Case series of 148 tongue-tied newborn babies evaluated with the assessment tool for lingual frenulum function.
OBJECTIVE
the Assessment Tool for Lingual Frenulum Function (ATLFF) is the only available tool designed to assess newborn babies for the severity of tongue-tie. The aim of this study was to describe the ATLFF scores obtained on a series of 148 tongue-tied newborn babies.


METHODS
prospective case series.


METHODS
a 420-bed community hospital in St. Paul, Minnesota, USA.


METHODS
newborn babies admitted to the normal newborn nursery from October 1, 2000 to May 1 2002.


RESULTS
all babies in the nursery were examined for tongue-tie. One-hundred and forty-eight tongue-tied babies were examined using the ATLFF by at least one of three examiners. The ATLFF could not be completed on five babies. Of the remaining babies, 40 (28%) received 'perfect' scores, five (3.5%) received 'acceptable' scores, and 19 (13.3%) received 'function impaired' scores. The remaining 79 (55.2%) babies received scores that did not fall into any of the three categories of scores. The inter-rater agreement on whether or not the baby had a score of 'function impaired' on the ATLFF was moderate (kappa=0.44).


CONCLUSIONS
few tongue-tied babies had a score of 'function impaired' on the ATLFF. It is a major limitation of the ATLFF that it does not classify most babies. The development and testing of a useful tool to determine which tongue-tied babies will have difficulty with breast feeding remains a research priority.
Madlon-Kay
Diane J
DJ
Department of Family Medicine and Community Health, University of Minnesota Medical School, 2615 E. Franklin Ave, Minneapolis, MN 55406, USA. madlo001@tc.umn.edu
Ricke
Lori A
LA
Baker
Nancy J
NJ
DeFor
Terese A
TA
D001942:Breast Feeding; D000013:Congenital Abnormalities / Q000451:nursing / Q000473:pathology; D006801:Humans; D007231:Infant, Newborn; D008035:Lingual Frenum / Q000002:abnormalities*; D009730:Nursing Assessment; D015588:Observer Variation; D011446:Prospective Studies; D012720:Severity of Illness Index