Abstract
Ankyloglossia (or tongue-tie) is a relatively uncommon congenital anomaly defined by an abnormally short lingual frenulum. Associations between tongue-tie and breastfeeding problems in infants have been inconsistent, and are a longstanding source of controversy in the medical community. Definitions of ankyloglossia vary, and management suggestions are not based on randomized controlled trials. Surgical correction involves cutting the lingual frenulum (frenotomy). Based on current available evidence, frenotomy cannot be recommended. If, however, the association between significant tongue-tie and major breastfeeding problems is clearly identified and surgical intervention is deemed necessary, frenotomy should be performed by a clinician experienced with the procedure and with appropriate analgesia. More definitive recommendations regarding the management of tongue-tie in infants await appropriately designed trials.
Keywords: Ankyloglossia, Breastfeeding, Infant
Footnotes
For more information, please refer to the full-text position statement at www.cps.ca/english/publications/CommunityPaediatrics.htm. This position statement replaces the previous Canadian Paediatric Society statement published in 2002.
COMMUNITY PAEDIATRICS COMMITTEE
Members: Drs Minoli Amit, St Martha’s Regional Hospital, Antigonish, Nova Scotia (Board Representative); Carl Cummings, Montreal, Quebec; Sarah Gander, Saint John Regional Hospital, Saint John, New Brunswick; Mark Feldman, Toronto, Ontario (Chair); Barbara Grueger, Whitehorse General Hospital, Whitehorse, Yukon; Anne Rowan-Legg, Children’s Hospital of Eastern Ontario, Ottawa, Ontario
Liaison: Dr Peter Nieman, Calgary, Alberta (Canadian Paediatric Society, Community Paediatrics Section)
Consultants: Drs Mia Lang, Royal Alexandra Hospital, Edmonton, Alberta; Alan Murdock, University of Alberta, St Albert, Alberta; Hema Patel, The Montreal Children’s Hospital, Montreal, Quebec
Principal author: Dr Anne Rowan-Legg, Ottawa, Ontario
The recommendations in this statement do not indicate an exclusive course of treatment or procedure to be followed. Variations, taking into account individual circumstances, may be appropriate. All Canadian Paediatric Society position statements and practice points are reviewed, revised or retired as needed on a regular basis. Please consult the “Position Statements” section of the CPS website (www.cps.ca/english/publications/statementsindex.htm) for the most current version.