AB180. SOH24AB_023. Factors influencing frenotomy: a prospective study

Background: Ankyloglossia or tongue-tie is a condition of a shortened lingual frenulum leading to restricted tongue movement. Its definition is not standardised and expert opinion regarding its clinical significance and management is divided. We aimed to assess factors that may influence a frenotomy being performed in an infant.

Methods: A prospective study of infants referred for consideration of lingual frenotomy to a single institution from January to October 2023 was conducted. Data including basic demographics, referring healthcare specialist, infant feeding regime, maternal lactation history, maternal breastfeeding issues, infant breastfeeding issues and clinical examination were collected.

Results: During this ten-month period, 157 infants with a mean age of 5 weeks, attended for division of the lingual frenulum. There were 83 male and 74 female patients. Following consultation 61% (n=96) underwent a frenotomy. Referrals to the specialist clinic came from a variety of healthcare specialists; public health nurses (n=67), neonatologists (n=45), International Board Certified Lactation Consultant (IBCLC) (n=23) and family physicians (n=21). Gender was not a predictor of frenotomy (P=0.97), patients 2 weeks (P<0.01) and maternal pain during feeding (P<0.01), as well as poor infant latch (P<0.01), were predictors of frenotomy.

Conclusions: In our institution, 39% of infants referred with suspected tongue tie did not require a frenotomy suggesting an over diagnosis in the community. Frenotomy was necessary and performed more frequently where there were maternal and infant breastfeeding issues.

Keywords: Ankyloglossia; frenotomy; lingual frenulum; neonate; tongue-tie