Recommendations Developed for Identifying, Managing Ankyloglossia

MONDAY, July 29, 2024 (HealthDay News) -- In a new clinical report issued by the American Academy of Pediatrics, and published online July 29 in Pediatrics, recommendations are presented for the identification and management of ankyloglossia in infants.

Jennifer Thomas, M.D., M.P.H., from Advocate Aurora Health in Milwaukee, Wisconsin, and colleagues address identification and management of ankyloglossia in infants and its impact on breastfeeding.

The authors note that infants with ankyloglossia and normal feeding patterns do not need interventions. There is no evidence base for frenotomy for other problems or to prevent issues such as speech articulation or obstructive sleep apnea in the future. Posterior ankyloglossia, which is poorly defined and lacks agreement from experts, should not be used as an indication for surgical intervention. Labial and buccal frenae do not require surgical intervention to improve breastfeeding. Sucking blisters are normal in newborn infants and not indicative of pathology. Suboptimal breastfeeding is complex; before any treatment is offered, every nursing dyad with painful or ineffective feeding should undergo a comprehensive breastfeeding assessment. Close monitoring, with support of breastfeeding in the hospital, early postdischarge follow-up, and monitoring of weight gain after discharge is recommended for newborn infants with possible symptomatic ankyloglossia. After other causes of breastfeeding problems have been evaluated and treated, surgical intervention of symptomatic ankyloglossia (versus laser) can reasonably be offered. Frenotomy should be performed by a trained professional. Attention to preventing surgical complications, hemorrhagic risk, and mitigating pain, and offering evidence-based postsurgical care is recommended.

"Further research, including a standardized approach to identifying and classifying ankyloglossia, long-term outcome measures, and a good description of the natural history of ankyloglossia by severity, including long-term risk of feeding problems, is needed," the authors write.

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