top of page


Signs & Symptoms:

1. Bartick MC, Schwarz EB, Green BD, et al. Suboptimal breastfeeding in the United States: Maternal and pediatric health outcomes and costsMatern Child Nutr. 2017;13(1):e12366. doi:10.1111/mcn.12366

2. Brahm P, Valdés V. Benefits of breastfeeding and risks associated with not breastfeeding. Rev Chil Pediatr. 2017;88(1):15-21.

3. Victora CG, Bahl R, Barros AJ, et al. Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect. Lancet. 2016;387(10017):475-490. doi:10.1016/S0140-6736(15)01024-7

4. Ballard JL, Auer CE, Khoury JC. Ankyloglossia: assessment, incidence, and effect of frenuloplasty on the breastfeeding dyad. Pediatrics. 2002;110(5):e63. doi:10.1542/peds.110.5.e63

5. Berry J, Griffiths M, Westcott C. A double-blind, randomized, controlled trial of tongue-tie division and its immediate effect on breastfeeding. Breastfeed Med. 2012;7(3):189-193. doi:10.1089/bfm.2011.0030

6. Benoiton L, Morgan M, Baguley K. Management of posterior ankyloglossia and upper lip ties in a tertiary otolaryngology outpatient clinic. Int J Pediatr Otorhinolaryngol. 2016;88:13-16. doi:10.1016/j.ijporl.2016.06.037

7. Patel PS, Wu DB, Schwartz Z, Rosenfeld RM. Upper lip frenotomy for neonatal breastfeeding problems. Int J Pediatr Otorhinolaryngol. 2019;124:190-192. doi:10.1016/j.ijporl.2019.06.008.

8. Wiessinger D, Miller M. Breastfeeding Difficulties as a Result of Tight Lingual and Labial Frena: A Case Report. J Hum Lact. 1995;11(4):313-316. doi:10.1177/089033449501100419.

9. Ito Y, Shimizu T, Nakamura T, Takatama C. Effectiveness of tongue-tie division for speech disorder in children. Pediatr Int. 2015;57(2):222-226. doi:10.1111/ped.12474

10. Messner AH, Lalakea ML. The effect of ankyloglossia on speech in children. Otolaryngol Head Neck Surg. 2002;127(6):539-545. doi:10.1067/mhn.2002.129731

11. Baxter R, Merkel-Walsh R, Baxter BS, Lashley A, Rendell NR. Functional Improvements of Speech, Feeding, and Sleep After Lingual Frenectomy Tongue-Tie Release: A Prospective Cohort Study. Clin Pediatr (Phila). 2020;59(9-10):885-892. doi:10.1177/0009922820928055

12. Govardhan C, Murdock J, Norouz-Knutsen L, Valcu-Pinkerton S, Zaghi S. Lingual and Maxillary Labial Frenuloplasty with Myofunctional Therapy as a Treatment for Mouth Breathing and Snoring. Case Rep Otolaryngol. 2019;2019:3408053. doi:10.1155/2019/3408053

13. Chen X, Xia B, Ge L. Effects of breast-feeding duration, bottle-feeding duration and non-nutritive sucking habits on the occlusal characteristics of primary dentition. BMC Pediatr. 2015;15:46. doi:10.1186/s12887-015-0364-1

14. Meenakshi S, Jagannathan N. Assessment of lingual frenulum lengths in skeletal malocclusion. J Clin Diagn Res. 2014;8(3):202-204. doi:10.7860/JCDR/2014/7079.4162

15. Vaz AC, Bai PM. Lingual frenulum and malocclusion: An overlooked tissue or a minor issue. Indian J Dent Res. 2015;26(5):488-492. doi:10.4103/0970-9290.172044





1. Bjørnæs KE, Elvbakken G, Dalhøi B, Garberg TH, Kaufmann J, Glomsrød E, Reiertsen O, Larsen S. Osteopathic manual therapy (OMT) in treatment of gastroesophageal reflux disease (GERD)Clin. Pract. 2019;16(3):1109-1115.

2. Belvaux A, Bouchoucha M, Benamouzig R. Osteopathic management of chronic constipation in women patients. Results of a pilot studyClin Res Hepatol Gastroenterol. 2017;41(5):602-611. doi:10.1016/j.clinre.2016.12.003

3. Barni A, Zecchillo D, Uberti S, Ratti S. Osteopathic Manipulative Treatment in a Paediatric Patient with Oesophageal Atresia and Tracheo-Oesophageal FistulaCase Rep Gastroenterol. 2019;13(1):178-184. doi:10.1159/000499445

4. Hayden C, Mullinger B. A preliminary assessment of the impact of cranial osteopathy for the relief of infantile colicComplement Ther Clin Pract. 2006;12(2):83-90. doi:10.1016/j.ctcp.2005.12.005

5. Philippi H, Faldum A, Schleupen A, et al. Infantile postural asymmetry and osteopathic treatment: a randomized therapeutic trialDev Med Child Neurol. 2006;48(1):5-4. doi:10.1017/S001216220600003X

6. Rechberger V, Biberschick M, Porthun J. Effectiveness of an osteopathic treatment on the autonomic nervous system: a systematic review of the literatureEur J Med Res. 2019;24(1):36. doi:10.1186/s40001-019-0394-5

7. Carnevali L, Lombardi L, Fornari M, Sgoifo A. Exploring the Effects of Osteopathic Manipulative Treatment on Autonomic Function Through the Lens of Heart Rate Variability. Front Neurosci. 2020;14:579365. doi:10.3389/fnins.2020.579365


Other references:

"Infants at the highest risk for rising weight patterns appear to benefit the most from longer breastfeeding duration."

Carling SJ, Demment MM, Kjolhede CL, Olson CM. Breastfeeding duration and weight gain trajectory in infancy. Pediatrics. 2015;135(1):111-119. doi:10.1542/peds.2014-1392

"The women in this study described a somewhat harrowing journey, which was at odds with the natural experience they had anticipated."

Edmunds JE, Fulbrook P, Miles S. Understanding the experiences of mothers who are breastfeeding an infant with tongue-tie: a phenomenological study. J Hum Lact. 2013;29(2):190-195. doi:10.1177/0890334413479174

"This review of research literature analyses the evidence regarding tongue-tie to determine if appropriate intervention can reduce its impact on breastfeeding cessation, concluding that, for most infants, frenotomy offers the best chance of improved and continued breastfeeding."

Edmunds J, Miles S, Fulbrook P. Tongue-tie and breastfeeding: a review of the literature. Breast Rev. 2011;19(1):19-26.

The following paper supports treatment using a multidisciplinary team - "evolution following the breastfeeding sessions, the myofunctional stimulation, and the lingual frenotomy was very favourable, thereby solving the suction problems that the newborn presented."

Ferrés-Amat E, Pastor-Vera T, Rodríguez-Alessi P, Ferrés-Amat E, Mareque-Bueno J, Ferrés-Padró E. Management of Ankyloglossia and Breastfeeding Difficulties in the Newborn: Breastfeeding Sessions, Myofunctional Therapy, and Frenotomy. Case Rep Pediatr. 2016;2016:3010594. doi:10.1155/2016/3010594

"This case study confirms that ankyloglossia may reduce maternal milk supply and that frenotomy can improve milk removal by the infant."

Garbin CP, Sakalidis VS, Chadwick LM, Whan E, Hartmann PE, Geddes DT. Evidence of improved milk intake after frenotomy: a case report. Pediatrics. 2013;132(5):e1413-e1417. doi:10.1542/peds.2012-2651.  

"Ultrasound imaging demonstrated that milk flow from the nipple into the infant's oral cavity coincided with both the lowering of the infants tongue and peak vacuum."

Geddes DT, Kent JC, Mitoulas LR, Hartmann PE. Tongue movement and intra-oral vacuum in breastfeeding infants. Early Hum Dev. 2008;84(7):471-477. doi:10.1016/j.earlhumdev.2007.12.008

bottom of page