RLF Referrals

Restricted lingual frenulum (RLF) referrals 

Our RLF service is currently taking referrals for both breast- and bottle-fed babies that are having feeding issues. Depending on the feeding issues you’re having your referral will be classed as routine, urgent or critical. Here are some of the symptoms an RLF baby maybe experiencing:



  • Inability to latch to the breast.
  • Shallow latch to the breast resulting in painful, sore, pinched, damaged nipples. Difficulty staying attached or slipping down to the nipple during a feed.
  • Shallow latch at the breast causing poor milk transfer and in turn a baby that either falls asleep at the breast quickly or is very fussy at the breast.
  • Uncoordinated sucking and swallowing.
  • Frequent feeding, >12 times in 24 hours.
  • Feeds for less than 5 minutes or for more than an hour.
  • Clicking at the breast, windy, fussy baby and reflux.
  • Dribbling during feeds.
  • Excessive weight loss or inability to gain expected weight (faltering weight). Or baby needing supplements to gain appropriate weight.


  • Exhausted from frequent feeds.
  • Blockages or mastitis
  • Low milk supply or breasts that still feel very full after feeds.

Bottle feeding:

  • Taking a long time to feed.
  • Take small frequent feeds.
  • Dribble a lot of milk from the sides of the mouth whilst feeding.
  • Have excessive wind/colic.
  • Reflux


  • Difficulty eating solids (over 6 months)

For bottle fed babies we recommend trying a few different bottle teats (usually a narrow, sloped teat) and paced bottle feeding to see if symptoms improve prior to referral.

Referrals will not be accepted under the age of 2 for speech issues alone.

If the health professional suspects an RLF and refers your child you will be contacted with an appointment, our aim is to contact patients within 2 weeks. At the appointment our team will do a more in-depth assessment of feeding and tongue function and discuss/perform frenulotomy if appropriate.