Consider treatment when the infant is having difficulty breastfeeding. Infants with mild to moderate tongue-tie, or ankyloglossia, are likely to breastfeed successfully and usually require no treatment (strength of recommendation [SOR]: B, a prospective controlled trial and a case-control study). However, mothers of infants with any degree of tongue-tie who have difficulty with breastfeeding despite lactation support report immediate improvement after frenotomy is performed on the baby. Complications from the procedure are minimal (SOR: B, a small randomized controlled trial [ RCT] and multiple uncontrolled cohort studies and case series).