Breastfeeding difficulties and oral cavity anomalies: The influence of posterior ankyloglossia and upper-lip ties

Int J Pediatr Otorhinolaryngol. 2015 Oct;79(10):1714-7. doi: 10.1016/j.ijporl.2015.07.033. Epub 2015 Jul 31.


Objective: Oral cavity anomalies may contribute to breastfeeding problems. The objective of this study was to describe our experience in a high-volume breastfeeding difficulty clinic with a focus on posterior ankyloglossia and upper-lip ties.

Methods: A retrospective review of patients from a dedicated breastfeeding difficulty clinic from January 2014 to December 2014 was performed. Those identified to have ankyloglossia and/or upper-lip ties underwent release procedures. Subjective breastfeeding changes were documented afterwards.

Results: Of the 618 total patients, 290 (47%) had anterior ankyloglossia, 120 (19%) had posterior ankyloglossia, and 14 (2%) had upper-lip tie. Some patients had both anterior ankyloglossia and upper lip-tie (6%), or posterior ankyloglossia and upper-lip tie (5%). For those with anterior ankyloglossia, 78% reported some degree of improvement in breastfeeding after frenotomy. For those with posterior ankyloglossia, 91% reported some degree of improvement in breastfeeding after frenotomy. Upper lip-tie release also led to improved breastfeeding (100%).

Conclusions: Anterior and posterior ankyloglossia and upper-lip tie, or combinations thereof, were commonly recognized in our study population. Many newborns, however, also had no oral cavity anomalies. Although causation cannot be implied, these oral cavity anomalies may contribute to breastfeeding difficulties in some cases.

Keywords: Ankyloglossia; Breastfeeding difficulty; Frenotomy; Frenulotomy; Upper-lip tie.

MeSH terms

  • Ankyloglossia
  • Breast Feeding*
  • Female
  • Humans
  • Infant, Newborn
  • Labial Frenum / abnormalities
  • Labial Frenum / surgery*
  • Lingual Frenum / abnormalities
  • Lingual Frenum / surgery*
  • Male
  • Mouth Abnormalities / complications
  • Mouth Abnormalities / surgery*
  • Retrospective Studies
  • Treatment Outcome