Are infants being referred too often for ankyloglossia?

Meant to help infants breastfeed more easily, the frenotomy procedure appears to be performed on some infants who don’t require it, according to a new study found in JAMA Otolaryngology-Head and Neck Surgery.

Researchers at the Massachusetts Eye and Ear Infirmary and Massachusetts General Hospital in Boston looked at mother-infant pairs who were referred to their clinic for difficulty with breastfeeding between March and December 2018. Each infant was given a comprehensive feeding evaluation by a speech and language pathologist before a surgical consultation occurred.

Of the infants that were included, 115 patients were referred to the surgical unit to undergo a lingual frenotomy. After the development of the feeding assessment program, 72 of the infants referred did not receive a frenotomy. Among those infants who did undergo a procedure, 10 had a labial frenotomy alone and 32 infants had labial and lingual frenotomies.

With a 10-fold increase in inpatient lingual frenotomies from 1997 to 2012 and insufficient evidence that the procedure provides any benefit for breastfeeding, the researchers concluded that development of programs such as the comprehensive feeding evaluation could reduce the number of unnecessary frenotomies performed. They also urged the development of multidisciplinary teams to promote coloration to treat infants who are referred for ankyloglossia.