Improving breastfeeding outcomes: the impact of tongue-tie.

A tongue-tie (ankyloglossia) is defined as a lingual frenulum that is short, tight and restricts normal tongue movement. The tongue-tied newborn baby then has a mechanical difficulty attaching to his mum's breast and maintaining attachment to feed effectively. In the hands of skilled carers, this mechanical problem can be resolved by releasing the frenulum (frenulotomy) and the baby's access to his/her mother's breast milk be preserved. Published research on this subject has undergone justifiable criticism. Robust methodology was lacking in earlier studies. An overview of the course of researchers' response to critique is discussed. The care pathway in place in mid-Norfolk for mother and baby dyads where the baby's tongue-tie compromises efficient breastfeeding is outlined.