Breastfeeding

Infant Ankyloglossia
August, 2024
 
Are you confused about how to diagnose infant ankyloglossia?
 
Are you unsure about who needs a referral for possible ankyloglossia release?
 
Should I be referring to a pediatrician, dentist, otolaryngologist or other practitioner who uses scissors or a laser for the release of a tongue tie?
 
Do maxillary (upper lip) frenulums need to be released?
 
The above are questions that many pediatricians have about ankyloglossia. The AAP has just released a new clinical report on Infant Ankyloglossia (7/29/24). This report was written by members of the Section on Breastfeeding, Council on Quality Improvement and Patient Safety, Section on Oral Health, Committee on Fetus and Newborn, and Section on Otolaryngology-Head and Neck Surgery.
 
The statement includes some recent anatomical work on the lingual frenulum, and a review of recent publications about ankyloglossia from around the world, The AAP statement:
 

• defines ankyloglossia,
• gives information about incidence of the diagnosis of ankyloglossia,
• discusses treatments available, including discussion of clipping vs. laser and other possible treatments,
• side effects of ankyloglossia release, and
• gives overall recommendations for care of the infant with ankyloglossia.

Unfortunately, the topic of infant ankyloglossia has not been evaluated using well designed randomized controlled studies. Side effects from ankyloglossia releases have been seen and some infants have had major complications including infant feeding refusal after the procedure.
 
Another good reference on this topic is the Academy of Breastfeeding Medicine’s Position statement on ankyloglossia. It is located on the Academy of Breastfeeding Medicine website.
 
https://www.bfmed.org/protocols
Just scroll down until you get to the ankyloglossia heading and click.