Published online May 24, 2010
PEDIATRICS Vol. 125 No. 6 June 2010, pp. e1500-e1504  












 














 








 





 


 


 



































 














   
 





CASE REPORTS
Ankyloglossia, Exclusive Breastfeeding, and Failure to ThriveGregory P. Forlenza, MDa, Nicole M. Paradise Black, MDa, Elayne G. McNamara, OTR/Lb, Sandra E. Sullivan, MD, IBCLCa 

a Department of Pediatrics, University of Florida, Gainesville, Florida; and 
b Department of Occupational Therapy, Shands Hospital at University of Florida, Gainesville, Florida 
A 6-month-old term boy was hospitalized to evaluate the cause of his failure to thrive, mandated as part of an investigation by the Department of Children and Families after an allegation of medical neglect was made. On admission the patient was below birth weight, and a medical workup for failure to thrive was pursued; however, he was noted to have severe ankyloglossia and was an exclusively breastfed infant. The only interventions during his hospitalization were frenotomy and assistance to the mother to increase her milk supply. The infant immediately experienced weight gain and has continued to show slow, but steady, weight gain as an outpatient. We illustrate here many of the controversies concerning ankyloglossia. 



Key Words: lingual frenum • failure to thrive 

Abbreviations: FTT = failure to thrive • DCF = Department of Children and Families • FDRBI = frenotomy decision rule for breastfeeding infants 


I am saddened to see that this baby and family had to go through this for 6 months and I am glad that they printed this in Pediatrics.  I'm glad the blame was not placed on breastfeeding.  Sincerely, Rachel Wahl RN IBCLC    		 	   		  
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