Posterior ties: A New Paradigm in Diagnosis, Function and Surgical Management in Ankyloglossia

Background: Although most women internationally are choosing to breastfeed, they are not meeting their own or global breastfeeding goals. The reasons for early weaning are diverse, with problems such as nipple pain, difficulties with feeding, and weight concerns that may result in early breastfeeding cessation. Tongue-tie in the newborn has been cited as a potential cause of these problems. Although many studies have been conducted on this clinical condition, these have been found to have methodological flaws, including lack of comparison groups and short-term follow-up. Randomised controlled studies have reported widespread cross-over between TT groups.

Method: The BoTTh study is a prospective longitudinal cohort study currently being undertaken with all consenting mother-baby dyads born at CHWC who have had a TT identified during the newborn examination. These babies will include those requiring frenotomy for improvement in breastfeeding and those not requiring TT division.  These 2 groups of babies will be compared with babies without a TT identified during the newborn examination. Following a baseline survey in the baby’s first week, the Infant Eating Assessment Tool (InfantEAT), along with questions around breastfeeding exclusivity problems and outcomes, will be applied via online survey at 1 week, 1 month, 3 months and 6 months of age.

Results: The BoTTh study commenced on the 13/04/2026 and is currently in progress; therefore, results are pending and will be presented at Tongue Time. As of 16/06/2026, we have recruited approximately 158 mothers and babies, of whom 57 babies require TT division.

Conclusions: To be presented at Tongue Time 2027.