A tongue tie update? Barbara and Nancy discuss a 2026 research study on tongue ties by Raol et al. and a commentary response in this episode of All Things Breastfeeding. One of the goals of LactaLearning is to provide recent studies that have the potential to impact clinical lactation practices. The debate over whether tongue ties are being over- or under-treated has been ongoing for several years. After reviewing the latest research on tongue ties for the upcoming edition (this edition is still at least a year away from being released), the research conclusion seems to be that there are absolutely cases where a tongue tie release appeared to be critical for an infant to be able to nurse effectively and/or without pain for the parent. On the other hand, it appears that more babies are undergoing this procedure, even though this may not have been the core issue.

The Raol study looked at 476 infants and found “Conclusions: Although ankyloglossia may affect breastfeeding experiences, ankyloglossia alone does not appear to affect breastfeeding maintenance or infant weight gain. Improving breastfeeding outcomes should include multidisciplinary management to focus on all potential causes and not only ankyloglossia.” What was so different about this recent study?  “Their study is unique in that none of the infants had a frenotomy or other surgical treatment of their ankyloglossia, and exclusive breastfeeding was assessed at 2–4 weeks, 3 months, and 6 months after delivery. Surprisingly, there were no differences in rates of exclusive breastfeeding at any time point, including at 6 months (82.3% [no ankyloglossia] vs 73.5% [assessed with ankyloglossia]; P?=?.25), and no differences in infant growth velocity at any time point.” Dr. Ann Will and Dr. Lydia Furman reported.

What was also unique was that, instead of releasing the tongues, they provided great lactation support and were grounded in a community that valued breastfeeding. Could this be enough for many babies?

There are flaws to the study as well. One issue was the way the authors identified tongue ties. It is not clear how many of the babies had more serious ties.

Again, this is food for thought.

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Raol, N., Silamkoti, B., Syed, S. M., Hosek, K., Theetla, P., & Madireddy, A. (2026). Ankyloglossia, breastfeeding, and infant weight gain: a mixed-methods study. Pediatrics, 157(1), e2024070531.
Witt, A., & Furman, L. (2026). Untreated Ankyloglossia: A Broader Perspective. Pediatrics, 157(1), e2025073238.
Bristol Tongue Assessment Tool
Martinelli Tongue Tie Assessment Lingual Frenulum Protocol for Infants
Thomas, K., Kliff, S., & Silver-Greenberg, J. (2023). Inside the booming business of cutting babies’ tongues. New York Times, 18.
LeFort, Y., Evans, A., Livingstone, V., Douglas, P., Dahlquist, N., Donnelly, B., Leeper, K., Harley, E., Lappin, S., and Academy of Breastfeeding Medicine. (2021). Academy of breastfeeding medicine position statement on ankyloglossia in breastfeeding dyads. Breastfeeding Medicine, 16(4), 278-281. https://www.nytimes.com/2023/12/18/health/tongue-tie-release-breastfeeding.html

Responses to the above article:

The post All Things Breastfeeding Episode 108: Tongue Tie Update appeared first on The Breastfeeding Center of Ann Arbor.