Report on assessment and management of tongue tie in infants launched at Faculty of Paediatrics Conference
The joint report, from the Royal College of Physicians of Ireland’s Faculty of Paediatrics and the Health Services Executive, follows intensive consultation and consensus on 15 recommendations to assess and manage tongue tie in infants. The paper, presented at the Faculty of Paediatrics Spring Conference this May, reflects alignment across specialties in infant feeding and surgical care.
Ankyloglossia is a condition that limits tongue movement due to a restrictive lingual frenulum. Healthcare professionals need to be well informed about the indications for frenotomy in breastfed infants with ankyloglossia.
The new guidance aims to support healthcare professionals and parents navigating ankyloglossia—a condition more commonly known as tongue tie. Notable highlights from the report include:
- Expert-Led Support: Breastfeeding difficulties must be evaluated by International Board-Certified Lactation Consultants (IBCLCs) or trained professionals. Optimal lactation support often mitigates the need for surgery.
- No Intervention Without Symptoms: Presence of a restrictive lingual frenulum does not mean a surgical treatment is required. If the breastfeeding dyad are not experiencing feeding issues, they can continue to be monitored without surgical intervention. The frenotomy procedure is not without risks and should be performed only by a trained healthcare professional experienced in infant care when deemed necessary.
- Myth Busting: The term posterior ankyloglossia is anatomically incorrect, restrictions can occur in the anterior or mid-tongue.
- Team-Based Care: Close postnatal monitoring and cross-discipline communication among paediatricians, GPs, public health nurses, and lactation experts are essential. Poor feeding can be attributed to many diagnoses other than tongue tie.
- Informed Consent & Safety First: Procedures must be performed by qualified professionals with proper safeguards, including Vitamin K administration and history taking in case of familial bleeding disorders.
- Beyond Breastfeeding: The report also addresses wider misconceptions, stating there is no evidence that frenotomy prevents speech delays or articulation issues. Speech and hearing assessments are recommended if concerns arise. There is no evidence that lip and buccal ties are a true pathological entity, so procedures to divide them should be discouraged.
- Continued Research: Further research is required to collect accurate data in Ireland and to fund lactation support and publicly available clinics to ensure equity of access
Read the full report (PDF, 3.7MB)
Further support for parents is available on the HSE website