The purpose of this 12-month study was to determine whether frenotomy for infants with ankyloglossia (tongue tie) improved maternal nipple pain and ability to breastfeed. A secondary objective was to determine whether frenotomy improved the length of breastfeeding.

Neonates who had difficulty breastfeeding and significant ankyloglossia were enrolled in this randomised, single-blinded, controlled trial and assigned to either a frenotomy (30 infants) or a sham procedure (28 infants). Breastfeeding was assessed by a pre-intervention and post-intervention nipple-pain scale and the Infant Breastfeeding Assessment Tool. The same tools were used at the 2-week follow-up and regularly scheduled follow-ups over a 1-year period. The infants in the sham group were given a frenotomy before or at the 2-week follow-up if it was desired.

Both groups demonstrated statistically significantly decreased pain scores after the intervention. The frenotomy group improved significantly more than the sham group (P < .001). Breastfeeding scores significantly improved in the frenotomy group (P = .029) without a significant change in the control group. All but 1 parent in the sham group elected to have the procedure performed when their infant reached 2 weeks of age, which prevented additional comparisons between the 2 groups.

The authors conclude that when frenotomy is performed for clinically significant ankyloglossia, there is a clear and immediate improvement in reported maternal nipple pain and infant breastfeeding scores. They recommend additional research should be done to determine the optimal timing of frenotomy and the ideal screening tool to detect significant ankyloglossia.

Efficacy of Neonatal Release of Ankyloglossia: A Randomized Trial. Melissa Buryk, David Bloom, and Timothy Shope. Pediatrics. published 18 July 2011, 10.1542/peds.2011-0077