title: Case series of 148 tongue-tied newborn babies evaluated with the assessment tool for lingual frenulum function.
abstract: 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.
authors.affiliation: Department of Family Medicine and Community Health, University of Minnesota Medical School, 2615 E. Franklin Ave, Minneapolis, MN 55406, USA. madlo001@tc.umn.edu
authors.forename: Diane J
authors.initials: DJ
authors.lastname: Madlon-Kay
authors.forename: Lori A
authors.initials: LA
authors.lastname: Ricke
authors.forename: Nancy J
authors.initials: NJ
authors.lastname: Baker
authors.forename: Terese A
authors.initials: TA
authors.lastname: DeFor
mesh_terms: 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