The many terms used to describe a lingual frenulum are due to the intermix of anatomical and functional descriptions. The interchangeable terms of ‘‘tongue-tie,’’ ‘‘ankyloglossia,’’ ‘‘sublingual frenulum,’’ and ‘‘short frenulum’’ are misleading to both lay people and professionals.
Based on current data (Haham A1, Marom R, Mangel L, Botzer E, Dollberg S. Prevalence of breastfeeding difficulties in newborns with a lingual frenulum: a prospective cohort series. Breastfeed Med. 2014;9:438-41.) we recommend the following terminology:
- Infants and mothers dyads who have breastfeeding difficulties not solved by a lactation consultation and judged as being due to the infant’s lingual frenulum should be clinically diagnosed as having ‘‘symptomatic tongue-tie’’ or ‘‘symptomatic ankyloglossia.’’
- Infants with no breastfeeding difficulties and those with breastfeeding difficulties that are corrected after a lactation consultation should be considered as having an asymptomatic ‘‘sublingual frenulum.’’
- The term ‘‘short frenulum’’ should be abandoned, given that clinical measurement of the length of the lingual frenulum is impossible and can be based solely on subjective assessment.
These definitions would differentiate between a normal anatomical finding and an abnormality in tongue function that affects breastfeeding. Given that 99.5% of infants have a sublingual frenulum and in the face of a paucity of clear indications for lingual frenotomy in the medical literature, we suggest that a lingual frenotomy should be reserved to infants with ‘‘symptomatic tongue-tie.’’