Twhansen

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 Professor Neonatal Intensive Care Unit Division of Paediatrics Rikshospitalet University Hospital and Faculty of Medicine University of Oslo Oslo, Norway References: 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