Jump to content


Want to join the discussions?

Sign up for a free membership! 

If you are a member already, log in!

(lost your password? reset it here)

99nicu.org 99nicu.org

Tie Tongue

Guest sbarak

Recommended Posts

Dear Colleagues,

I think that most of you treat many cases of tie tongue. I would like to know what is the criteria you consider for cutting the frenulum, and who does it?

Thank you for your response

Dr. Barak

Link to comment
Share on other sites


Cutting the frenulum feels, to me, as one of the least evidence-based treatment in neonatology. (also saying that we do a lot of non-evidence based things everyday!)

We do this very infrequently, but sometimes, if the midwifes feels sure about that feeding could be associated with a tight frenulum.

Our ENT people would suggest themselves to do it, since a bad cut can heal with even further tightness. But we do ourselves too sometimes, with a pair of scissors, max 2 cuts, to the tounge muscle.

Link to comment
Share on other sites

  • 3 months later...
  • 2 weeks later...

I have never encountered a feeding problem due to tongue tie. We do not cut it ,and leave it as such. Only when there is speech problem later in infancy mostly on insistence of parents ,a cut is given by a surgeon ,which is very infrequent in my practice . If the tonuge can protude upto or beyond lips , there is no cause for conern for speech problem too.

Link to comment
Share on other sites

  • 5 weeks later...

Dear colleagues,

I have read your interesting discussion re tongue tie (ankyloglossia). In our group we used to be rather sceptical about cutting the frenulum. However, some time ago we reviewed the literature again because the issue is often raised by midwives and baby nurses. Following this review, we felt obliged to modify our previous stance. Indeed, there appears to be reasonable evidence suggesting that a very short frenulum may be associated with lactation difficulties. Thus, maternal reports of very sore nipples or frank pain on lactation, combined with evidence of insufficient food intake by the baby, appear to be associated with ankyloglossia. In some such instances, cutting the frenulum appears to resolve or, at least, significantly improve the situation. Currently we will consider cutting the frenulum if the above mentioned signs/symptoms occur in the presence of a frenulum which appears sufficiently short to impede the movement of the tip of the tongue. Some interesting references are listed below.

Thor Willy Ruud Hansen, MD, PhD


Neonatal Intensive Care Unit

Division of Paediatrics

Rikshospitalet University Hospital

and Faculty of Medicine

University of Oslo

Oslo, Norway


Hogan M, Westcott C, Griffiths M. Randomized, controlled trial of division of tongue-tie in infants with feeding problems. J Paediatr Child Hlth 2005;41:245-50

Dollberg S, Botzer E, Grunis E, Mimouni FB. Immediate nipple pain relief after frenulotomy in breast-fed infants with ankyloglossia: a randomized, prospective study. J Pediatr Surg 2006;41:1598-600

Srinivasan A, Dobrich C, Mitnick H, Feldman P. Ankyloglossia in breastfeeding infants: the effect of frenulotomy on maternal nippole pain and latch. Breastfeeding Medicine 2006;1:216-24

Hall DMB, Renfrew MJ Tongue tie. Common problem or old wives' tale? Arch Dis Child 2005;90:1211-5

Link to comment
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now
  • Create New...