Is tongue-tie release in the newborn an increasing problem? A retrospective study of tongue-tie cases at an Australian tertiary hospital.

Background: Release of tongue-tie in the newborn has been performed on a more regular basis at the Centenary Hospital for Women and Children (CHWC) in Canberra, Australia since 2006 and clear clinical pathways and guidelines have been established. Since that time, there has been an increase in the numbers referred for tongue-tie assessment. In 2018, the tongue-tie assessment and treatment forms were modified to capture more data during the breastfeeding and tongue-tie assessment. Aims: To review the mother/baby pairs who were assessed for tongue-tie release at the CHWC in 2014 and 2018. Methods: Tongue-tie assessment and treatment forms for babies referred for tongue-tie release from 1 January 2014 to 30 June 2014 and 1 January 2018 to 30 June 2018 were reviewed. Data collected included gestational age, birth weight, gender, day of release, tongue-tie type and additionally, data from 2018 included presenting breastfeeding problems, frenulum attachment to the inferior alveolar ridge (IAR) and immediate breastfeeding outcomes. Results: In 2014, 115 mother/baby pairs were assessed for tongue-tie release, and this increased by 25% to 143 mother/ baby pairs in 2018 over the same 6-month period. In 2014, 109/115(95%) tongue-tie releases were performed and in 2018 there was a non-significant 1% decrease, with 135/143(94%) releases. There was also a shift in the tongue-tie type presenting in 2018, with more 25% (Type 4) attachments (17/113[15%] vs 41/143[28.7%] p=0.01 respectively) and fewer 100% (Type 1) attachments (18/113[15.9%] vs 11/143[7.7%] p=0.039 respectively). Regarding the IAR, all the 75- 100% tongue-ties attached to the IAR, together with a significant proportion of the 25 to 50% tongue-ties. Conclusion: While there was an increase in referrals between 2014 and 2018, there was no evidence of a significant increase in number of tongue-tie releases between the two periods. This may reflect the importance of a thorough assessment of breastfeeding, breastfeeding problems and tongue function. [ABSTRACT FROM AUTHOR]