A specialist registrar in a district general hospital receives a call from a health visitor who has seen a 2-week-old baby who is struggling to breastfeed adequately and who has a marked tongue tie. The parents are extremely anxious and after searching the internet are now requesting a tongue division as they are certain that this is the cause of the problem. The health visitor can also recall many success stories after this procedure and is concerned that without it the mother will abandon breastfeeding altogether. She asks you to refer the baby to the ENT specialists with a view to division.

Structured clinical question

In babies with poor breastfeeding and a tongue tie [patient], does division of the tongue tie [intervention] compared to breastfeeding advice alone [comparison] improve feeding [outcome]?

Search strategy and outcome

Secondary sources

Cochrane and BestBETS: no relevant results.

NICE guidelines: one interventional procedure guideline.

Primary sources

Medline (1996–November Week 3 2008) searched via Ovid with Breastfeeding …