History of Frenotomy for Ankyloglossia:

  • 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

scissors and retractor 

References :

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

About Dr. Ballard

Dr. Ballard is an associate professor of Pediatrics, Obstetrics and Gynecology at the University of Cincinnati College of Medicine. More ...