Bye Bye Tongue Tie

Updated 12 July 2022

Some babies are born with the condition tongue-tie, which has the medical name ankyloglossia. The fold of skin under the tongue that connects to the tongue to the bottom of the mouth is shorter than usual, which restricts the movement of the tongue. This can cause problems with breastfeeding or bottle-fed babies and the baby may not gain weight at the normal rate.

Some babies require a surgical intervention in order to release the tongue, which is known as a frenulotomy or frenotomy. Frenulotomy services may be offered by the NHS or independent healthcare professionals such as doctors, dentists or midwives.

The provider is a registered midwife who offers private tongue-tie services to the community in North West London, parts of Middlesex and Hertfordshire. The provider is qualified to provide frenulotomy divisions for babies up to the age of one year, however the provider only treats babies up to and including 6 months of age. Babies above 6 months or with complex anatomy that aren’t safe to treat in the home setting are referred to ENT services.

The registered manager is a sole trader who provides the regulated activity. This will be their first CQC inspection since registration in 2019. The service is registered with the CQC to provide the following regulated activity:

• Surgical procedure

Updated 12 July 2022

We carried out an inspection of Bye Bye Tongue-tie using our comprehensive methodology on 10th May 2022. This was followed by telephone interviews with parents of babies treated by the tongue-tie practitioner. In this report, we use the term ‘parent’ to describe either the birth parent or primary carer of the baby.

This was the first time we inspected the service. We rated it as good because it was safe, effective, caring, responsive, and well led:

• The practitioner had training in key skills, understood how to protect babies and their parents from abuse, and managed safety well.
• Risk assessments were completed for all babies using an evidence-based standard assessment tool. The practitioner recognised risks to patients, acted on them and kept good care records.
• According to feedback we received, the practitioner treated babies and their parents with compassion and kindness, took account of their individual needs, and helped parents understand the condition.
• The practitioner provided emotional support to parents and made it easy for them to give feedback. Parents could access the practitioner when they needed it and did not have to wait long for assessment or treatment.
• The practitioner followed national guidance and there was evidence of quality monitoring through regular audit.
• The process of seeking and recording consent was thorough and included sufficient information to allow for informed decisions to be made by the parent.
• There was a high level of aftercare available to parents following the procedure.

However:

• While the practitioner controlled infection risks well, we noted a small stock of haemostatic dressings (designed to reduce blood loss from a cut in the skin) that were out of date. This meant the dressings may not have been fully effective.
• Although suitable arrangements existed, the practitioner should seek written confirmation of level four safeguarding support from her employing trust or local authority.

Updated 12 July 2022

We have not previously inspected the service. We rated it as good. See the overall summary for details.