Tongue‐tie and frenotomy

Abstract

Journal of Paediatrics and Child HealthVolume 51, Issue 2 p. 227-228 Heads UpFree Access Tongue-tie and frenotomy First published: 09 February 2015 https://doi.org/10.1111/jpc.12846_3AboutSectionsPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat Frenotomy for tongue-tie causes almost as much controversy as circumcision. The evidence is best for frenotomy in severe tongue-tie. Severity is measured by the appropriately named acronym, the LATCH score. A recent meta-analysis1 found four randomised controlled trials (RCTs) of frenotomy compared with lactation support for breastfeeding outcome (infant feeding or maternal nipple pain). The authors report moderate quality evidence for the effectiveness of frenotomy and no major complications.1 In a new RCT of 107 infants, early frenotomy in mild-moderate tongue-tie did not improve the infant's feeding at 5 days, but did improve what the authors called maternal breastfeeding self-efficacy: mothers felt better although the intervention had no measurable effect on infant feeding or maternal nipple pain.2 After the 5-day clinic visit, 44 (85%) of 52 control mothers asked for frenotomy.2 If frenotomy is being performed despite evidence that it is ineffective, this raises ethical concerns. Furthermore, a recent letter reporting neonatal Staphylococcus aureus septicaemia as a major complication suggests frenotomy may not be as safe as some claim.3 The controversy continues. References 1Ito Y. Pediatr. Int. 2014; doi: 10.1111/ped.12429; [Epub ahead of print]. Wiley Online LibraryWeb of Science®Google Scholar 2Emond A et al. Arch. Dis.Child Fetal Neonatal Ed. 2014; 99: F189– 195. CrossrefPubMedWeb of Science®Google Scholar 3Reid N, Rajput N. Acute feed refusal followed by Staphylococcus aureus wound infection after tongue-tie release. J. Paed. Child Health 2014; 50: 1030– 1031. Wiley Online LibraryWeb of Science®Google Scholar Reviewer: David Isaacs, david.isaacs@health.nsw.gov.au Volume51, Issue2February 2015Pages 227-228 ReferencesRelatedInformation