Breastfeeding problems should be the only relevant criteria for deciding whether to carry out a frenotomy in infancy

Abstract

Performing a frenotomy on tongue-tied infants is controversial, particularly with regard to breastfeeding issues. This paper reviews the literature to bring together clinical experiences and scientific evidence in this field. I found that some tongue-tied babies may exhibit breastfeeding problems, while others may feed perfectly. The literature suggests that medical breastfeeding-related problems should be the only relevant criteria to guide the decision-making for a frenotomy in infancy. The advantages and disadvantages of either a wait and see position or surgical approach are addressed.

Conclusion: The cornerstones for best practice are the meticulous examination, correct diagnosis and classification of tongue-tied infants.

Keywords: Breastfeeding; Frenotomy; Hazelbaker score; Tethered tongue; Tongue-tie.