Tongue-tie, breastfeeding difficulties and the role of Frenotomy

Acta Paediatr. 2012 Jul;101(7):687-9. doi: 10.1111/j.1651-2227.2012.02661.x. Epub 2012 Apr 5.


A greater emphasis on exclusive breastfeeding in recent years has re-ignited the historical debate over the role of ankyloglossia (tongue-tie) in infants with breastfeeding difficulties. Several prospective cohort studies and randomized control trials have been published in this area in the last 10-15 years. We critically evaluated recent evidence and attempted to answer two important clinical queries in this area, that is, (i) whether ankyloglossia is associated with breastfeeding difficulties and (ii) whether frenotomy helps mother-baby dyad in such setting?

Conclusion: Neonates with tongue-tie are at increased risk for breastfeeding difficulties. An early recognition of this association by primary care provider and prompt referral to a lactation consultant is important. In cases with clearly documented breastfeeding difficulties, frenotomy often results in rapid improvement in symptoms.

MeSH terms

  • Breast Feeding*
  • Congenital Abnormalities / physiopathology
  • Congenital Abnormalities / surgery*
  • Humans
  • Infant, Newborn
  • Lingual Frenum / abnormalities
  • Lingual Frenum / surgery*
  • Tongue Diseases / physiopathology
  • Tongue Diseases / surgery*
  • Treatment Outcome