Using the electronic baby bottle to support tongue-tie diagnosis in infants: a prospective study

Background Tongue-tie may interfere with infant feeding, but diagnosis remains challenging due to lack of objective criteria.Aims/objectives To evaluate the clinical utility of the electronic baby bottle (EBB), a novel device recording intraoral forces during suckling.Material and methods A prospective cohort study across four ENT clinics included 106 infants under 3 months, assessed at baseline and 1-week follow-up. ENT specialists rated the EBB’s diagnostic value; tongue anatomy and mobility were screened using the TABBY scoring system. Eighty-five infants underwent frenotomy; 21 not meeting diagnostic criteria served as controls.Results The EBB received high diagnostic value scores in both groups, with no significant change following frenotomy. TABBY scores improved significantly post-operatively (mean difference 3.87 (95% CI 3.4–4.3), p < 0.001), consistent with expected anatomical changes. Infant cooperation was positively associated with device utility (p < 0.001). Frenotomy was associated with significant improvements in caregiver-reported symptoms, including latch quality, breast pain, and feeding duration.Conclusions and significance ENT specialists rated the EBB as subjectively useful, but no signal-level change was detected following frenotomy using clinician-based rating. Subjective interpretation of EBB readouts is insufficient as a standalone diagnostic approach; automated signal analysis on biomechanical responsiveness is required to realise the device’s diagnostic potential. Further prospective validation is needed before clinical adoption can be recommended.