Policy on Management of the Frenulum in Pediatric Patients
Policy statement
The AAPD supports additional research on the causative association between ankyloglossia and difficulties in breastfeeding or speech articulation, between a hyperplastic labial frenulum and increased risk of caries or periodontal disease, and upper lip restriction and difficulties with breastfeeding/latch. The AAPD recognizes that causes other than ankyloglossia are more common for breastfeeding difficulties and that, while frenulotomy for an infant with ankyloglossia can lead to an improvement in breastfeeding, not all infants with ankyloglossia require surgical intervention.3 Due to the broad differential diagnosis, a team-based approach including consultation with other specialists can aid in treatment planning. Further randomized controlled trials and other prospective studies of high methodological quality are necessary to determine the indications and long-term effects of frenulotomy/frenulectomy.