A growing number of infants in recent years have been diagnosed with ankyloglossia, also called “tongue-tie.” According to a report by the American Academy of Pediatrics (AAP), however, tongue-tie often leads to surgery that could be overused and might not resolve the breastfeeding concerns.
The AAP reviewed the research on diagnosis and treatment of ankyloglossia and offers evidence-based recommendations to help pediatricians care for the breastfeeding infant in its report “Identification and Management of Ankyloglossia and its Effect on Breastfeeding in Infants,” published in the August 2024 Pediatrics.
As pediatricians, the doctors at Pediatric Partners of Augusta rely on guidance from the AAP. We take any diagnosis very seriously, especially one that could result in surgery.
The AAP encourages us to first consider nonsurgical options to address breastfeeding challenges rather than a frenotomy (surgery to enhance mobility of an infant’s tongue movement).
Maternal pain is one of the most common complaints that leads to the tongue-tie diagnosis. It can occur if the infant’s tongue does not extend and elevate because of a restrictive lingual frenulum (the web of tissue that attaches the tongue to the floor of the mouth).
Pain can lead to poor milk transfer and insufficient growth. Some mothers stop breastfeeding when they can’t resolve the problem. An ineffective latch and poor weight gain are the main reasons pediatricians consider a diagnosis of ankyloglossia.
The American Academy of Pediatrics recommends exclusive breastfeeding for about 6 months, with continuation for 2 years or longer as mutually desired by mother and infant.
The AAP recommends that pediatricians, do the following:
- Identify feeding problems early to support successful breastfeeding outcomes.
- Offer comprehensive care for infants by collaborating with lactation consultants, speech-language pathologists, and other specialists.
- Reserve frenotomy for cases in which nonsurgical interventions have failed. The procedure is safe, and poor outcomes are rare.
- Avoid recommending post-frenotomy stretching exercises in which the parents open the wound several times to prevent reattachment.
As pediatricians, we understand why a breastfeeding mother would be eager for a solution to breastfeeding concerns. If you are experiencing breastfeeding difficulties, please consult your pediatrician. Aside from three pediatric care offices in the Augusta area, Pediatric Partners of Augusta operates the Bella Bambino newborn care clinic, where mothers can connect with lactation consultants to discuss breastfeeding issues.
Clinical reports created by AAP are written by medical experts, reflect the latest evidence in the field, and go through several rounds of peer review before being approved by the AAP Board of Directors and published in Pediatrics.