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When TT presents as a significant barrier to breastfeeding, a frenotomy may be recommended. Universally accepted diagnostic criteria for TT are lacking and wide prevalence estimates are reported. New referral processes and a Frenotomy Assessment Tool were implemented in one Canadian health region to connect breastfeeding dyads with a provider for TT evaluation and frenotomy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To determine the proportion of babies with TT as well as the frequency of frenotomy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This cross\u2010sectional study included infants who initiated breastfeeding at birth and were referred for TT evaluation over a 14\u2010month period. Data were collected retrospectively by chart review and analyzed using SPSS. Factors associated with frenotomy were examined using logistic regression.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Two hundred and forty\u2010one babies were referred. Ninety\u2010two percent (<jats:italic>n<\/jats:italic> = 222) were diagnosed with TT and 66.0% (<jats:italic>n<\/jats:italic> = 159) underwent frenotomy. In the multivariate model, nipple pain\/trauma, inability to latch, inability to elevate tongue, and dimpling of tongue on extension were associated with frenotomy (<jats:italic>P<\/jats:italic> &lt; 0.05). Most referrals in our region resulted in a diagnosis of TT; however, the number of referrals was lower than expected, and of these two\u2010thirds underwent frenotomy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Interpretation<\/jats:title><jats:p>TT is a relatively common finding among breastfed infants. Future research should examine whether a simplified assessment tool containing the four items associated with frenotomy in our multivariate model can identify breastfed infants with TT who require frenotomy.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ped4.12416","type":"journal-article","created":{"date-parts":[[2024,2,29]],"date-time":"2024-02-29T06:54:06Z","timestamp":1709189646000},"page":"53-60","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["A cross\u2010sectional study of breastfed infants referred for tongue tie assessment and frenotomy in one Canadian health region"],"prefix":"10.1002","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5207-2186","authenticated-orcid":false,"given":"Tiffany A.","family":"Lee","sequence":"first","affiliation":[{"name":"School of Pharmacy Memorial University of Newfoundland (MUN)  St. John's Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jessica","family":"Bishop","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Memorial University of Newfoundland (MUN)  St. John's Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anne","family":"Drover","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Memorial University of Newfoundland (MUN)  St. John's Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1343-4249","authenticated-orcid":false,"given":"William K.","family":"Midodzi","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Memorial University of Newfoundland (MUN)  St. John's Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1447-9203","authenticated-orcid":false,"given":"Laurie K.","family":"Twells","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Memorial University of Newfoundland (MUN)  St. John's Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,2,28]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41390\u2010020\u201001239\u2010y"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/0890334418816973"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.26306"},{"key":"e_1_2_7_5_1","first-page":"1027","article-title":"Prevalence, diagnosis, and treatment of ankyloglossia: methodologic review","volume":"53","author":"Segal LM","year":"2007","journal-title":"Can Fam Physician."},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/mcn.13115"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/pch\/18.4.210"},{"key":"e_1_2_7_8_1","unstructured":"Health Canada.Breastfeeding your baby 2019. 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