TONGUE-TIE TRAINING FAQ'S
The Association of Tongue-tie Practitioners does not provide training in tongue-tie division. However, we receive lots of enquiries about training so here are the answers to some frequently asked questions.
Who can divide tongue-ties?
NICE Guidance (2005) states: Division of ankyloglossia (tongue-tie) for breastfeeding should only be performed by registered healthcare professionals who are properly trained. This stance on limiting the role to registered healthcare professionals has been supported by the Department of Health.
A registered health care professional is someone who holds a healthcare qualification and has professional registration with a regulatory body. There are 9 health and care regulators in the UK, the General Medical Council, General Dental Council, Nursing and Midwifery Council, General Osteopathic Council, General Chiropractic Council, General Optical Council, Health and Care Professionals Council, General Pharmaceutical Council and Pharmaceutical Society of Northern Ireland.
But suitability and eligibility to train to do tongue-tie division does not just depend on registration with one of these regulators. The procedure of tongue-tie division (frenulotomy) has to fall within the scope of practice for the professional performing it.
In the UK most tongue-tie divisions performed on infants are carried out by doctors with relevant training and experience (usually paediatric, ENT and oral surgeons) or nurses, health visitors and MWs with specialist training infant feeding (many are IBCLCs also). Dentists with appropriate training in tongue-tie division in infants may also carry out the procedure. However, dentists in the UK have had difficulties in obtaining indemnity cover due to issues around scope of practice. International Board Certified Lactation Consultants (IBCLCs) are not registered healthcare professionals in the UK and the International Board of Lactation Consultant Examiners have issued an advisory statement on this stating that frenulotomy would fall outside the scope of practice of an IBCLC in the UK.
Anyone wanting to train to do tongue-tie division needs to reflect on their suitability. The feeding issues that can be associated with tongue-tie are complex and division is often not an instant fix and there are often lots of other factors that have to be addressed. So it is essential that those performing this procedure have advanced breastfeeding skills (preferably IBCLC) or work alongside someone with advanced breastfeeding skills. UNICEF Baby Friendly courses are basic level, not advanced level. The course is for health professionals who are in direct contact with families and UNICEF state: Completion of this course does not equate to a formal qualification in infant feeding support.
More information on advanced training in breastfeeding is available at these links:
International Board of Lactation Consultant Examiners
Lactation Consultants of Great Britain
The charities below offer advanced training (breastfeeding counsellor level) to those who have personal experience of breastfeeding and can commit to giving their time in a volunteer capacity supporting other mothers in a breastfeeding counsellor role. The exception is the Association of Breastfeeding Mothers who also offer an advanced course to healthcare professionals without the requirement to have personal experience or work as a volunteer.
Association of Breastfeeding Mothers
Additionally, anyone providing tongue-tie division needs skills and experience in tongue-tie assessment using evidence based tools and needs training and experience in infection control, aseptic technique, managing bleeding and other complications, and cardiopulmonary resuscitation. Some babies and families present with complex medical histories and the implications of these need to be fully understood in order to adequately risk assess and decide whether proceeding with the procedure is safe or not. Therefore significant medical knowledge and experience is required.
Where can I train to do tongue-tie division?
There are currently three NHS centres offering training in division at the University of Wolverhampton, University of Hull and Southampton General Hospital.
The University of Wolverhampton and The University of Hull have a Level 7 (Master’s level) accredited course who will train healthcare professionals planning to divide in the NHS and private practitioners. They have a charge for their training.
Southampton General Hospital’s training is also for both NHS and private practitioners.
Russell Hall Hospital, Dudley work with Wolverhampton university to deliver and train those planning to divide in the NHS and who have agreement from their managers.
Russells Hall Hospital, Dudley Contact: N.Bowen@wlv.ac.uk 01902 518862
University of Hull
Frenulotomy CPD module level 7
https://www.hull.ac.uk/study/cpd/modules/frenulotomy
Please contact module leader Louise Lewis 01482 463103
Southampton General Hospital
Southampton General Hospital Contact Erin Winteridge
02381 206677 or Fax: 02381 204750
Health Professional Training in frenulotomy – by Dee Bell RM, IBCLC and Specialist Tongue-tie Practitioner
Dee is able to train registered health care professionals to perform frenulotomy (tongue-tie release procedure), if they have completed an accredited Infant Feeding program and theoretical study around infant tongue-tie. Accredited training in both these areas is available at The Infant Feeding Academy, but accredited training with other organisations is also acceptable. Please get in touch if you are not sure.
More information is available at www.theinfantfeedingacademy.co.uk or contact us on info@theinfantfeedingacademy.co.uk
Other Training Courses
Training in tongue-tie assessment and other related topics is available from the providers listed below. All enquiries should be directed to the provider, not The Association of Tongue-tie Practitioners.
Sarah Oakley Registered Nurse , Registered Health Visitor, International Board Certified Lactation Consultant and Tongue-tie Practitioner provides regular study days in Cambridgeshire and will travel to provide training too.
See http://sarahoakleylactation.co.uk/training-courses/
Diana Warren RGN (Adult and Neonatal) , IBCLC Lactation Consultant, Tongue-Tie Practitioner, and Infant Feeding Specialist (LEAARC)
Diana Has provided a free presentation for healthcare professionals to view at the link below.
The presentation houses videos on recognising some common symptoms of a tongue-tie and discusses a frenulotomy procedure (tongue-tie division) using scissors. It looks at the risks of the procedure, and the benefits too whilst acknowledging and addressing common misconceptions. The presentation is approximately a one-hour snapshot which includes films and discussion through an online platform. ('Baby Massage', 'Baby and Toddler Yoga 2in1 Course', 'Breastfeeding Know-How' and 'Introducing Solids' are also available for online access and are aimed predominantly for parents/caregiver(s) for infants through the same website). This presentation is for information and learning only, it is NOT for a frenulotomy surgical procedure practical/competency training.
https://d-restricted.co.uk/online-courses/tongue-tie/
CQC (England), HIS (Scotland) & R&QIA (N.Ireland)
- Private practitioners in England are legally required to be registered with the Care Quality Commission (CQC; www.cqc.org.uk).
- Scottish frenulotomy providers are regulated by Healthcare Improvement Scotland (HIS;www.healthcareimprovementscotland.org).
- The Regulation & Quality Improvement Authority regulates our Northern Irish providers (R&QIA; www.rqia.org.uk).
- Currently, Welsh providers do not have to register with Healthcare Inspectorate Wales (HIW).