References

Bhandarkar KP, Dar T, Karia L, Upadhyaya M. Post frenotomy massage for ankyloglossia in infants – does it improve breastfeeding and reduce reoccurrence?. Matern Child Health J. 2022; 26:(8) https://doi.org/10.1007/s10995-022-03454-x

Dell'Olio F, Baldassarre ME, Russo FG Lingual laser frenotomy in newborns with ankyloglossia: a prospective cohort study. Italian J Pediatrics. 2022; 48

Dhir S, Landau BP, Edemobi S, Meyer AK, Durr ML. Survey of pediatric otolaryngology frenotomy practice patterns. Laryngoscope. 2022; 132:(12)2505-2512 https://doi.org/10.1002/lary.30102

Dixon B, Gray J, Elliot N, Shand B, Lynn A. A multifaceted programme to reduce the rate of tongue-tie release surgey in newborn infants: observational study. Int J Pediatric Otorhinolaryngology. 2018; 113:(2018)156-163

Emmerson VC. Does frenotomy improve breastfeeding problems in neonates with ankyloglossia?. Br J Midwifery. 2018; 26:(3)171-179

Finigan V, Long T. The eff ectiveness of frenulotomy on infantfeeding outcomes: a systematic literature review. Evid Based Midwifery. 2013; 11:(2)40-45

Fox R, Wise P, Dodds R, Newburn M, Frigueras J, McMullen S. United Kingdom tongue tie services: a post code lottery. MIDIRS. 2016; 26:(2)243-249

Ghaheri BA, Lincoln D, Mai TNT, Mace JC. Objective improvement after frenotomy for posterior tonguetie: a prospective randomized trial. Otolaryngol Head Neck Surg. 2022; 166:(5)976-984 https://doi.org/10.1177/01945998211039784

Hazelbaker AKUSA: Aidan and Eva Press; 2010

Hill RR, Pados BF. Gastrointestinal symptom improvement for infants following tongue-tie correction. Clin Pediatr. 2023; 62:(2)136-142 https://doi.org/10.1177/00099228221117459

Ingram J, Copeland M, Johnson D. The development and evaluation of a picture tongue assessment tool for tongue-tie in breastfed babies (TABBY). Int Breastfeeding J. 2019; 14

Knight M, Ramakrishnan R, Ratushnyak S Frenotomy with breastfeeding support versus breastfeeding support alone for infants with tongue-tie and breastfeeding difficulties: the FROSTTIE RCT. Health Technol Assess. 2023; 27:(11) https://doi.org/10.3310/WBBW2302

Madlon-Kay DJ, Ricke LA, Baker NJ, DeFor TA Case series of 148 tongue-tied newborn babies evaluated with the assessment tool for lingual frenulum function. Midwifery. 2008; 24:353-357

Murias I, Grzech-Lesniak K, Murias A Efficacy of various laser wavelengths in the surgical treatment of ankyloglossia: a systematic review. Life-Basel. 2022; 12:(4) https://doi.org/10.3390/life12040558

London: National Institute for Health and Clinical Excellence; 2005

Oakley SLondon, UK: Pinter and Martin LTD; 2021

Watson GBurlington, MA: Jones and Bartlett; 2013

Is access to NHS tongue tie services equitable for mothers and babies in the UK?

02 December 2023
Volume 31 · Issue 12

Abstract

Background/Aims

NHS tongue tie service provision throughout the UK has previously been described as a ‘post code lottery’. A 2021 survey was conducted, with the aim to provide an update to a 2016 survey of tongue tie services in the UK.

Methods

A total of 179 trusts or health boards were approached with similar survey questions to a 2016 survey and achieved a response rate of 72% (n=130).

Results

There were similarities to the findings of the previous National Childbirth Trust survey, although there was an overall increase in NHS services provided. There is still variation in terms of the lead professional involved in delivering tongue tie services at the point of contact with the mother and baby, the criteria used for referral, the waiting time for assessment and treatment and the follow-up processes. Evidence supporting most aspects of care is limited, which causes much professional discussion.

Conclusions

The provision of NHS tongue tie services is still a ‘post code lottery’ and inequitable for mothers and babies.

The provision of tongue tie services has previously been the subject of investigation by the parents’ charity, the National Childbirth Trust (NCT). In 2016, Fox et al (2016) reported the results of a survey undertaken of the 167 NHS acute trusts/boards across the UK and 20 community trusts available in the UK at the time. Their published findings were taken from 86 respondents, a 51% response rate. They concluded that tongue tie services were ‘a post code lottery’ and made several recommendations to help address variability and improve care for families (Fox et al, 2016). Their main findings included that 54% of respondents accepted referrals for bottle-fed babies (18% did not, the remaining trusts did not know), and most (88%) used oral assessment alone for referral criteria (assessment tools had not been generated at that time). The maximum age for referral ranged from 1–2 months to unlimited (limit of 1–2 months: 13%, limit of 2–3 months: 16%, limit of 3–4 months: 33%, no limit: 33%), and waiting time between referrals and receiving treatment varied (67% were given an appointment within 2 weeks). Reported barriers to setting up a service included funding, availability of staff, training and venue.

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