A systematic review: The effects of frenotomy on breastfeeding and speech in children with ankyloglossia

Int J Speech Lang Pathol. 2021 Aug;23(4):349-358. doi: 10.1080/17549507.2020.1849399. Epub 2021 Jan 27.


Purpose: The primary objective of this systematic review was to determine if frenotomy for ankyloglossia improves breastfeeding or speech outcomes in infants and children ages birth to 12.Method: Literature selection focussed on the presence of ankyloglossia, reported as either posterior or submucosal, and the impact of surgical treatment. The two populations that were included involve infants who were breastfeeding and children with speech delays. Six search engines were utilised (PubMed, Medline, Cochrane Database, CINHAL Plus, ERIC and PsychINFO). The selected articles critically examined study characteristics, measurement tools, outcome measures, design, and summary of results, and bias.Result: Five articles met the inclusion criteria related to infants who had undergone a frenotomy and who were examining changes in breastfeeding outcomes and two articles met the inclusion criteria for changes in speech production following a frenotomy.Conclusion: Research supports the use of frenotomy in children with ankyloglossia to reduce nipple pain and improve maternal self-efficacy during breastfeeding. The classification of ankyloglossia, assessment tools used, age and timing of frenotomy, in terms of breastfeeding improvements were inconsistent across the studies. Ankyloglossia release for children with speech delays is currently inconclusive due to lack of objective data and research quality. Overall, the review also revealed inconsistent definitions of ankyloglossia severity, standardised outcome measures and research protocols.

Keywords: Speech; swallowing; systematic review; treatment.

Publication types

  • Systematic Review

MeSH terms

  • Ankyloglossia* / surgery
  • Breast Feeding
  • Child
  • Female
  • Humans
  • Infant
  • Language Development Disorders*
  • Lingual Frenum / surgery
  • Speech
  • Treatment Outcome