or anytime thereafter if problems emerge.

2. Incidence of tongue tie ranges from 0.02% to 4.8% in

various studies (1,2,13,19,23,26,29).

a. There appears to be a genetic predisposition in some

families.

(1) Frequently, when an infant presents for possible

frenotomy, someone in the immediate family

has a tongue tie.

b. Most studies report an approximately 2:1 male predominance.

3. In a recent study, 22% of 425 North American pediatricians surveyed indicated they had performed frenotomies; however, only 10% reported being taught the

technique during residency (21).

D. Indications

1. In the neonate, presence of ankyloglossia, usually in a

breast-feeding infant, causing one or more of the following (4,5,13,22,23,27–30).

a. Maternal nipple trauma, pain, nipple/breast infection

b. Poor latch

c. Ineffective suckling; continuous suckling

d. Weight loss, poor infant weight gain, failure to thrive

e. Early weaning

E. Contraindications

1. Presence of genioglossus muscle or vascular tissue in the

frenulum, with no thin membranous tissue for incision

Fig. 57.1. Newborn with significant ankyloglossia. Note heartshaped tongue, inability to raise tongue tip toward roof of mouth.

Fig. 57.2. Newborn with posterior Ankyloglossia. Note thick

posterior fibrous band. (Photograph courtesy of Evelyn Jain, BA,

BSc, MD, FCFP.)