Assessing ankyloglossia: Prevalence, complications, and the controversy of frenotomy

Introduction: Ankyloglossia, or a short lingual frenulum, can interfere with breastfeeding, harming the infant's development, injuring the mother's nipples, and prompting early discontinuation of nursing. Objective: To analyze the existing literature on ankyloglossia, its epidemiology and related complications, as well as its correct diagnosis and treatment. Methodology: A search was carried out in the Pubmed, Google Scholar and Scopus databases using the keywords “ankyloglossia”, “breastfeeding”, “lingual frenulum”, and “pediatrics”. Results: The prevalence of ankyloglossia varies widely according to age and method of evaluation, being higher in newborns. Moderate or severe ankyloglossia limits tongue mobility and is associated with breastfeeding difficulties such as poor latch, nipple pain and sucking problems in the newborn. The lack of a clear definition of ankyloglossia complicates its diagnosis and treatment, although the Hazelbaker scale is one of the most widely accepted. Frenotomy, a common procedure to cut the lingual frenulum, is not recommended for all infants with ankyloglossia. Conclusion: Ankyloglossia is a condition whose prevalence varies according to age and method of assessment, being more common in newborns. Although frenotomy has been shown to be effective in improving breastfeeding-related symptoms such as poor latch, nipple pain and sucking difficulties, it is not suitable for all infants.