Tongue tie

Ankyloglossia, also known as tongue tie, is a congenital anomaly characterised by an abnormally short lingual frenulum; the tip of the tongue cannot be protruded beyond the lower incisor teeth. There are few more controversial issues in infant feeding than tongue tie. Tongue tie and its impact on infant feeding are dogged by misinformation, misunderstanding, denial and conflicting ideas. This is compounded by poor education amongst healthcare professionals and some breastfeeding supporters. Tongue tie is caused by incomplete normal tissue degeneration during the embryological formation period of the tongue. A validated assessment tool should be used to assess tongue tie which looks at both function as well as appearance. The most well-known and frequently used tool is the Hazelbaker Assessment Tool for Lingual Frenulum Function (HATLFF) which was developed by American lactation consultant Dr Alison Hazelbaker in 1993. A simpler tool derived from the HATLFF is the Bristol Tongue Assessment Tool.