Tongue-Tie

• Popularity of casual frenotomy in the early 20th century
• Procedure fraught with complications: bleeding, infection, scarring, "regenerating"
• Fell into disrepute in the mid 20th century
• Concurrent popularity of formula feeding
• Older and recent text books claimed frenotomy unnecessary
• Current resurgence of breastfeeding demands revisit of topic

• A surgical procedure involving clipping of the lingual frenulum parallel to the tongue
• Must be familiar with oral anatomy
• Requires aseptic technique and sterile instruments
• Neonatal, outpatient or office procedure
• No anesthesia if performed under 3-4 months
• Minimal blood loss
• Infant may breastfeed immediately after procedure

References :
Jeanne L. Ballard, Christine E. Auer and Jane C. Khoury
Ankyloglossia: Assessment, Incidence, and Effect of Frenuloplasty on the
Breastfeeding Dyad J Pediatrics 2002;110;63-DOI: 10.1542/peds.110.5.e63