Multi-disciplinary approach to neonatal ankyloglossia

Aim:Recent UK media attention paid to tongue-tie release has been reflected in an increase of referrals to our OMFS unit. To date, the gold-standard for management has been drawn up by NICE (2005) to enable breastfeeding. With the collaboration of our neonatal colleagues, we have developed a multidisciplinary approach in order to achieve a systematic and streamlined process. Pilot multidisciplinary approach: National Institute of Clinical Excellence (NICE) guidelines recommend that tongue-tie release should be carried out as early as possible. This correlates with the WHO recommendations of breastfeeding up to the age of 6 months. However, due to the lack of consensus between professional bodies in diagnosis and treatment, mothers have reported limited knowledge of tongue tie and its impact on breast feeding. We propose a midwife led multidisciplinary approach to provide a clear pathway for referral and management of neonatal ankyloglossia. This will involve the participation of infant feeding specialist midwives for assessment of ankyloglossia and direct referral to OMFS team for surgical procedure and management of any complications. Specialist midwives are gradually trained to provide the surgical procedure. The neonates will then be followed up to ensure that the mother is supported with breastfeeding and referred on to an appropriate neonatologist/paediatrician if the issue remains unsolved. Conclusion: This midwife led approach supported by OMFS can be implemented in other Hospital Trusts. Awareness, training and dissemination of information as well as a team approach will be essential in creating successful clinical outcomes and maximising patient satisfaction levels.