{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T16:51:13Z","timestamp":1790268673576,"version":"4.1.0"},"reference-count":35,"publisher":"American Academy of Pediatrics (AAP)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,1,1]]},"abstract":"<jats:sec>\n                    <jats:title\/>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Ankyloglossia may cause breastfeeding difficulties, potentially leading to early cessation of exclusive breastfeeding (EBF). However, increases in rates of frenotomy have not resulted in increases in EBF rates, and, in some regions, ankyloglossia is not regarded as a major barrier to successful breastfeeding. We sought to elucidate the contribution of untreated ankyloglossia to early cessation of EBF.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>We conducted a sequential explanatory mixed-methods study at an urban tertiary care hospital for women and children in Hyderabad, India. We evaluated for ankyloglossia and breastfeeding difficulties in mother\u2013infant dyads recruited within 48\u00a0hours after birth. Primary outcomes of EBF and infant weight gain were compared between infants with (tongue-tie [TT]) or without (No-TT) ankyloglossia. Semistructured interviews were conducted to identify reasons contributing to early cessation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>A total of 476 dyads were recruited over 3 months. There was no significant difference in rates of EBF at 6\u00a0months (No-TT 81.4% vs TT 78.6%; P\u2009=\u2009.6) or infant weight gain velocity from 0 to 3\u00a0months (No-TT 26.3 g\/d vs TT 26 g\/d; P\u2009=\u2009.86) or from 3 to 6\u00a0months (19.3 g\/d vs 20.4 g\/d; P\u2009=\u2009.49). Maternal concern for inadequate supply was associated with lower EBF odds at 6\u00a0months (odds ratio 0.22; P\u2009=\u2009.003). Mothers with early cessation in either group rarely reported issues with infant breastfeeding skill or nipple pain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>Although ankyloglossia may affect breastfeeding experiences, ankyloglossia alone does not appear to affect breastfeeding maintenance or infant weight gain. Improving breastfeeding outcomes should include multidisciplinary management to focus on all potential causes and not only ankyloglossia.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1542\/peds.2024-070531","type":"journal-article","created":{"date-parts":[[2025,12,12]],"date-time":"2025-12-12T00:02:33Z","timestamp":1765497753000},"source":"Crossref","is-referenced-by-count":5,"title":["Ankyloglossia, Breastfeeding, and Infant Weight Gain: A Mixed-Methods Study"],"prefix":"10.1542","volume":"157","author":[{"given":"Nikhila","family":"Raol","sequence":"first","affiliation":[{"name":"1Texas Children\u2019s Hospital, Houston, Texas"},{"name":"2Bobby R. Alford Department of Otolaryngology-Head and Neck Surgery, Baylor College of Medicine, Houston, Texas"},{"name":"3Department of Pediatrics, Baylor College of Medicine, Houston, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bhavani","family":"Silamkoti","sequence":"additional","affiliation":[{"name":"4InOrder, Hyderabad, Telangana, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Summaiya Maryam","family":"Syed","sequence":"additional","affiliation":[{"name":"5Cloudnine Hospitals, Hyderabad, Telangana, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathleen","family":"Hosek","sequence":"additional","affiliation":[{"name":"1Texas Children\u2019s Hospital, Houston, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Priyadarshini","family":"Theetla","sequence":"additional","affiliation":[{"name":"6Department of Pediatrics, Osmania Medical College, Hyderabad, Telangana, India"},{"name":"7Niloufer Hospital for Women and Children, Hyderabad, Telangana, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alimelu","family":"Madireddy","sequence":"additional","affiliation":[{"name":"7Niloufer Hospital for Women and Children, Hyderabad, Telangana, India"},{"name":"8Department of Neonatology, Osmania Medical College, Hyderabad, Telangana, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2025,12,12]]},"reference":[{"issue":"2","key":"2025123118575216900_r1","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1038\/s41390-020-01239-y","article-title":"The prevalence of ankyloglossia in children aged &lt;1\u00a0year: a systematic review and meta-analysis","volume":"90","author":"Hill","year":"2021","journal-title":"Pediatr Res."},{"issue":"2","key":"2025123118575216900_r2","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1007\/s13312-017-1014-5","article-title":"Ankyloglossia in infancy: an Indian experience","volume":"54","author":"Kumar","year":"2017","journal-title":"Indian Pediatr."},{"issue":"7","key":"2025123118575216900_r3","doi-asserted-by":"crossref","first-page":"382","DOI":"10.1093\/pch\/pxx112","article-title":"Changes in the incidence and surgical treatment of ankyloglossia in Canada","volume":"22","author":"Lisonek","year":"2017","journal-title":"Paediatr Child Health."},{"issue":"4","key":"2025123118575216900_r4","first-page":"215","article-title":"Diagnostic et prise en charge de l\u2019ankyloglossie chez le jeune enfant [Diagnosis and management of ankyloglossia in young children]","volume":"116","author":"Veyssiere","year":"2015","journal-title":"Rev Stomatol Chir Maxillofac Chir Orale."},{"issue":"10","key":"2025123118575216900_r5","doi-asserted-by":"crossref","first-page":"1032","DOI":"10.1001\/jamaoto.2017.0948","article-title":"Diagnosis and treatment of ankyloglossia in newborns and infants: a review","volume":"143","author":"Walsh","year":"2017","journal-title":"JAMA Otolaryngol Head Neck Surg."},{"issue":"1","key":"2025123118575216900_r6","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3122\/jabfm.18.1.1","article-title":"Newborn tongue-tie: prevalence and effect on breast-feeding","volume":"18","author":"Ricke","year":"2005","journal-title":"J Am Board Fam Pract."},{"issue":"2","key":"2025123118575216900_r7","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1016\/j.anpedi.2013.10.030","article-title":"Prevalencia de anquiloglosia en reci\u00e9n nacidos en el Principado de Asturias [Prevalence of ankyloglossia in newborns in Asturias (Spain)]","volume":"81","author":"Gonz\u00e1lez Jim\u00e9nez","year":"2014","journal-title":"An Pediatr (Barc)."},{"issue":"6","key":"2025123118575216900_r8","first-page":"1027","article-title":"Prevalence, diagnosis, and treatment of ankyloglossia: methodologic review","volume":"53","author":"Segal","year":"2007","journal-title":"Can Fam Physician."},{"issue":"5\u20136","key":"2025123118575216900_r9","doi-asserted-by":"crossref","first-page":"246","DOI":"10.1111\/j.1440-1754.2005.00604.x","article-title":"Randomized, controlled trial of division of tongue-tie in infants with feeding problems","volume":"41","author":"Hogan","year":"2005","journal-title":"J Paediatr Child Health."},{"issue":"6","key":"2025123118575216900_r10","doi-asserted-by":"crossref","first-page":"539","DOI":"10.1067\/mhn.2002.129731","article-title":"The effect of ankyloglossia on speech in children","volume":"127","author":"Messner","year":"2002","journal-title":"Otolaryngol Head Neck Surg."},{"issue":"4","key":"2025123118575216900_r11","first-page":"319","article-title":"The prevalence of ankyloglossia in 302 newborns with breastfeeding problems and sucking difficulties in Barcelona: a descriptive study","volume":"18","author":"Ferr\u00e9s-Amat","year":"2017","journal-title":"Eur J Paediatr Dent."},{"issue":"5","key":"2025123118575216900_r12","doi-asserted-by":"crossref","first-page":"489","DOI":"10.1136\/archdischild-2014-306211","article-title":"Tongue-tie and frenotomy in infants with breastfeeding difficulties: achieving a balance","volume":"100","author":"Power","year":"2015","journal-title":"Arch Dis Child."},{"issue":"6","key":"2025123118575216900_r13","doi-asserted-by":"crossref","first-page":"e1458","DOI":"10.1542\/peds.2015-0658","article-title":"Treatment of ankyloglossia and breastfeeding outcomes: a systematic review","volume":"135","author":"Francis","year":"2015","journal-title":"Pediatrics."},{"issue":"3","key":"2025123118575216900_r14","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1111\/apa.16609","article-title":"Severity and prevalence of ankyloglossia-associated breastfeeding symptoms: A systematic review and meta-analysis","volume":"112","author":"Cordray","year":"2023","journal-title":"Acta Paediatr."},{"issue":"1","key":"2025123118575216900_r15","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1038\/s41390-023-02784-y","article-title":"Quantitative impact of frenotomy on breastfeeding: a systematic review and meta-analysis","volume":"95","author":"Cordray","year":"2024","journal-title":"Pediatr Res."},{"issue":"5","key":"2025123118575216900_r16","doi-asserted-by":"crossref","first-page":"976","DOI":"10.1177\/01945998211039784","article-title":"Objective Improvement After Frenotomy for Posterior Tongue-Tie: A Prospective Randomized Trial","volume":"166","author":"Ghaheri","year":"2022","journal-title":"Otolaryngol Head Neck Surg."},{"issue":"3","key":"2025123118575216900_r17","doi-asserted-by":"crossref","first-page":"102393","DOI":"10.1016\/j.amjoto.2020.102393","article-title":"Characteristics and considerations for children with ankyloglossia undergoing frenulectomy for dysphagia and aspiration","volume":"41","author":"Buck","year":"2020","journal-title":"Am J Otolaryngol."},{"issue":"1","key":"2025123118575216900_r18","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1007\/s00455-019-10040-x","article-title":"Posterior Tongue Tie, Base of Tongue Movement, and Pharyngeal Dysphagia: What is the Connection?","volume":"35","author":"Brooks","year":"2020","journal-title":"Dysphagia."},{"issue":"1","key":"2025123118575216900_r19","doi-asserted-by":"crossref","first-page":"e188","DOI":"10.1542\/peds.2007-2553","article-title":"Frenulotomy for breastfeeding infants with ankyloglossia: effect on milk removal and sucking mechanism as imaged by ultrasound","volume":"122","author":"Geddes","year":"2008","journal-title":"Pediatrics."},{"issue":"1","key":"2025123118575216900_r20","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1001\/archotol.126.1.36","article-title":"Ankyloglossia: incidence and associated feeding difficulties","volume":"126","author":"Messner","year":"2000","journal-title":"Arch Otolaryngol Head Neck Surg."},{"issue":"4","key":"2025123118575216900_r21","doi-asserted-by":"crossref","first-page":"F344","DOI":"10.1136\/archdischild-2014-307503","article-title":"The development of a tongue assessment tool to assist with tongue-tie identification","volume":"100","author":"Ingram","year":"2015","journal-title":"Arch Dis Child Fetal Neonatal Ed."},{"issue":"1","key":"2025123118575216900_r22","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1186\/s13006-019-0224-y","article-title":"The development and evaluation of a picture tongue assessment tool for tongue-tie in breastfed babies (TABBY)","volume":"14","author":"Ingram","year":"2019","journal-title":"Int Breastfeed J."},{"key":"2025123118575216900_r23","doi-asserted-by":"crossref","first-page":"114523","DOI":"10.1016\/j.socscimed.2021.114523","article-title":"Sample sizes for saturation in qualitative research: a systematic review of empirical tests","volume":"292","author":"Hennink","year":"2022","journal-title":"Soc Sci Med."},{"issue":"2","key":"2025123118575216900_r24","first-page":"73","article-title":"Eight ways to get a grip on intercoder reliability using qualitative-based measures","volume":"13","author":"Cofie","year":"2022","journal-title":"Can Med Educ J."},{"issue":"2","key":"2025123118575216900_r25","doi-asserted-by":"crossref","first-page":"e2024067605","DOI":"10.1542\/peds.2024-067605","article-title":"Identification and management of ankyloglossia and its effect on breastfeeding in infants: clinical report","volume":"154","author":"Thomas","year":"2024","journal-title":"Pediatrics."},{"issue":"10","key":"2025123118575216900_r26","doi-asserted-by":"crossref","first-page":"12247","DOI":"10.3390\/ijerph121012247","article-title":"Nipple pain in breastfeeding mothers: incidence, causes and treatments","volume":"12","author":"Kent","year":"2015","journal-title":"Int J Environ Res Public Health."},{"key":"2025123118575216900_r27","doi-asserted-by":"crossref","first-page":"110212","DOI":"10.1016\/j.ijporl.2020.110212","article-title":"Factors associated with frenotomy after a multidisciplinary assessment of infants with breastfeeding difficulties","volume":"138","author":"Diercks","year":"2020","journal-title":"Int J Pediatr Otorhinolaryngol."},{"issue":"9","key":"2025123118575216900_r28","doi-asserted-by":"crossref","first-page":"817","DOI":"10.1001\/jamaoto.2019.1696","article-title":"Association of feeding evaluation with frenotomy rates in infants with breastfeeding difficulties","volume":"145","author":"Caloway","year":"2019","journal-title":"JAMA Otolaryngol Head Neck Surg."},{"key":"2025123118575216900_r29","doi-asserted-by":"crossref","first-page":"156","DOI":"10.1016\/j.ijporl.2018.07.045","article-title":"A multifaceted programme to reduce the rate of tongue-tie release surgery in newborn infants: observational study","volume":"113","author":"Dixon","year":"2018","journal-title":"Int J Pediatr Otorhinolaryngol."},{"issue":"8","key":"2025123118575216900_r30","doi-asserted-by":"crossref","first-page":"687","DOI":"10.1089\/bfm.2022.0059","article-title":"The association between breastfeeding self-efficacy and mode of infant feeding","volume":"17","author":"Fan","year":"2022","journal-title":"Breastfeed Med."},{"issue":"5","key":"2025123118575216900_r31","doi-asserted-by":"crossref","first-page":"799","DOI":"10.1111\/apa.14229","article-title":"Prospective questionnaire study showed that higher self-efficacy predicted longer exclusive breastfeeding by the mothers of late preterm infants","volume":"107","author":"Gerhardsson","year":"2018","journal-title":"Acta Paediatr."},{"issue":"9","key":"2025123118575216900_r32","doi-asserted-by":"crossref","first-page":"e0238363","DOI":"10.1371\/journal.pone.0238363","article-title":"Multifactorial influence on duration of exclusive breastfeeding; a Danish cohort study","volume":"15","author":"Kronborg","year":"2020","journal-title":"PLoS One."},{"issue":"4","key":"2025123118575216900_r33","doi-asserted-by":"crossref","first-page":"633","DOI":"10.1177\/08903344241271411","article-title":"Stakeholder perspectives on research, policy and practice priorities to increase human milk feeding rates in the United Kingdom","volume":"40","author":"Burton","year":"2024","journal-title":"J Hum Lact."},{"issue":"1","key":"2025123118575216900_r34","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1186\/s13006-024-00671-8","article-title":"Factors affecting infant feeding choices with a focus on barriers to exclusive breastfeeding in Western Jamaica: a qualitative study","volume":"19","author":"Datnow-Martinez","year":"2024","journal-title":"Int Breastfeed J."},{"issue":"4","key":"2025123118575216900_r35","doi-asserted-by":"crossref","first-page":"1220","DOI":"10.1016\/j.tjnut.2023.02.010","article-title":"Moderate accuracy of survey responses about infant and young child feeding counseling reported by mothers with children less than 1\u00a0year of age in India","volume":"153","author":"Kim","year":"2023","journal-title":"J Nutr."}],"container-title":["Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/doi\/10.1542\/peds.2024-070531\/1899318\/pediatrics.2024070531.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/doi\/10.1542\/peds.2024-070531\/1899318\/pediatrics.2024070531.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T23:58:02Z","timestamp":1767225482000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.aap.org\/pediatrics\/article\/157\/1\/e2024070531\/205748\/Ankyloglossia-Breastfeeding-and-Infant-Weight-Gain"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,12]]},"references-count":35,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12,12]]},"published-print":{"date-parts":[[2026,1,1]]}},"URL":"https:\/\/doi.org\/10.1542\/peds.2024-070531","relation":{},"ISSN":["0031-4005","1098-4275"],"issn-type":[{"value":"0031-4005","type":"print"},{"value":"1098-4275","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,12]]},"article-number":"e2024070531"}}