The prevalence of ankyloglossia in children aged <1 year: a systematic review and meta-analysis

Pediatr Res. 2021 Aug;90(2):259-266. doi: 10.1038/s41390-020-01239-y. Epub 2020 Nov 13.

Abstract

Background: Despite the low level of evidence supporting the correction of tongue-tie for breastfeeding problems, recognition and treatment has increased substantially over the past 15 years. Prevalence reporting of tongue-tie is variable. The purpose of this study was to quantitatively synthesize the prevalence of tongue-tie in children aged <1 year and to examine the psychometric properties of the assessment tools used for diagnosing tongue-tie in these studies.

Methods: PRISMA and MOOSE guidelines were followed, with selection of studies and data extraction verified by two authors. Random-effects meta-analyses were performed to determine an overall prevalence rate, prevalence by infant sex, and prevalence by diagnostic method.

Results: There were 15 studies that met inclusion criteria. Overall prevalence of tongue-tie (N = 24,536) was 8% (95% CI 6-10%, p < 0.01). Prevalence was 7% in males and 4% in females. Prevalence was 10% when using a standardized assessment tool compared to 7% when using visual examination alone (p = 0.16). Available assessment tools for diagnosis of tongue-tie do not have adequate psychometric properties.

Conclusions: Tongue-tie is a common anomaly, which has the potential to impact infant feeding. Development of a psychometrically sound assessment of tongue-tie is needed.

Impact: The overall prevalence of tongue-tie in infants aged <1 year is 8%. Available diagnostic tools for tongue-tie do not have adequate psychometric testing. Prevalence data can assist health care providers in the recognition of tongue-tie as a potential barrier to infant feeding to promote maternal breastfeeding success.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Ankyloglossia / diagnosis
  • Ankyloglossia / epidemiology*
  • Breast Feeding
  • Checklist
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Physical Examination
  • Predictive Value of Tests
  • Prevalence
  • Psychometrics
  • Severity of Illness Index