Tongue tie; review of literature
| Author(s) | Number and age group studied | How cases were identified | Type of study and intervention | Results |
|---|---|---|---|---|
| TT, tongue tie; ATLFF, Assessment Tool for Lingual Frenulum Function. | ||||
| Messner et al3 | Examined 1041 newborns. Identified 50 TT cases (4.8%). M: F ratio 2.6:1 | Screened by one doctor, confirmed by one colleague | Observational follow up study but no intervention | 30/36 TT cases and 33/36 controls breast fed to 2 months (p = 0.29). 9 cases and 1 control experienced breast feeding difficulties |
| 36 cases of TT enrolled and 36 controls without TT | ||||
| Hogan et al4 | Examined 1866 babies. Identified 201 TT cases (10.7%). M:F ratio 1.6:1. 44% TT cases had problems feeding. 57 TT babies entered study (40 breast fed and 17 bottle fed) | Photos to assist staff in postnatal checks | Randomised to immediate frenulotomy or support by lactation counsellor, at mean age 20 days (3–70), median age 14 days | TT cases treated by frenulotomy; 27/28 marked improvement. Counselled cases managed conservatively; 1/29 improved |
| Ballard et al5 | Examined 2763 breast fed in-patient babies and 273 attenders at lactation clinic. | One observer examining all babies. ATLFF used | 123 cases underwent frenulotomy at age 1–2 days | Latch improved in all, pain scores fell significantly |
| M:F ratio 1.5:1. Identified TT in 3.2% in-patients and 12.8% clinic attenders | ||||
| Ricke et al6 | Examined 3490 babies, identified 148 TT cases (4.24%). M:F ratio 2.3:1. | Nurses assisted by photos, ATLFF by team | Observational study, no intervention | Mothers of TT babies three times more likely to give up breast feeding by one week; however, 80% TT breast feeding well at one week. TT and non-TT breast feeding in equal numbers at 1 month. Mothers with TT babies reporting more pain at one month but not statistically significant. Small numbers so type II errors possible |
| Enrolled 49 TT babies for study with 2 matched non-TT breast fed babies as controls | ||||
| Ramsay7 | Case series | Referrals to paediatric surgeon | Measured nipple tip to hard soft palate junction by ultrasound, pre- and post-frenulotomy | Distance changed from 7.99 mm to 6.49 mm. Milk transfer increased from 3.3 to 7.2 ml/min. At least 7 day interval between frenulotomy and 2nd measurement |
| Messner and Lalakea8 | Case series of speech problems: 30 children age 1–12 | Measured tongue protrusion and inter-incisal distance | Frenulotomy | Speech improved. 25 mothers had tried to breast feed; 21 said no problems |
| Fernando9 | Case series, n ⩾200 | Various; majority presenting with speech disorders | Frenulotomy | Improved to varying degree. 20% had history of BF problems: 80% did not |