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. 2024 Feb 28;8(1):53-60.
doi: 10.1002/ped4.12416. eCollection 2024 Mar.

A cross-sectional study of breastfed infants referred for tongue tie assessment and frenotomy in one Canadian health region

Tiffany A Lee  1 , Jessica Bishop  2 , Anne Drover  2 , William K Midodzi  2 , Laurie K Twells  2
Affiliations

A cross-sectional study of breastfed infants referred for tongue tie assessment and frenotomy in one Canadian health region

Tiffany A Lee et al. Pediatr Investig. .

Abstract

Importance: Tongue tie (TT) is a condition that can cause infant feeding difficulties due to restricted tongue movement. When TT presents as a significant barrier to breastfeeding, a frenotomy may be recommended. Universally accepted diagnostic criteria for TT are lacking and wide prevalence estimates are reported. New referral processes and a Frenotomy Assessment Tool were implemented in one Canadian health region to connect breastfeeding dyads with a provider for TT evaluation and frenotomy.

Objective: To determine the proportion of babies with TT as well as the frequency of frenotomy.

Methods: This cross-sectional study included infants who initiated breastfeeding at birth and were referred for TT evaluation over a 14-month period. Data were collected retrospectively by chart review and analyzed using SPSS. Factors associated with frenotomy were examined using logistic regression.

Results: Two hundred and forty-one babies were referred. Ninety-two percent (n = 222) were diagnosed with TT and 66.0% (n = 159) underwent frenotomy. In the multivariate model, nipple pain/trauma, inability to latch, inability to elevate tongue, and dimpling of tongue on extension were associated with frenotomy (P < 0.05). Most referrals in our region resulted in a diagnosis of TT; however, the number of referrals was lower than expected, and of these two-thirds underwent frenotomy.

Interpretation: TT is a relatively common finding among breastfed infants. Future research should examine whether a simplified assessment tool containing the four items associated with frenotomy in our multivariate model can identify breastfed infants with TT who require frenotomy.

Keywords: Breastfeeding; Community health services; Nutrition; Pediatrics.

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Conflict of interest statement

The authors declare no conflict of interest.

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