title: Ankyloglossia and the Breastfeeding Infant: Assessment and Intervention.
abstract: BACKGROUND
  Our current culture defines breastfeeding and the use of human breast milk as the preferred criterion standard for infant nutrition. Medical and health professionals have a responsibility to support breastfeeding in the mother-infant dyad. This includes the recognition of anatomical barriers to breastfeeding such as a tongue-tie, ankyloglossia.
  
  
  OBJECTIVE
  The purpose of this article is to enrich and expand the clinical knowledge of health professionals about the physical assessment of ankyloglossia and its impact on breastfeeding. Techniques for assessing anterior and posterior ankyloglossia and interventions across the spectrum are discussed. We also explore maternal emotional experiences of breastfeeding an infant with ankyloglossia.
  
  
  METHODS
  A systematic literature search from MEDLINE, CINAHL, and Cochrane databases was performed. The search results consisted of qualitative and quantitative studies performed involving infants with anykloglossia and breastfeeding experiences. Data and findings from the search results were analyzed and reviewed.
  
  
  RESULTS
  Ankyloglossia, commonly referred to as tongue-tied, can result in weight loss, painful breastfeeding, and a cessation of breastfeeding prematurely. Depending on severity, interventions to alleviate breastfeeding difficulties can range from a lactation consultation to surgical intervention. The options for treatment and intervention must be discussed thoroughly with caregivers.
  
  
  CONCLUSIONS
  Thorough assessment of the breastfeeding dyad is essential to discovering ankyloglossia and its role in breastfeeding difficulties. Intervening appropriately can prevent negative outcomes associated with ankyloglossia and breastfeeding.
  
  
  CONCLUSIONS
  Future studies should be focused on developing universal tools for grading ankyloglossia and the effects of ankyloglossia on speech development. There is also a gap in the knowledge regarding ankyloglossia in the preterm infant and its impact on developing breast and bottle-feeding technique in the neonatal intensive care unit.
authors.affiliation: Neonatal Nurse Practitioner Program, University of Pennsylvania School of Nursing, Philadelphia.
authors.forename: Christine
authors.initials: C
authors.lastname: Manipon
mesh_terms: D000072676:Ankyloglossia / Q000451:nursing* / Q000601:surgery; D001942:Breast Feeding / Q000379:methods*; D006801:Humans; D007231:Infant, Newborn; D008035:Lingual Frenum / Q000601:surgery*; D019647:Oral Surgical Procedures; D012017:Referral and Consultation