Difficulties with newborn breastfeeding can occur when movement of the infant’s tongue or upper lip is restricted. These conditions, ankyloglossia (tongue-tie) and concomitant lip-tie, are characterized by congenitally short frenulums of the tongue and upper lip.

A recent comparative effectiveness review of the literature concluded that the strength of evidence is low to insufficient to draw firm conclusions regarding whether frenotomy improves infants’ ability to breastfeed. In addition, there are no data on combined frenotomy and lip-tie clipping.

As awareness of ankyloglossia and lip-tie as potential causes for breastfeeding pain has grown, many families are seeking out surgical correction. The evidence is incomplete, however, on whether correction of these congenital lesions improves the infant’s ability to breastfeed.

Ankyloglossia restricts the tongue from extending and elevating, both of which are necessary for milk removal from the breast. Lip-tie prevents the upper lip from moving well beyond the upper gum, potentially causing...

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