See what happens when you go away for over a month and the journals pile up!

"An Infant's Glossal Anomaly: A Diagnosis on the Tip of the Tongue". Leung, Leung, Hon. Consultant for Pediatricians, Aug. 2015, pg 357,360
"Ankyloglossia is usually a harmless condition.  The frenulum usually lengthens as the chld gets older and with progressive stretching and thinning of the frenulum.  Treatment  usuallymis unnecessary apart from parental education and reassurance.

The absolute indication for surgical intervention (frenotomy and less commonly, frenuloplasty) is breastfeeding difficulties as a result of the ankyloglossia.  Frenuloplasty usually is reserved for ankyloglossia that is not relieved by frenotomy or patients with a very thick frenulum.  The optimal timing of surgical intervention is controversial.  Some authors suggest that ankyloglossia shuld be treated as early as possible to minimize breastfeeding problems.  Other authors recommend 2 to 3 weeks as reasonable timing for intervention, since 50% of breastfeeding infants with ankyloglossia will not encounter any problems and there fore do not require surgical intervention.  "  Goes on to explain procedure and  talks about articulation problems. Ends with a paragraph about how systematic review of 20 studies didn't show improvement in articulation [maybe if it had been done younger there wouldn't even be articulation problems!} 23 ref given.

Oh well I'll have to think about answering this one! Pat in SNJ

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