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Eligible studies reported baseline breastfeeding symptoms\/severity from tongue\u2010tied infants. Two reviewers independently screened studies, extracted data, and assessed quality. Low\u2010quality studies were excluded. Main outcomes were weighted mean severity scores for dyads with ankyloglossia relative to reference values for successful breastfeeding. Meta\u2010analyses used inverse\u2010variance\u2010weighted random\u2010effects models.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 1328 screened studies, 39 were included (5730 infants with ankyloglossia). The mean LATCH score for patients with untreated ankyloglossia, 7.1 (95% CI: 6.7\u20137.4), was significantly below the good\u2010breastfeeding threshold. The mean Infant Breastfeeding Assessment Tool score, 10.0 (8.2\u201311.7), was not significantly below the good\u2010breastfeeding threshold. The mean Infant\u2010Gastroesophageal Reflux Questionnaire\u2010Revised score, 18.2 (10.5\u201326.0), was consistent with gastroesophageal reflux disease. The mean Breastfeeding Self\u2010Efficacy Scale\u2010Short Form score, 43.7 (39.3\u201348.1), indicated significant risk of cessation of exclusive breastfeeding within 1\u20133\u2009months. Mean nipple pain was 4.9 (4.1\u20135.7) on a 0\u201310 scale, greater than typical scores for breastfeeding mothers without nipple damage. Total prevalence of breastfeeding difficulties was 49.3% (95% CI: 47.3\u201351.4%). Early, undesired weaning occurred in 20.3% (18.5\u201322.2%) of cases before intervention.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Ankyloglossia is adversely associated with breastfeeding success and maternal well\u2010being.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apa.16609","type":"journal-article","created":{"date-parts":[[2022,11,28]],"date-time":"2022-11-28T06:30:00Z","timestamp":1669617000000},"page":"347-357","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":32,"title":["Severity and prevalence of ankyloglossia\u2010associated breastfeeding symptoms: A systematic review and meta\u2010analysis"],"prefix":"10.1111","volume":"112","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2659-0964","authenticated-orcid":false,"given":"Holly","family":"Cordray","sequence":"first","affiliation":[{"name":"Children's Healthcare of Atlanta  Atlanta Georgia USA"},{"name":"Department of 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