I don't think this has been systematically examined on any large scale, but in the articles currently used as references by most of us, they cite a prevalence of about five per cent if assessed visually, and the general impression is that half of these cases need intervention in order to feed normally.  Visual assessment will not pick up posterior or submucosal tongue ties in most cases.
As I understand it, the kind of reduced tongue mobility Judy mentions is not limited to cases in which the frenulum is tight or short, but also includes cases in which normal anatomy is compromised through events in birth.  Thus the incidence of true tongue-tie would hardly be affected by birth practices, but breastfeeding difficulties resulting from mechanical problems stemming from birth would.  Maybe it isn't of any consequence to distinguish between them if solutions are reached by the same pathway, but my bias is that diagnosis should be as specific as possible, if we want to deal with the root causes of problems.

Rachel Myr
Kristiansand, Norway

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