Tongue tie and breastfeeding clinic in Kingston
with Dr Mariana Colmenares Castano, breastfeeding and lactation medicine specialist, IBCLC lactation consultant and tongue tie practitioner
Tongue tie assessment and release for babies, and breastfeeding and lactation medicine for mothers, in one appointment at KONCEPT® Medical Clinic in Kingston upon Thames. Dr Mariana Colmenares Castano is a GMC-registered doctor, an internationally trained paediatrician and an International Board Certified Lactation Consultant (IBCLC) since 2011. She has carried out more than 4,000 tongue tie releases, and she sees mother and baby together so that the feed, the tongue and the mother’s health are all assessed as one.
Infant feeding clinic · Kingston
Over the past 15 years, Dr Colmenares has supported families through complex breastfeeding challenges, including difficulties with oral motor skills that can arise from a variety of causes, tongue tie among them.
Her NHS role as a Specialty Doctor in community paediatrics, with a focus on neurodevelopment, shapes the way she practises. Years of working with babies and families have taught her that lasting breastfeeding success comes from looking at mother and baby together, not just one part of the puzzle, so her support takes a holistic approach.
When she assesses a tongue tie, she looks beyond anatomy alone to how the tongue actually functions. Her approach draws on orofacial myofunctional therapy (techniques that help the muscles of the mouth and face work together more effectively).
Where it is in a baby’s best interest, she will also work alongside other professionals, such as osteopaths, chiropractors or physiotherapists.
Dr Colmenares is trained in the YTM® Infant Method protocol of orofacial myology, which she offers in clinic as a 6 session programme. It can be a useful complement to treatment, taking a more holistic approach that focuses on function and tension release, not only on the anatomical restriction of the tongue frenulum.
In other cases, the best outcome comes from a tongue tie release straight away, paired with hands-on technique and breastfeeding support for mother and baby.
Tongue tie, also called ankyloglossia, is where the strip of skin that joins the underside of the tongue to the floor of the mouth (the lingual frenulum) is shorter or tighter than usual.1 Many babies with a tongue tie feed well and need no treatment. For others, the tie stops the tongue lifting and reaching forward far enough to feed comfortably, and feeding becomes hard work for both baby and mother.
The same signs can come from positioning and attachment, milk supply, reflux or other conditions. The Academy of Breastfeeding Medicine describes tongue tie as a functional diagnosis: the skin under the tongue is a normal structure, and seeing it is not by itself a reason to cut it.5 Dr Colmenares watches a feed, examines mother and baby, and recommends a release only when it is likely to help. She teaches other clinicians on exactly this point, including a 2025 international conference session on cases where a tongue tie release is not the whole solution.
A tongue tie release, called a frenotomy or tongue tie division, is a small procedure. Your baby is wrapped and held securely, the tongue is gently lifted, and the tight strip of skin is divided with sterile scissors. It takes a few seconds, and in young babies it is usually done without anaesthetic.1 Your baby is brought straight back to feed, which comforts them and helps any small bleeding to settle.
No release is done without a full assessment and a plan made by Dr Colmenares. She is an experienced clinician and can carry out a tongue tie division in babies up to 12 months of age. Whether a release is right always depends on the clinical situation, the thickness of the frenulum and the associated risks, so every baby is assessed first. If a release is needed and cannot be done in clinic, she can talk through the options and refer you on to the appropriate service.
The evidence supports tongue tie division as a safe, effective option when it’s properly assessed: NICE (the National Institute for Health and Care Excellence) has found no major safety concerns with the procedure, and evidence that it can improve breastfeeding,3 while a Cochrane review found that frenotomy reduces mothers’ nipple pain in the short term, with many babies also feeding more effectively afterwards.4 When division is combined with the right functional and holistic support (assessing not just the tie but how the tongue functions, and guiding the breastfeeding relationship around it), it can make a real, positive difference for both mother and baby, which is why Dr Colmenares recommends it after a full feeding assessment confirms it’s the right step for you.
Dr Colmenares does not classify tongue ties as anterior or posterior. She assesses how your baby’s tongue works and how that affects feeding, and the decision to release a tie depends on that functional impact, not on how the tie looks.5 She assesses and releases tongue ties that are causing feeding difficulties whether your baby is breastfed or bottle-fed.
The skin that joins the upper lip to the gum is a normal structure. At present there is not enough evidence that dividing a lip tie improves breastfeeding.5 Dr Colmenares will look at it as part of the assessment, but lip tie division is not offered at this clinic.
A little bleeding is common and usually stops once your baby is feeding. A small white or yellow patch often forms under the tongue while it heals, and this is normal. Serious complications are rare.3,4 Dr Colmenares explains the possible risks before you decide, and you leave with written aftercare advice and a plan for follow-up. See tongue tie aftercare.
Feeding often improves soon after a release, but for some families it takes time and further support. Follow-up appointments are there to adjust the plan as your baby learns to use the tongue more freely.
Before you come, and after a release, see before your appointment and tongue tie aftercare.
What to do before you come, and how to care for your baby after a tongue tie release. The aftercare advice follows NHS hospital guidance and the Association of Tongue-tie Practitioners.8,9,10,11
If you see bleeding at home.
Call 999 at any time if your baby has difficulty breathing, or is floppy or very unwell. If the wound is red or swollen, your baby has a temperature of 38°C or above, refuses feeds or is very sleepy, contact your GP the same day, or NHS 111 when the surgery is closed.11 KONCEPT® is not an emergency service. For questions about feeding or healing that are not urgent, call us in opening hours.
Practising privileges. Dr Colmenares sees private patients at KONCEPT® on a practising-privileges basis. She is an independent doctor, not an employee of KONCEPT®, and KONCEPT® provides the CQC-registered premises, booking, and clinical and administrative support.
Dr Colmenares qualified in medicine at the National Autonomous University of Mexico (UNAM) and completed her paediatric training at the Instituto Nacional de Pediatría, a national referral centre for child health in Mexico. She also trained at the Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, and she is board certified in paediatrics by the Consejo Mexicano de Certificación en Pediatría.
She became an International Board Certified Lactation Consultant in 2011 and has worked in breastfeeding medicine for more than 15 years, first in Mexico and now in London. In the NHS she is a Specialty Doctor in Paediatrics at Chelsea and Westminster Hospital NHS Foundation Trust, where she works in community paediatrics with a focus on child development.
Internationally, she is Secretary and a board member of the Academy of Breastfeeding Medicine, a worldwide organisation of doctors that publishes clinical protocols on breastfeeding care, and she was recently recognised as a Fellow of the Academy of Breastfeeding Medicine. She has worked as part of expert committees with the World Health Organization, and on national breastfeeding projects in Mexico with the National Institute of Public Health and UNICEF. She was a founding member of the Mexican association of certified lactation consultants, where she led its education programme, and she teaches doctors, midwives and lactation consultants and speaks at international conferences on tongue tie and breastfeeding medicine.
She is trained by The British Institute of Orofacial Myology (TBIOM) in the YTM® Infant Method protocol of myofunctional therapy, and is certified by The Feeding Trust as a Feeding as Learning practitioner.
Her approach is thorough and considered, never rushed. Recognising that a tongue tie is only one part of a wider picture, she evaluates the whole feed (the baby’s growth and development, the mother’s comfort and milk supply) before making any recommendation. Where a release is appropriate, it can be carried out during the same appointment.
Many breastfeeding problems have more than one cause. As a doctor and an IBCLC lactation consultant, Dr Colmenares can examine both mother and baby, work out what is causing the problem, and put a management plan in place in the same appointment, including medical treatment where it is appropriate. She sees babies who are breastfed, bottle-fed and mixed-fed, with a main focus on the first year of life, and is happy to discuss seeing older babies and toddlers.
Finding the cause of pain, from attachment and positioning to tongue tie or infection.
Assessment and treatment for breast inflammation, and a plan to help prevent it coming back.
Looking at feeding, the baby’s transfer of milk and the mother’s health, then a plan to build supply.
Support when there is too much milk or a very fast flow that makes feeds difficult.
Checking growth, feeding pattern and milk transfer, with a clear plan and follow-up.
Telling normal baby behaviour apart from symptoms that need treatment.
Assessment of symptoms, guidance on the breastfeeding parent’s diet in the early months, and support with feeding plans as your baby grows.
A functional assessment of how the tongue works during a feed and, only if it is appropriate after assessment, a release at the same appointment.
Support for babies who are bottle-fed or mixed-fed, combining breast and bottle in a way that works for your family.
Introducing solid foods, moving on to new textures and widening the range of foods, for babies and toddlers.
Choosing a pump, flange fitting, building a pumping routine and keeping breastfeeding going alongside work.
Preparing for feeding before your baby arrives, including when feeding may be more complex, such as expected prematurity or cleft lip or palate.
Other ways to be seen: Follow-up in person £160 Weekly drop-in £50 Breastfeeding Support Programme £480 YTM® Infant Method protocol of orofacial myology £750 Video appointment £190* Video follow-up £100* Triage call by video £40* Prescription review by video £50*
*Video appointments are being set up. Please call 020 8129 1011 to check availability.
If Dr Colmenares advises a blood test for you, for example to check your thyroid or your iron levels, it can be taken here at the clinic.
Thyroid test Iron and anaemia check Women’s blood tests Hormone tests
IBCLC stands for International Board Certified Lactation Consultant, the international credential in lactation care. It is awarded by the International Board of Lactation Consultant Examiners after an examination and renewed every five years. Dr Colmenares has held it since 2011. Combined with her medical training, it means one clinician can assess the feed, examine mother and baby, and treat.
A breastfeeding and lactation medicine specialist is a physician with advanced training in the medical management of breastfeeding, going beyond general lactation support to address the clinical complexities that can arise for mother or baby, such as low milk supply, complex nipple pain, tongue tie or growth concerns. In the United States and Canada, this specialism is formally recognised through board certification by the North American Board of Breastfeeding and Lactation Medicine (NABBLM), established in 2023. Internationally, the field is united by the Academy of Breastfeeding Medicine (ABM), a global organisation of physicians promoting evidence-based breastfeeding care, with regional bodies such as the European Association of Breastfeeding Medicine (EABM) working to build the same recognition and physician networks across Europe.
*Video appointments are being set up. Please call 020 8129 1011 to check availability.
Breastfeeding and lactation support with a tongue tie division is £315 in total. Video appointments suit families who cannot easily travel, or where an examination is not needed. A tongue tie release is always done in person at the clinic. Prices are fixed, and the tongue tie division (£75) is only added when it is needed and you agree to it.
The NHS provides comprehensive care for mothers and babies, through midwives, health visitors, GPs and, in many areas, infant feeding teams, and it remains the right route for many families. KONCEPT® is designed to complement, not replace, that care. Access to NHS tongue tie assessment varies by region and provider. If you choose to see Dr Colmenares privately, we can share a summary of the appointment with your GP, midwife or health visitor on request.
NHS provision varies by region and clinical context, and the NHS pathway remains appropriate for many patients. KONCEPT® encourages continued NHS GP involvement and shares clinical summaries with your NHS GP on request.
If your baby or you are unwell. KONCEPT® is not an emergency service. If your baby is unwell, is feeding much less than usual or has far fewer wet nappies, or if you have a painful breast with a high temperature or feel unwell, contact your NHS GP the same day, or NHS 111 when the surgery is closed. In an emergency call 999 or go to A&E. Contact KONCEPT® in opening hours for bookings and questions about your appointment.
KONCEPT® Medical Clinic is at 46 to 48 Wood Street, Kingston upon Thames, KT1 1UW, in Kingston town centre opposite Kingston station. The clinic is easy to reach from Kingston upon Thames, Surbiton, New Malden, Wimbledon, Richmond upon Thames, Putney, Teddington, Hampton, Twickenham, Esher, Cobham, Walton-on-Thames and Thames Ditton, with direct trains from London Waterloo and road access from the A3. Call 020 8129 1011 for the next available appointment with Dr Colmenares.
Tongue tie, also called ankyloglossia, is where the strip of skin that joins the underside of the tongue to the floor of the mouth is shorter or tighter than usual and limits how the tongue moves.1 Studies estimate that about 4 to 11 in every 100 newborn babies have some degree of tongue tie.2 Many of them feed well and need no treatment.
A baby whose tongue tie affects feeding may find it hard to latch or stay attached to the breast or bottle, feed for a long time, make clicking noises, dribble, or cough and choke during feeds.1 The breastfeeding mother may have sore or damaged nipples or painful, swollen breasts. These signs have other causes too, so the whole feed is assessed, not only the tongue.
No. Treatment is not usually needed if a tongue tie is not causing problems.1 Tongue tie is judged by how the tongue works during a feed, not by how the skin under the tongue looks.5 Dr Colmenares recommends a release only when her assessment shows the tie is likely to be affecting feeding.
No release is done without a full assessment and a plan made by her. She can carry out a tongue tie division in babies up to 12 months of age, depending on the clinical situation, the thickness of the frenulum and the associated risks. If a release is needed and cannot be done in clinic, she can talk through the options and refer you on to the appropriate service.
Your baby is wrapped and held securely, the tongue is gently lifted, and the tight strip of skin is divided with sterile scissors. It takes a few seconds and in young babies it is usually done without anaesthetic.1 Your baby is then brought straight back to feed, which comforts them and helps any small bleeding to settle.
Most babies are unsettled for a short time and calm down once they are feeding. A little bleeding is common and usually stops with feeding. Around 1 in 400 babies need pressure to stop the bleeding, and hospital treatment is very rarely needed.8 Serious complications are rare.3,4 Dr Colmenares explains the possible risks before you decide, and you leave with written aftercare advice.
Feed your baby as usual, as often as they want. A diamond-shaped wound under the tongue soon turns white or yellow and usually heals over 7 to 14 days, which is normal.10,11 There are some exercises that may be considered helpful to improve tongue movement and function. You do not need to stretch or massage the wound.9
Bleeding at home after the procedure is extremely rare. If you see bleeding, offer a feed first. If it has not stopped within 15 minutes, press on the wound with a finger and clean gauze or muslin for 10 minutes. If it is still bleeding, keep pressing and call 999 or go to A&E.8
For a red or swollen wound, a temperature of 38°C or above, or a baby who refuses feeds, contact your GP, or NHS 111 when the surgery is closed. KONCEPT® is not an emergency service. You leave with a written aftercare leaflet and a follow-up appointment.
Posterior tongue tie is a term some people use for a tie that sits further back under the tongue. Dr Colmenares does not classify tongue ties as anterior or posterior. Her functional assessment looks at how your baby’s tongue works and how that affects feeding, and the decision to release a tie depends on that functional impact, not on how the tie looks.5
Yes. Dr Colmenares sees babies who are breastfed, bottle-fed and mixed-fed. Her focus is not on one feeding method or on particular products. She supports families through the whole journey of feeding and eating, from feeding difficulties at any stage and combining breast and bottle, to starting solids and moving on to new textures, with the aim of helping each family meet its own feeding goals.
Her main focus is the first year of life. She is also happy to discuss seeing older babies and toddlers, for example for feeding difficulties that continue past the first year, selective eating, starting solids and food progression, growth, weaning and extended breastfeeding. Tongue tie division is done in babies up to 12 months of age.
For breastfeeding concerns, Dr Colmenares sees mother and baby together, even when the main concern seems to be on the mother’s side, such as low milk supply, nipple pain or mastitis. Breastfeeding involves both of you, so a full assessment needs to include your baby as well, and treating only one of you risks missing the cause. Some appointments can take place online where that is appropriate.
Yes. An antenatal consultation is a chance to prepare for feeding before your baby arrives, talk through any concerns and make a plan that fits your goals. Dr Colmenares sees families with straightforward pregnancies, and families who know ahead of time that feeding may be more complex, for example with expected prematurity, cleft lip or palate, congenital heart disease, a neurological condition or syndrome, or another condition found during pregnancy. Planning early can help you know what to expect, how to protect your milk supply and which feeding options may be available after the birth. Please call 020 8129 1011 to book.
Yes. Dr Colmenares can help you choose a pump, check your flange fit so pumping is more comfortable and effective, build a pumping routine, and plan ahead for returning to work while keeping breastfeeding going.
Yes. Dr Colmenares sees babies with cow’s milk protein allergy. This includes guidance on the breastfeeding parent’s diet in the early months, and support with feeding plans as your baby grows.
No. Lip tie division is not offered at KONCEPT®. At present there is not enough evidence that dividing a lip tie improves breastfeeding.
Please bring your baby’s red book (Personal Child Health Record), the formula you use if your baby has any formula, your pump and flanges if you are pumping so the fit can be checked, and a cloth or muslin. If possible, try not to feed your baby just before the appointment, so Dr Colmenares can watch a feed while you are with her. If your baby is hungry and unsettled on the way, feed them as you normally would.
Yes. Dr Colmenares has been an International Board Certified Lactation Consultant (IBCLC) since 2011 and was recertified in 2026. IBCLC is the international credential in lactation care, awarded by the International Board of Lactation Consultant Examiners after an examination and renewed every five years. She is also a GMC-registered doctor, so she can examine and treat both mother and baby.
Dr Colmenares completed her paediatric training at the Instituto Nacional de Pediatría in Mexico and is board certified in paediatrics in Mexico. In the UK she works as a Specialty Doctor in Paediatrics at Chelsea and Westminster Hospital NHS Foundation Trust. She is registered with the General Medical Council with a licence to practise (GMC 7874258). The name on her GMC record is Mariana Colmenares Castano.
No. Dr Colmenares sees private patients at KONCEPT® on a practising-privileges basis. She is an independent GMC-registered doctor who is responsible for her own clinical practice, and KONCEPT® provides the CQC-registered premises, booking, and clinical and administrative support.
A new patient appointment with Dr Colmenares for breastfeeding, feeding and lactation support is £240 for 60 minutes and covers the assessment of mother and baby, examination and a management plan. If a tongue tie division is needed and you agree to it, it is added to the same appointment for £75, so the total is £315.
An in-person follow-up appointment is £160 for 30 minutes. A weekly 30 minute drop-in to review progress and tongue tie recovery is £50. The YTM® Infant Method protocol of orofacial myology is £750 in total for 6 sessions (1, 3 and 6 in clinic, 2, 4 and 5 online) and includes the new patient appointment, a tongue tie division if required and the YTM® tool, with £30 refunded if the tool is brought back at the final session. The 6 week Breastfeeding Support Programme is £480.
Video appointments are also available: a 15 minute triage call is £40, a new patient video appointment is £190, a video follow-up is £100 and a 15 minute prescription review, including the prescription, is £50. Video appointments are being set up, so please call 020 8129 1011 to check availability. Prices are fixed.
Yes. Dr Colmenares offers video appointments, booked through KONCEPT®, for families who cannot easily travel or where an examination is not needed: a 15 minute triage call (£40), a 60 minute new patient appointment (£190), a 30 minute follow-up (£100) and a 15 minute prescription review, including the prescription (£50). A tongue tie can only be released in person, so if a release may help she will arrange an appointment at the clinic. Video appointments are being set up, so please call 020 8129 1011 to check availability.
No. You can book directly by calling 020 8129 1011. You do not need a referral from your GP, midwife or health visitor, and we are happy to share a summary of the appointment with them if you would like us to.
Dr Colmenares sees families at KONCEPT® Medical Clinic, 46 to 48 Wood Street, Kingston upon Thames, KT1 1UW. The clinic is opposite Kingston station and is easy to reach from Surbiton, New Malden, Wimbledon, Richmond, Teddington, Twickenham and Esher.
New patient appointment £240, with a tongue tie release £75 if it is needed. Mother and baby are seen together, in a CQC-registered clinic in the heart of Kingston upon Thames. No referral is needed.
Reviewed by Dr Maryam Attarzadeh, GMC-registered doctor and Medical Director, KONCEPT® Medical Clinic. Last reviewed 24 September 2026. Next review 24 September 2027.
KONCEPT® Medical Clinic is registered with the Care Quality Commission for the regulated activities provided at our Kingston upon Thames premises. Assessments and procedures on this page are carried out by Dr Mariana Colmenares Castano, who sees private patients at KONCEPT® on a practising-privileges basis, is on the General Medical Council register (GMC 7874258) and remains accountable to the GMC under Good Medical Practice. Information on this page is factual and individual results vary.