Frenulums under the tongueand at the midline at the top and bottom lips are normal. They are only abnormal if they are thickened or restrict movement of the tongue or lips. They are known as a tongue-tie or (ankyloglossia) or lip-tie (maxillary labial frenulum).

The main indications for surgical management of a tongue or lip tie are:

- breastfeeding problems

- failure for baby to gain weight

- significant pain or nipple trauma to the mother, or

- potential problems with speech or tooth decay in the future

If a mild to moderate tongue or lip tie exists and the mother and baby are not experiencing any abnormal symptoms, there may not be any indication to treat it.

No, your baby does not require a referral letter to obtain a Medicare rebate.

The optimal age at our clinic is 1-4 weeks but we are happy to perform the procedure on babies up to the age of 10 weeks.

We recommend a single dose of paracetamol 45 min prior to your appointment if your baby is over 4 weeks of age and 4kg weight. Your baby is given 1mL sucrose orally at the time of procedure, which is proven to reduce procedural pain for infants.

For lip tie releases, we inject a local anaesthetic to prevent the baby from having any sensation in the area during the procedure.

It is not unusual for a baby to sleep 6-8 hours after the procedure and to miss a feed. Some babies will be irritable for a number of minutes to hours afterwards. Behaviourally, most babies are back to themselves within 24-48 hours.

Most babies resume feeding within 15 minutes of the procedure. Feeding is usually better immediately after the procedure, and further improvement is usually observed over the three to four days that follow.

The main concern following the procedure is the low risk (less than one in a hundred) of bleeding once you go home. You will be provided with emergency contact numbers at the time of the procedure so that your surgeon is contactable.The risk of scarring requiring subsequent surgery following newborn tongue tie release is 1% in our practice. While a yellow scab like appearance under the tongue is normal following tongue tie release, wound infection is very rare.If there are increased problems with feeding or redness/swelling under the chin, then contact your surgeon for advice.

The main concern following the procedure is the low risk (less than one in a hundred) of bleeding once you go home. You will be provided with emergency contact numbers at the time of the procedure so that your doctor is contactable. The risk of scarring requiring subsequent surgery following newborn tongue tie release is less than 1%. While a yellow scab-like appearance under the tongue is normal following tongue tie release, wound infection is very rare. If there are increased problems with feeding or redness/swelling under the chin, then contact your doctor for advice.

NO stretching exercises will be suggested for your baby following the procedure.

No follow up is routinely required following the procedure but we can see any patients that are worried or concerned. For those living out of town, please organise a review with your GP or paediatrician if required.