CQC : Independent Midwives are exempt from CQC as long as they meet the following criteria:

They work independently of the NHS, they work alone and that the procedure is carried out within a home setting.

As an independent Midwife, I can still practice frenulotomy, however procedures at the Eton and Bristol Clinics are suspended for the moment, until CQC clarifies its position with the Association of Tongue Tie Practitioners.  I am able to offer frenulotomy within the home setting.


Tongue Tie (Ankyloglossia)

Tongue tie or Ankyloglossia, is a common breastfeeding and bottle feeding problem, roughly affecting feeding in around 44% of babies who have one.

The piece of skin under the tongue (the frenulum) is formed during the development of the fetus at around 5 weeks gestation. the tongue is sealed to the floor of the mouth, and as the baby develops, the tongue and the floor separate leaving a natural variation of a piece of skin that can be left behind. In most 55% of cases, this piece of skin causes no issues, however in 44% of babies it can have the following symptoms:

* Sore nipples that do not heal despite professional and skilled breastfeeding assistance on positionning and attachment,

* Greater than 10% weight loss in the first five days following birth,

* Mastitis, in particular recurrent Mastitis,

* Gassy, fussy babies, babies where reflux meds seem to make no difference

* Babies that start a feed well, yet slip off the nipple,

* Babies that constantly fall asleep at the breast,

* Babies that will attach, but not suck... 

(sometimes accused as being Lazy Babies)

* Babies that will not latch at all, 

(or will only latch with the use of a nipple shield),

* Babies who feed in excess of 12 times in 24hrs, take a log time to feed (over an hour) or whom fall asleep within the first few minutes of a feed.

* Babies who dribble and leak or even squirt milk out of the corners of their mouth during a feed.

If you are experiencing any of these symtoms, it is suggested that your baby can be checked by a trained practitoner to rule it out, or to treat as necesary if that is what you desire. I am fully qualified and insured to both assess and divide tongue-ties in babies up to six months old, and am a member of the Association of Tongue-Tie Practitioners.

The procedure is classed as a Domicillary Procedure (one that is safe to be done within the home setting) and I offer appointments at my clinic, or at your own home.

Risks for the procedure: 

1:1000 babies will bleed a tiny bit more than the other 999. The heel prick test on day 5 takes four circles of blood from baby's heel. The majority of babies will bleed ONE or TWO of the blood spot circles during the tie release. The ONE baby in 1000 will bleed THREE or FOUR of those circles. Therefore worst case scenario is that the baby bleeds the same as from the heel on day 5.

1:10,000 babies may develop an infection. This maifests as a temerature a couple of days following the procedure, and in the cases of infection, the baby was artificially fed so the hypothesis was that the teat on the bottle wasnt as clean as it could have been while the baby was healing. Therefore all mothers are advised to ensure sterilisation techniques for all bottles and dummies following the procedure.

Frenulotomy Service includes Consultation, Division of the tongue tie and Post procedure feeding plan, Including telephone support :


The research link takes you to an excellent site from an American Lactation Consultant: Catherine Watson-Genna, her toolbar on the left hand side has links to all the current research and evidence and is a valuable resource.

Example of a Posterior Tongue Tie:

Example of an Anterior Tongue Tie:

Tongue ties are generally classified as either Posterior (one at the back of the tongue) , Central (one in the middle) and Anterior (one at the front/tip of the tongue).

However, the degree of the problem is based on the Tongue MOBILITY and FUNCTION, severity of the tongue tie is nothing to do with what it looks like.

The video clip above shows the release of a posterior tongue tie, if you feel it would help you to see how the procedure is performed then please take a look.

Note that the baby cries before the snip has happened, and that once the baby is back with his mum, he feeds well and is relaxed and happy. The time spent out of mum's arms is 1 min...


Eton Clinic:

Thursday 12-2pm. (Except the month of Aug due to hall closure)
Austin Leigh Baldwin Institute
Eton High Street
SL4 6AF 

New Tongue Tie Service For Bristol!

Tuesday Clinic 1pm- 5pm
Helios Medical Centre
17 Stoke Hill
Stoke Bishop

Please call Sarah to make an Appointment!

Having breast fed my first baby I had experienced how difficult and stressful it could be to ‘get back on track’ with weight gain after a late diagnosis tongue tie. When my second child was born we weren’t able to get an appointment for a release in the first 7 days so we decided to go private. Sarah was great - she came to our house as arranged the day after we got home from hospital. She went through the facts making everything clear and answered all our questions. The release went really smoothly and my baby was feeding better in minutes. We haven’t looked back - we were delighted to make birth weight by day 10 and have a really solid weight gain at our first weigh in with the health visitor. Getting the tongue tie release early on has made the first few weeks of my baby’s life an altogether more joyful experience for the whole family and we’d recommend her highly.'  

Nicky and Baby Claudia