Oral frenula in newborns: When should you refer for evaluation and intervention?

Ankyloglossia is a common congenital anomaly, characterized by limited tongue mobility because of anatomical restriction by the lingual frenulum. The reduced tongue mobility has been associated with breastfeeding difficulty. Consensus on the functional effect of ankyloglossia is lacking and a small minority of pediatricians and otolaryngologists believe it affects feeding. A larger proportion of lactation specialists believe ankyloglossia contributes to feeding issues. Diagnostic assessment tools can guide the appropriateness of surgical correction in cases of ankyloglossia. Recent attention has been directed to the role of the maxillary frenulum in breastfeeding difficulty. We will review current literature on both topics with the aim to clarify when pediatric patients should be referred for appropriate surgical intervention.