Feeding difficulties & tongue tie assessment
Bring your feeding concerns to a specialist. Assessment comes first, followed by a discussion of whether tongue tie treatment may be appropriate.
- Assessment before treatment
- Babies and older children
- Pediatric and dental specialists
A tongue tie is a tight band of tissue that can limit how the tongue moves. It only needs treatment when it is causing a problem — most often with feeding. An assessment separates a tie that needs help from one that needs nothing at all.
What parents notice first
Feeding difficulty that continues despite support is the clearest reason to arrange an assessment. These are some of the signs families notice.
Feeding signs in babies
- A shallow latch that keeps slipping, often with clicking during feeds
- Long, tiring feeds and hunger again soon afterwards
- Slow weight gain despite feeding often
- A heart-shaped tongue tip or a tongue that cannot lift to the roof of the mouth
Pain and milk supply
- Pain that does not settle once the latch has been corrected
- Cracked or pinched nipples or a nipple that looks flattened after a feed
- Blocked ducts or mastitis coming back
- Supply falling because milk is not being removed well
Eating and speech in older children
- A tongue that cannot move freely
- Difficulty with eating or swallowing
- Unclear t, d, n, l, s and z sounds that speech therapy has not resolved
What the assessment involves
- 01Feeding historyWe start with what is actually happening: how feeds go, how long they take, and what you have already tried.
- 02Mouth examinationThe clinician looks at the frenulum, and more importantly at how far the tongue can actually move.
- 03Watching a feedWhere feeding is the concern, we watch one. A tie is judged by what it does, not by how it looks.
- 04A clear recommendationYou leave knowing what was found, what it explains, and what we suggest doing about it.
Sometimes the recommendation is treatment. Sometimes it is feeding support, or reassurance that nothing needs doing at all.
When treatment may help — and when it may not
A release is considered when the tongue is restricted and that restriction is causing a real problem. One without the other is not a reason to treat.
A release may be discussed when
- Feeding stays painful despite latch and positioning support
- Your baby cannot maintain a latch
- Feeding is inefficient enough to be affecting weight gain
- Limited tongue movement is linked to a problem found at assessment
Treatment may not be needed when
- The frenulum is visible but feeding is going well
- Your baby is growing normally
- The symptoms are better explained by something else
- It is being considered only just in case, for future speech
What treatment involves, if you go ahead
If a release is recommended, the clinician explains the method, comfort measures and aftercare before you decide.
Before
Consent, and a last check
The clinician confirms the tie is what is causing the problem, explains what they propose, and answers your questions before anything is done.
During
The release
The clinician gently supports your baby and releases the restrictive tissue. The procedure itself takes seconds. Ask which method they use and why.
Straight after
A feed
You feed as soon as it is done. That feed is part of the assessment too — it is the earliest sign of whether anything has changed.
Healing
The days that follow
A white or yellow patch under the tongue is expected while it heals. Feeding may change straight away or settle gradually over the following days.
Aftercare
Before you leave, the clinician will show you what to do at home. Follow the instructions given for your child.
- FeedingFeed soon afterwards, and often. Comfort feeding is fine.
- Exercises, if you were given themSome children are shown mouth or stretching exercises. Do them as demonstrated, and only if they were prescribed for your child.
- What healing looks likeA white or yellow patch under the tongue, and a day or so of fussiness, are usual.
- When to call usSignificant bleeding, fever, refusal to feed, or reduced tongue movement while healing. None of those are expected.
- Follow-upCome back so we can see how feeding has actually changed, rather than only how the mouth looks.
Who you would see
Dr. Medhat Abu-ShaabanConsultant Pediatrician, Allergy Specialist & Medical Director
Dr. Tala BelbeissiConsultant Pediatrician
- Assessment
- Tongue tie is assessed by the pediatric team and by our pediatric dentists. Describe what is happening when you book and reception will arrange the appropriate clinician.
- Treatment
- Where a release is recommended, who performs it is confirmed at the assessment. Ask who it will be, and which method they use.
Does every tongue tie need treatment?
No. Plenty are found in babies who are feeding well and growing normally, and those need nothing at all. Treatment is for a tie that is causing a problem.
Will it hurt?
Comfort measures depend on your child’s age and the method used. The clinician will explain these before you agree to treatment, and you can feed your baby straight afterwards.
What about lip tie?
The upper lip can be restricted too, and it is looked at during the same visit. The same rule applies: it is treated when it is causing a problem, not because it is visible.
Can reflux or colic be caused by tongue tie?
Where the mechanics of feeding are fine, reflux and colic are usually explained by something else. That is worth working out before a release is considered.
Does insurance cover assessment or treatment?
It depends on your insurer, your plan and what is done. Tell reception your insurer when you book and they will confirm your cover before the visit.
Your next step
Start with an assessment.
Tell us your child’s age and what is happening with feeding or tongue movement. Reception will arrange the appropriate clinician.
- Opening hours
- Sat-Fri: 9AM - 6PM
- Insurance
- Direct billing with 15 insurers. Check yours
- Find us
- Al Razi Building 64, Block B
Dubai Healthcare City