feeds of expressed breastmilk, screened human donor breastmilk or formula feed by bottle.
    • Baby is still jaundiced – even with additional feeds offered as above. This is extremely uncommon.
    • Baby has to be tube fed because their tongue tie means they cannot feed at the breast or bottle at all. This is extremely uncommon.
    • Mother is being supported under the NNUH perinatal mental health team and is experiencing significant difficulties which are made worse by feeding issues thought to be due to their baby's possible tongue tie.
    • Mother is suffering severe nipple trauma that prevents baby from feeding at the breast.

    All other babies will still be supported by the midwifery and health visiting teams.

  • Norfolk & Norwich University hospital

    If your baby requires an assessment of their tongue and feeding (to consider if they need further referral for tongue tie release), they will initially be offered a video assessment to discuss and assess a feed; their positioning and attachment when feeding; their tongue function and their suck and swallow during a feed.

    Not all babies who have an initial assessment will need a referral.

    If it isn’t possible to fully assess these things in a video call you will be asked to bring your baby to a face to face clinic.

    Because of the current careful precautions regarding COVID-19, the assessor will be dressed in full PPE;

    • Apron and gloves
    • Surgical fluid resistant mask
    • Visor.

    Please do not be worried, this is to protect you, your baby and staff.

    If it is decided that your baby needs a further referral for tongue tie release you will be sent an appointment date and time to attend the hospital for the procedure.

    Queen Elizabeth Hospital

    Babies who meet the referral criteria detailed above will be offered a hospital assessment in the RLF (Tongue Tie) Clinic and full PPE will be in use for any procedure required as detailed above.

    If this assessment is declined or the criteria are not met parents will be offered telephone advice by the Infant Feeding Team.

    James Paget Hospital

    Babies who meet the referral criteria detailed above will be initially offered a telephone or video call through the Infant Feeding Co-ordinator.

    If this indicates that your baby requires further assessment you will be offered a hospital appointment and full PPE will be in use for any procedure required as detailed above.

     

Who Can Help?

You can contact the Healthy Child Programme by calling Just One Number on 0300 300 0123 or texting Parentline on 07520631590. Our opening hours are 8am-6pm Monday-Friday (excluding bank holidays) and 9am-1pm on Saturdays. There is also support available from our infant feeding champions.

If you are 11-19 you can text ChatHealth on 07480635060 for confidential advice from one of our team.

You can speak to other Norfolk parents and carers by clicking our online community forum below. 

      

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