Glossary

Term · Feeding Your Baby

frenotomy

Also: tongue-tie release, tongue tie release, tongue-tie division, frenulotomy

A small procedure that cuts a tight band of tissue under the tongue to free its movement. Done for some babies with feeding trouble, not all.

In plain words

A frenotomy is a quick cut to the frenulum, the band of tissue under the tongue. It is brief, and many babies are settled again within minutes. Some clinics use numbing gel, and some do not. A provider may offer it when a seems to make feeding painful or ineffective. It is not automatic. Studies comparing the procedure with no procedure have mixed results. Some mothers report less nipple pain afterward. Others notice little change in feeding. Bleeding is usually small. Healing takes a few days, and some providers also teach stretching exercises for the tongue. The decision depends on how the baby feeds, not only on how the tie looks.

The deeper version

Frenotomy divides the lingual frenulum, usually with scissors or a laser, to increase tongue mobility in infants with ankyloglossia. Decisions rest on functional assessment during a feed rather than appearance alone. Tools include the (1993), the Coryllos classification of types I to IV by location, and the Bristol Tongue Assessment Tool (Ingram 2015). The 2017 Cochrane review by O'Shea and colleagues found low- to moderate-quality evidence that frenotomy reduces maternal nipple pain in the short term, with inconsistent effects on infant feeding. Professional guidance emphasizes functional assessment before division, and evidence that lip and buccal ties cause feeding problems is weak. Serious complications are uncommon. The main controversy is the steep rise in release rates and wide regional variation, which exceed plausible changes in incidence.

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Sources

  • O'Shea JE and colleagues — Frenotomy for tongue-tie in newborn infants. Cochrane Database of Systematic Reviews, 2017
  • American Academy of Pediatrics — Identification and management of ankyloglossia and its effect on breastfeeding in infants: clinical report (2024)

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