Controversy Over Tongue-Tie: Divisions in the Community of Healthcare Professionals

Figures & data

Table 1. Health professions involved in diagnosis of ankyloglossia affecting breastfeeding and its treatment according to professional consensus statements

Profession	Suspect	Diagnose	Treat
ENT surgeons (UK)/Otolaryngologists (US)	Yes	Otolaryngologists have expertise in anatomy and function of the head and neck but only “a cursory knowledge of breastfeeding methods and problems” (Messner et al. 2020: 9)	Yes
Midwives	Midwives may do an initial assessment of a perceived tongue-tie using the TABBY assessment tool following short training (Ingram et al. 2019)	Midwifery Council of New Zealand acknowledges that it is within the midwife’s competency to assess for ankyloglossia (NZCOM 2017)
IBCLC who are not regulated healthcare professionals.	Can suspect ankyloglossia (IBCLC 2017)	No	No
Dentists	Yes	Yes	Can treat after an appropriately trained healthcare professional using appropriate diagnostic assessment has identified ankyloglossia where non-surgical interventions have been exhausted. Should only be performed in clinical settings with specialist training and ability to respond to emergencies and adverse effects (The Australian Dental Association 2020)
LactationProfessionals: IBCLC and regulated healthcare professional who have received adequate training.	Yes	Yes	It is within the scope of the midwife who has completed specific training to assess, diagnose and treat ankyloglossia (NZCOM 2017)

Figure 1. Major positions on frenotomy, per the grid-group typology.