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Is access to NHS tongue tie services equitable for mothers and babies in the UK?

02 December 2023
Volume 31 · Issue 12



NHS tongue tie service provision throughout the UK has previously been described as a ‘post code lottery’. A 2021 survey was conducted, with the aim to provide an update to a 2016 survey of tongue tie services in the UK.


A total of 179 trusts or health boards were approached with similar survey questions to a 2016 survey and achieved a response rate of 72% (n=130).


There were similarities to the findings of the previous National Childbirth Trust survey, although there was an overall increase in NHS services provided. There is still variation in terms of the lead professional involved in delivering tongue tie services at the point of contact with the mother and baby, the criteria used for referral, the waiting time for assessment and treatment and the follow-up processes. Evidence supporting most aspects of care is limited, which causes much professional discussion.


The provision of NHS tongue tie services is still a ‘post code lottery’ and inequitable for mothers and babies.

The provision of tongue tie services has previously been the subject of investigation by the parents’ charity, the National Childbirth Trust (NCT). In 2016, Fox et al (2016) reported the results of a survey undertaken of the 167 NHS acute trusts/boards across the UK and 20 community trusts available in the UK at the time. Their published findings were taken from 86 respondents, a 51% response rate. They concluded that tongue tie services were ‘a post code lottery’ and made several recommendations to help address variability and improve care for families (Fox et al, 2016). Their main findings included that 54% of respondents accepted referrals for bottle-fed babies (18% did not, the remaining trusts did not know), and most (88%) used oral assessment alone for referral criteria (assessment tools had not been generated at that time). The maximum age for referral ranged from 1–2 months to unlimited (limit of 1–2 months: 13%, limit of 2–3 months: 16%, limit of 3–4 months: 33%, no limit: 33%), and waiting time between referrals and receiving treatment varied (67% were given an appointment within 2 weeks). Reported barriers to setting up a service included funding, availability of staff, training and venue.

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