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

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.