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). 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:
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.
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.RHH-Tongue-Tie-Training-Information
Where can I train to do tongue-tie division?
There are currently only two centres offering training in division. Both have long waiting lists. Dudley will only train those planning to divide in the NHS and who have agreement from their managers. They have a charge for their training. Southampton’s training is for both NHS and private practitioners. Please contact them directly for more information:
Russells Hall Hospital, Dudley Contact N.Bowen@wlv.ac.uk 01902 518862
Southampton General Hospital Contact Jayne Threlfall RM IBCLC firstname.lastname@example.org, 02381 206677 or Fax: 02381 204750
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.
Lynn Timms Registered Nurse, Registered Health Visitor, International Board Certified Lactation Consultant, Tongue-tie Practitioner, BSc (Psychology) and Teacher in Developmental Baby Massage provides study sessions for health professionals and breastfeeding volunteers. http://breastfeedingmatters.co.uk/index.html
Care Quality Commission
Currently private practitioners in England are legally required to be registered with the CQC. Scotland has its own regulator. All listed tongue tie practitioners currently practising in England are fully CQC compliant. For more information please see the CQC website
Other courses of interest
COVID19, Delivery and the Newborn – https://www.goldlearning.com/ce-library/all-lectures/covid19-delivery-and-the-newborn-detail
COVID-19: The Infant Microbiome