To improve the assessment of breastfeeding difficulties associated with tongue-tie, we have developed and evaluated 3 tools for clinicians to use during a feasibility RCT of frenotomy for tongue-tie: The Bristol Breastfeeding Assessment Tool (BBAT), Bristol Tongue Assessment Tool (BTAT) and TABBY (tongue-tie and breastfed babies) tool.

CACH team: Jenny Ingram, Debbie Johnson, Alan Emond.

Assessment of tongue-tie is enhanced by using structured assessment tools to evaluate breastfeeding and the severity of the tongue-tie combined with clinical judgement and a discussion with the mother about the comfort and perceived efficacy of breastfeeding.

Bristol Breastfeeding Assessment Tool (BBAT) facilitates improved targeting of optimum breastfeeding positioning and attachment advice to mothers acquiring early breastfeeding skills or experiencing problems with an older baby. It is used internationally in 18 countries and other UK cities and has been translated into 11 languages.

Bristol Tongue Assessment Tool (BTAT) provides an objective, clear and simple measure of the severity of a tongue-tie, to inform selection of infants for frenotomy (tongue-tie division) and monitor the effect of the procedure. It is used internationally in 9 countries and several UK centres and has been translated into 6 languages including Finnish and Portuguese.

TABBY (Tongue-tie and Breastfed Babies) Assessment tool was produced in response to requests to translate the BTAT. This simple picture version of the BTAT aids and enhances consistent assessment of infants with tongue-tie and can be used for training. It is used widely in many countries.

The study was completed in 2014 but interest in the assessment tools continues with requests throughout 2022.

Publications

• BBAT: 

https://www.sciencedirect.com/science/article/pii/S0266613814001788?via%3Dihub

• BTAT: 

https://fn.bmj.com/content/100/4/F344

• TABBY:

https://internationalbreastfeedingjournal.biomedcentral.com/articles/10.1186/s13006-019-0224-y