Does frenotomy help infants with tongue-tie overcome breastfeeding difficulties?

Abstract

Q: Does frenotomy help infants with tongue-tie overcome breastfeeding difficulties? Evidence-based answer: Probably not. No evidence exists for improved latching after frenotomy, and evidence concerning improvements in maternal comfort is conflicting. At best, frenotomy improves maternal nipple pain by 10% and maternal subjective sense of improvement over the short term (0 to 2 weeks) (strength of recommendation [SOR]: B, randomized controlled trials [RCTs] with conflicting results for maternal nipple pain and overall feeding). No studies have evaluated outcomes such as infant weight gain following frenotomy. Experts don't recommend frenotomy unless a clear association exists between ankyloglossia (tongue-tie) and breastfeeding problems. Frenotomy should be performed with anesthesia by an experienced clinician to minimize the risk of complications (SOR: C, a practice guideline.)