Pilot Study of the Prevalence of Tongue-tie and Its Impact on Breastfeeding Among Infants at a Single Baby Friendly Hospital

Background: Tongue-tie (TT) is a congenital condition in which the lingual frenulum is short, thickened, and/or tight, often causing breastfeeding problems. Recent anecdotal reports suggest reported prevalence estimates of 4-10% are lower than current observations. A pilot study was performed to assess TT prevalence in newborns and breastfeeding implications.

Methods: Newborns were enrolled at the University of Utah Hospital with an initial assessment by International Board Certified Lactation Consultants using both the Hazelbaker Assessment Tool and the Dobrich Assessment Tool.  Breastfeeding was measured with a follow-up phone contact at one week.

Results: A total of 106 newborns were enrolled and examined, mostly on the 2^nd day of life. Based upon the Hazelbaker assessment scoring categories, 55.7% scored in a concerning range. The Dobrich tool requires observed breastfeeding and we were unable to assess many items (83.0% missing ≥ one item). Yet, results from the Dobrich tool were concerning in 56.6% of newborns. The response rate for the one week survey was 63.3%. Women whose babies had a concerning score by either tool were more likely to have given their baby something other than breastmilk (42.0% vs 26.3%, p>0.05) and to have sought lactation support (55.1% vs 33.3%, p>0.05) by the one week survey.

Conclusions: We observed apparent TT prevalence greater than what is reported in the literature. The assessment tools may not be reliable in newborns less than 3-5 days old. Future, larger studies should investigate the best means of early screening for TT to support interventions for breastfeeding dyads.