When should you treat tongue-tie in a newborn?
Another prospective, uncontrolled cohort study followed 215 infants (mean age 19 days) with tongue-tie and breastfeeding difficulties despite lactation support. Investigators gauged the extent of tongue-tie by visual inspection before frenotomy.
At 24 hours after frenotomy, 57% of mothers reported improved breastfeeding and 64% breastfed through 3 months (compared with the British national average of 30%). The likelihood of breastfeeding at 3 months after frenotomy didn’t correlate with the original extent of tongue-tie.6
A prospective, uncontrolled case series measured the overall incidence of tongue-tie—88 infants out of 2763 consecutive births (3.2%)—and the incidence of tongue-tie among infants with breastfeeding problems—35 infants among 273 presenting to a lactation center (12.8%). Mothers reported significant improvements in latching and nipple pain 3 days after frenotomy.7
Recommendations
The Community Paediatrics Committee of the Canadian Paediatric Society says that most of the time, tongue-tie is an anatomical finding without significant consequences for breastfeeding. Surgical intervention isn’t usually warranted, but may be necessary if significant tongue-tie is associated with major breastfeeding problems.8
The Academy of Breastfeeding Medicine also says that breastfeeding assistance, patient education, and reassurance may be sufficient; if frenotomy is necessary, a physician should do it.9
