Accreditation of midwife lactation consultants to perform infant tongue-tie release.

Infants with a tongue-tie or ankyloglossia have a short lingual frenulum, which can lead to problems with breastfeeding: attachment difficulties, nipple pain and damage, poor weight gain and eventually a reduction in milk supply. Trained clinicians can release the frenulum (frenotomy) in infants having difficulty with breastfeeding. Although traditionally performed by medical practitioners, we argue that this simple procedure is within the scope of practice of other clinicians. This paper outlines the process of setting up and maintaining credentialing for midwife lactation consultants (International Board Certified Lactation Consultants (IBCLCs)) to assess infant tongue-ties and perform frenotomy when appropriate at a tertiary maternity hospital. Since 2005, 11 midwives/IBCLCs have been credentialed to perform frenotomies at The Breastfeeding Education and Support Services at The Royal Women's Hospital in Melbourne, Australia. We believe that nurses/midwives/lactation consultants working in other settings could be trained to perform frenotomies, thus enabling faster resolution of breastfeeding problems.