The need for frenotomy in children with tongue tie is not universally accepted. It is however understood that among other problems, such as impaired speech, tongue tie impedes breast feeding possibly leading to early weaning. Therefore, with recent resurgence of breast feeding, the need for release of tongue tie has an added dimension. This study looks into breast feeding with and without division of tongue tie, using the Infant Breastfeeding Assessment Tool which has four domains, namely readiness to feed, rooting, fixing (latching on) and sucking pattern. Scores out of three in each domain add up to a maximum of 12 and have been used to assess the outcomes after surgical intervention and co-ordinated breast feeding support. Forty-two children participated in the study of which 36 underwent frenotomy and in this group, 29 mothers (81%) reported improvement in breast feeding. The results were better if frenotomy was performed in infants before the age of 30 days. Only one out of six mothers in the group not undergoing surgical intervention, but receiving continued support from infant feeding co-ordinator, reported improvement. Similar results are quoted from the literature. The authors accept that the numbers are small and telephone assessment could have been biased. However, the publication does emphasise the need for a very simple procedure, not even requiring anaesthesia, if done at an early age. 

Tongue-tie division to treat breastfeeding difficulties: our experience.
Sharma SD, Jayaraj S.
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Madhup K Chaurasia

Mid and South Essex NHS Foundation Trust, UK.

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