Ankyloglossia and Breastfeeding Duration: A Multicenter Birth Cohort Study.

Background and Objective: The prevalence of ankyloglossia and its impact on breastfeeding practices may be overestimated, leading to surgical overtreatment in newborns. The study was conducted to estimate the prevalence of ankyloglossia in the first year of life and investigate the association with exclusive and total breastfeeding duration in different regions of Brazil. Materials and Methods: This multicenter prospective cohort study involved the recruitment of mother-infant pairs soon after childbirth in public hospitals in three state capitals in Brazil. Interviews were held with the mothers after birth, at 6 and 12 months to collect sociodemographic variables and data on exclusive and total breastfeeding duration. At 12 months of age, the children were submitted to a dental examination for classification of the lingual frenulum using the Bristol Tongue Assessment Tool. Data analysis involved Poisson regression with robust variance, with the calculation of unadjusted and adjusted relative risk (RR). Results: The final sample was composed of 293 children. The prevalence of defined and suspected ankyloglossia was 1% and 4.8%, respectively, totaling 5.8% (confidence interval [95% CI]: 3.1-8.5). No significant difference was found in the prevalence of exclusive and total breastfeeding at 1, 4, and 6 months between children with defined/suspected ankyloglossia and those without ankyloglossia. The multivariable analysis showed that the probability of the child achieving 6 months of breastfeeding did not differ between groups (RR = 0.98; 95% CI: 0.79-1.23; p = 0.907). Conclusion: The prevalence of defined ankyloglossia was very low and defined/suspected ankyloglossia was not associated with exclusive or total breastfeeding duration. Clinical Trial Registration: Registered with clinicaltrials.gov (n° NCT03841123).

New Validated Tool to Diagnose Breastfeeding Dysfunction.

BACKGROUND: Breastfeeding behaviors and experiences exist on a continuum. What differentiates normal from dysfunctional is defined by frequency and severity. No current validated tool addresses the subjective experience of dyads with a predictive score that can be followed over time. RESEARCH AIM: To create and validate a self-report tool to assess breastfeeding and evaluate its ability to predict risk of breastfeeding dysfunction. METHODS: This study used a cross-sectional design to determine the validity of a novel instrument to assess breastfeeding dysfunction. We gave the initial questionnaire to 2085 breastfeeding dyads. We assessed content validity by comparison with other tools. We used exploratory factor analysis with varimax rotation for concept identification and Cronbach's alpha for internal consistency. We employed logistic regression to assess the tool's ability to differentiate between normal breastfeeding and breastfeeding dysfunction. RESULTS: Factor analysis mapped 17 questions to four concepts to create a score (FLIP; flow, latch, injury [to the nipple], and post-feed behavior). Internal consistency and reliability of the scores in these concepts were acceptable (Cronbach's alpha ≥ 0.087 for all measures). A logistic regression model that controlled for infant age, with a breastfeeding dysfunction risk classification threshold of 60%, yielded a correct classification of 88.7%, with 93.1% sensitivity, 64.6% specificity, and a 6.5% false positive rate. CONCLUSIONS: The FLIP score was determined to be a valid and reliable instrument for quantifying the severity of breastfeeding dysfunction in children under 1 year old. Further studies will assess its usefulness in the management of breastfeeding dysfunction.

Quantitative impact of frenotomy on breastfeeding: a systematic review and meta-analysis.

BACKGROUND: Symptoms related to infant ankyloglossia/tongue-tie may deter mothers from breastfeeding, yet frenotomy is controversial. METHODS: Databases included PubMed, Embase, CINAHL, PsycINFO, Web of Science, and Google Scholar from 1961-2023. Controlled trials and cohort studies with validated measures of surgical efficacy for breastfeeding outcomes were eligible. Meta-analyses synthesized data with inverse-variance weighting to determine standardized mean differences (SMD) between pre-/postoperative scores. RESULTS: Twenty-one of 1568 screened studies were included. Breastfeeding self-efficacy improved significantly post-frenotomy: medium effect after 5-10 days (SMD 0.60 [95% CI: 0.48, 0.71; P < 0.001]), large effect after 1 month (SMD 0.91 [CI: 0.79, 1.04; P < 0.001]). Nipple pain decreased significantly post-frenotomy: large effect after 5-15 days (SMD -1.10 [CI: -1.49, -0.70; P < 0.001]) and 1 month (SMD -1.23 [CI: -1.79, -0.67; P = 0.002]). Frenotomy had a medium effect on infant gastroesophageal reflux severity at 1-week follow-up (SMD -0.63 [CI: -0.95, -0.31; P = 0.008]), with continued improvement at 1 month (SMD -0.41 [CI: -0.78, -0.05; P = 0.04]). From LATCH scores, breastfeeding quality improved after 5-7 days by a large SMD of 1.28 (CI: 0.56, 2.00; P = 0.01). CONCLUSIONS: Providers should offer frenotomy to improve outcomes in dyads with ankyloglossia-associated breastfeeding difficulties. PROTOCOL REGISTRATION: PROSPERO identifier CRD42022303838 . IMPACT: This systematic review and meta-analysis showed that breastfeeding self-efficacy, maternal pain, infant latch, and infant gastroesophageal reflux significantly improve after frenotomy in mother-infant dyads with breastfeeding difficulties and ankyloglossia. Providers should offer frenotomy to improve breastfeeding outcomes in symptomatic mother-infant dyads who face challenges associated with ankyloglossia.

The buccal frenum: Trends in diagnosis and indications for treatment of buccal-ties among 466 healthcare professionals.

BACKGROUND: The buccal frenum is connective tissue that adheres the mucosa of the cheek to the alveolar process. When restricted, this condition is commonly known as a buccal- or cheek-tie. Restrictive buccal frena are often treated during tongue- and lip-tie procedures, yet widely accepted classification, diagnostic and treatment guidelines are lacking. OBJECTIVE: Provide a scoping review on the evaluation and management of buccal-ties, including diagnosis, classification, symptoms and treatment, by surveying healthcare providers with experience evaluating and managing oral restrictions. METHODS: Literature review and IRB-approved survey to assess practice patterns among healthcare providers identified from online directories of tongue-tie release providers and associated allied health professionals. RESULTS: A multidisciplinary group of 466 providers responded. About 87% indicated that they assess buccal restrictions. Evaluation methods included finger sweep (89.1%), visual inspection (76.4%), tissue blanching (66.5%) and functional assessment (53.4%). Around 94% of providers reported that objective and subjective findings are both needed for diagnosis and that an estimated 5%-10% of infants may be affected. About 70% of providers release buccal-ties (if needed) simultaneously with tongue-ties, and 76.8% recommend post-operative stretches as necessary for optimal healing. Respondents indicated a need for further research, evidence-based assessments, a classification system and treatment protocols. CONCLUSION: Evaluating a buccal frenum to diagnose a symptomatic buccal-tie relies upon visual inspection, palpation and assessment of oral function. Survey data and clinical experience are summarized to review classification systems, diagnostic/evaluation criteria and treatment recommendations as a foundational cornerstone for future works to build upon.

Relationship between Ankyloglossia and Breastfeeding: A Bibliometric Review

ABSTRACT Objective: To assess global trends in the publication of studies investigating the association between ankyloglossia and breastfeeding. Material and Methods: An electronic search was performed in the Scopus database without restrictions. Observational studies and clinical trials were included. Bibliometric indices such as publication year, authors, co-authors, journals, field of knowledge, countries, and the most cited keywords were analyzed using the VOSviewer program. Results: The search retrieved 350 studies, and 68 were selected. The first article was published in 2000 in the United States. The United States presented the highest number of publications (n=21), followed by Brazil (n=9) and the United Kingdom (n=9). An increase in publications on this theme was observed in 2013; 2021 was the year with the highest number of publications (n=14). The most common word was "frenulum". The authors with the highest number of publications were Botze and Dollbert from Israel (n=3), Ghaheri, and Mace from the United States (n=3). Among the journals, "Breastfeeding Medicine" presented the highest number of publications (n=7), followed by the "International Journal of Pediatric Otorhinolaryngology" (n=6), "CODAS" (n=5), "Journal of Human Lactation" (n=4) and "Pediatrics" (n=3); the latter published the top-cited studies, with 412 citations. Conclusion: There has been an increase in recent articles evaluating the correlation between ankyloglossia and breastfeeding, indicating the growing interest of researchers in this field.

The development of a specialist tongue tie assessment clinic for neonates.

OBJECTIVES: Ankyloglossia or tongue tie is a condition where the lingual frenulum restricts tongue movement, negatively impacting breastfeeding. An increasing number of infants diagnosed with ankyloglossia may lead to unnecessary procedures. To limit the overtreatment of this problem, we established a specialist clinic to provide the best available evidence-based care to the mother-infant dyad. METHODS: We discuss the development of a specialist tongue tie assessment clinic in our unit. RESULTS: From January to October 2023, there were 162 visits to the clinic by 157 patients. During this time, there were 96 frenotomies performed. CONCLUSIONS: The mother-infant dyad is a vulnerable patient group. Establishing a specialist tongue tie assessment clinic with otolaryngology and lactation expertise provides the best available evidence-based care.

Ranula Formation After Lingual Frenectomy in a Newborn.

Ankyloglossia is a developmental anomaly characterized by a shortened lingual frenulum, which can range from cases with no clinical relevance to severe cases, where frenectomy may be indicated. In newborns, this indication has increased exponentially. The purpose of this report is to discuss obstruction of the sublingual caruncle, with a recurrent ranula, as a post-surgical complication of laser lingual frenectomy performed in a newborn. The treatment provided is also discussed (marsupialization and removal of the affected sublingual glands). Lingual frenectomy should be performed with great care, especially in newborns, because the sublingual caruncles can be affected and complications can occur.

The Impact of Ankyloglossia Beyond Breastfeeding: A Scoping Review of Potential Symptoms.

OBJECTIVE: The purpose of this study was to evaluate the spectrum of pediatric quality-of-life sequelae associated with ankyloglossia that may affect children who do not undergo tongue-tie release (frenotomy) during infancy. DATA SOURCES: This study contains data from PubMed, Embase, CINAHL, PsycINFO, Web of Science, and Google Scholar (1961-January 2023). REVIEW METHOD: The review followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews reporting guidelines. Experimental and observational studies were eligible if they reported baseline outcomes associated with ankyloglossia in children above a year of age. Two reviewers independently screened studies, extracted data, and assessed quality. Low-quality studies were excluded. CONCLUSIONS: Twenty-six of 1,568 screened studies (> 1,228 patients) were included. Six studies were high quality and 20 were medium quality. Studies identified various symptoms that may be partially attributable to ankyloglossia after infancy, including speech/articulation difficulties, eating difficulties, dysphagia, sleep-disordered breathing symptoms, dental malocclusion, and social embarrassment such as oral hygiene issues. Multiple comparative studies found associations between ankyloglossia and risk factors for obstructive sleep apnea; a randomized controlled trial found that frenotomy may attenuate apnea severity. Ankyloglossia may also promote dental crowding. IMPLICATIONS FOR PRACTICE: Ankyloglossia may be associated with myriad effects on children's quality of life that extend beyond breastfeeding, but current data regarding the impact are inconclusive. This review provides a map of symptoms that providers may want to evaluate as we continue to debate the decision to proceed with frenotomy or nonsurgical therapies in children with ankyloglossia. A continuing need exists for controlled efficacy research on frenotomy for symptoms in older children and on possible longitudinal benefits of early frenotomy for maxillofacial development. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.23900199.

Surgical and Speech Therapy Evaluation of Lingual Frenulum.

Interdisciplinary evaluation is essential to diagnose and define clinical conduct for children and adults presenting with an altered lingual frenulum; however, there are few reports on the subject in the literature. In this context, the following study exemplifies a proposed protocol for the surgical and SLT treatment of a lingual frenulum based on a review of the literature and the experience of speech and language therapists and maxillofacial surgeons from hospitals in Santiago de Chile. After its application, a history of breastfeeding with difficulties and a maintained preference for soft foods was reported. Upon anatomic examination, the lingual apex was heart-shaped, and the lingual frenulum was fixed in the upper third of the ventral side of the tongue, with a pointed shape, submerged up to the apex, and of adequate thickness. Meanwhile, upon functional examination, the tongue was descended at rest, performed tongue protrusion with restrictions (raising and clicking), did not achieve attachment or vibration, and presented distortion of the sounds / r/ and /rr/. With this information, an altered lingual frenulum was diagnosed, with the indication for surgery and postoperative speech and language therapy. The constructed instrument allowed for the standardization of the evaluation in different teams but should be validated in future research.

Ankyloglossia in Australia: Practices of health professionals.

OBJECTIVES: To investigate the opinions and practices of health professionals involved in ankyloglossia diagnosis and management in Australia. METHOD: Two hundred and thirty-seven health professionals across Australia responded to an online survey including their diagnostic and management practice of ankyloglossia. Descriptive statistics, content analysis and thematic analysis were used to analyse quantitative data and open-ended responses, respectively. RESULTS: Most (91.6%) respondents reported they are responsible for the assessment and diagnosis of ankyloglossia in their clinical practice. A majority (56.7%) reported using more than one assessment tool in clinical practice. Less than half (46.4%) reported providing treatment to manage ankyloglossia. Surgical management was used by 44.5%, and 56.4% used non-surgical management as their primary treatment of ankyloglossia. Of the total sample, 26.6% had completed no further training or professional development in the field. 46% of respondents stated they always educate parents about ankyloglossia diagnoses, whereas 29.5% reported they always educate parents about management of ankyloglossia. Of respondents, a high level of confidence was reported by 62.6% of health professionals in the assessment of infants with ankyloglossia. Of those who perform surgical management, 53.7% reported feeling extremely confident in their skills. Fifty-two percent of respondents reported they were dissatisfied with the current service delivery for infants with ankyloglossia. CONCLUSIONS: The diagnosis, management and education practices varied greatly amongst health professionals in Australia. Clinical guidelines for all relevant health professionals are needed to ensure standardised diagnosis and management processes. In future, this will help guide evidence-based diagnosis and intervention for infants with ankyloglossia.

The effect of frenectomy for tongue-tie, lip-tie, or cheek-tie on breastfeeding outcomes: A systematic review of articles over time and suggestions for management.

OBJECTIVE: Tongue-tie, or ankyloglossia, is a common condition characterized by an abnormally short or tight lingual frenulum and is known to cause breastfeeding difficulties, leading to damage to the nipple, early discontinuation of breastfeeding, and delayed infant growth. In addition to tongue-tie, abnormal frenulums such as the labial frenulum and buccal frenulum can cause lip-tie and cheek-tie, respectively. While both of these conditions have been reported to potentially cause similar issues related to breastfeeding as tongue-tie, limited research has been conducted to understand their effects and how we should treat these conditions. METHODS: In this systematic review, we conducted a comprehensive search of MEDLINE to analyze the trend in publications of all three of these conditions and their impact on breastfeeding for the past 36 years. Keywords included, "tongue-tie", "lip-tie", "cheek-tie", and "breastfeeding outcomes". RESULTS: We found that publications describing the effect of only tongue-ties on breastfeeding have increased exponentially over time while less focus has been on other oral ties. It was also discovered that the majority of studies describing only lip-tie or tongue-tie were editorials, commentary, perspectives, or consensus statements. Finally, we found that articles describing more than one abnormal frenulum were more likely to be cited and articles describing tongue-tie only were published in the highest impact factor journals. CONCLUSION: This study revealed a significant increase in publications discussing tongue-tie and a lack of research on lip-tie and cheek-tie in relation to breastfeeding. The findings highlight the need for more comprehensive research and attention to lip-tie and cheek-tie, as well as standardized diagnostic criteria. Ongoing debate surrounding management of these conditions stem from the lack of investigations on the impact of these abnormal frenulums and outcomes post-frenectomy. Future high-quality studies, specifically prospective cohort studies and randomized controlled trials, are necessary to provide more robust evidence and guide clinical practice.

Frenillo lingual corto: resultados de una intervención para mejorar la continuidad asistencial / Short lingual frenulum: results of an intervention to improve continuity of care

Introducción: la discrepancia entre los criterios de derivación de pacientes con diagnóstico de frenillo lingual corto/anquiloglosia (FLC/A) a la consulta de cirugía plástica infantil desde Atención Primaria (AP) y los criterios propuestos por parte de los profesionales de la unidad para la realización de frenotomía lingual motivó la creación de un tríptico informativo sobre la patología para intentar homogeneizar la actuación entre niveles asistenciales. El objetivo principal del trabajo consiste en analizar el impacto de la intervención en las derivaciones de estos pacientes a atención especializada (AE). Material y métodos: redacción y divulgación de la información entre los profesionales de AP adscritos al área de salud de nuestro hospital. Análisis retrospectivo de las derivaciones a AE y de la actuación llevada a cabo en consulta en los 2 años previos al envío de la información. Análisis prospectivo de las consultas atendidas en el año posterior a la difusión del tríptico. Comparación de ambos periodos. Resultados: se analizaron 874 consultas; de ellas, el 59,6% se realizó previa difusión del tríptico. Las derivaciones se ajustaron a los criterios propuestos por la UCPI (Unidad de Cirugía Plástica Infantil) en un 61,9% de los casos, observándose una reducción significativa en los pacientes mal derivados entre ambos periodos de tiempo (41,8% vs. 32,6%). Se comprobó una disminución estadísticamente significativa en el número de pacientes derivados sin un problema funcional claro asociado al FLC (34,4% vs. 23,3%). Conclusiones: la difusión de un tríptico informativo sobre FLC/A ha demostrado ajustar las derivaciones hechas desde AP a los criterios propuestos para frenotomía lingual en la UCPI de nuestro hospital (AU)

Introduction: we created an informative triptych about short lingual frenulum/ ankyloglossia (SLF/A) to avoid discrepancy in the referral criteria of patients to the pediatric plastic surgery consultation from primary care (PC). The main objective is to analyze the impact of this intervention on the referrals to specialized care (SC).Material and methods: the information was sent to the primary care professionals attached to the health area of our hospital. We performed a retrospective analysis of the referrals to SC in the 2 years prior sending the information. We compared these results with the prospective analysis of the consultations attended in the year after sending the triptych.Results: we analyzed 874 consultations. 59.6% of them were attended prior sending the information. 61.9% of the referrals adjusted to the proposed criteria for lingual frenotomy, observing a significant reduction in the wrongly referred patients between the compared periods of time (41.8% vs 32.6%). We also found a significant reduction in the number of patients with no functional problem associated to the SLF (34.4% vs 23.3%).Conclusions: our informative triptych about SLF/ ankyloglossia has adjusted referrals from PC to the proposed criteria for lingual frenotomy in our hospital. (AU)

[On the reasons for ankyloglossia relapse. Part 1. Frenotomy in newborns]. / O prichinakh povtornoi plastiki uzdechki yazyka. Chast' 1. Frenulotomiya v grudnom vozraste.

The article presents modern data on the structure of the lingual frenulum in newborns and factors associated with restricted tongue mobility besides the length of the mucosal part of the frenulum. The diversity of these factors dictates to limit the indications for frenectomy in newborns to cases with breastfeeding negative events evaluated and documented by a pediatrician. The assessment protocol should include weight gain but also child and mother position, duration, and comfort of the breastfeeding sessions, as well as breast condition in mother. The cases of long-term complications of frenotomy performed in newborns are described, as well as a case illustrating indications for frenotomy associated with chronic injury (Riga-Fede disease).

Ankyloglossia in Central Australia: Prevalence, identification and management in infants.

PURPOSE: To investigate the prevalence and management of ankyloglossia for infants in Central Australia. METHOD: Retrospective chart review consisting of a medical file audit of infants (n = 493) <2 years old diagnosed with ankyloglossia from January 2013 to December 2018 in the primary hospital in Central Australia. Patient characteristics, reason for diagnosis, reason for procedure and outcomes of procedures routinely recorded in the patient clinical files were recorded. RESULTS: The overall prevalence of ankyloglossia in this population was 10.2%. Frenotomy was performed in 97.9% of infants diagnosed with ankyloglossia. Infants with ankyloglossia were more likely to be male (58% vs 42%), diagnosed and managed with a frenotomy on the third day of life. Most ankyloglossia diagnoses were identified by a midwife (>92%). Most frenotomy procedures were completed by lactation consultants who were also midwives (99%) using blunt-ended scissors. More infants were classified with posterior ankyloglossia than anterior ankyloglossia (23% vs 15%). A frenotomy procedure resolved feeding issues in 54% of infants with ankyloglossia. CONCLUSIONS: The prevalence of ankyloglossia and rate of frenotomy procedures were high when compared to previous reports in the general population. Frenotomy for ankyloglossia in infants with breastfeeding difficulties was found to be effective in more than half of the reported sample, improving breastfeeding and decreasing maternal nipple pain. A standardised approach and validated screening or comprehensive assessment tool for the identification of ankyloglossia is indicated. Guidelines and training for relevant health professionals on non-surgical management of the functional limitations of ankyloglossia are also recommended.

Perfil de serviços públicos que realizam avaliação do frênulo lingual em neonatos no Rio Grande do Norte / Profile of health services that assessthelingual frenulum of newborns in public and maternity hospitals of Rio Grande do Norte state / Perfil de servicios que realizanevaluación del frenillo lingual en neonatos en hospitales públicos y maternidades del estado de Rio Grande do Norte

Introdução:A anquiloglossia é caracterizada pela alteração do frênulo lingual resultando na restrição dos movimentos da língua. A avaliação do frênulo lingual em neonatos é importante para diagnosticar precocemente essa alteração. Objetivo:Traçar perfil de serviços que realizam avaliação do frênulo lingual em neonatos nos hospitais e maternidades públicas do estado do Rio Grande do Norte. Metodologia:Trata-se de um estudo observacional, descritivo e transversal, com abordagem quantitativa. Foram incluídos na pesquisa as maternidades públicas e filantrópicas do estadoque realizam procedimentos obstétricos e assistência materno-infantil. As informações acerca da avaliação do frênulo lingual em neonatos e caracterização desses serviços foram coletadas por meio de um questionário eletrônico. Os dados foram armazenados em planilhas no Excel e analisados através do programa estatístico SPSS versão 23.0, em queforam conduzidas análises das variáveis investigadas.Resultados:Participaram do estudo 23 hospitais e maternidades públicas do estado, econstatou-se que apenas 7 (30,44%) ofertam a avaliação do frênulo lingual em neonatos no próprio estabelecimento, enquantoas demais encaminham para outros serviços. O exame foi implantado nas maternidades entre os anos de 2014 e 2018. A quantidade de profissionais que realizam esta avaliação variou entre 1 e 9 por instituição, e os profissionais envolvidos foram os fonoaudiólogos e cirurgiões-dentistas. A prevalência da anquiloglossia variou de 3,7% a 14,5%. A maioria das maternidades realizam a frenotomia e o profissional que executa é o médico ou cirurgião-dentista.Conclusões:Constatou-se uma baixa oferta da avaliação do frênulo lingual em neonatos no próprio estabelecimento de nascimento. Além disso, essa oferta ainda não acontece de forma universal, principalmente no interior do estado (AU).

Introduction:Ankyloglossia is characterized by alterations in the lingual frenulum resulting in restricted tongue movements. Assessing the lingual frenulum in newborns is important for early diagnosis of this disorder. Objective:Describe the profile of health servicesthat assess the lingual frenulum of newborns in public and maternity hospitals of Rio Grande do Norte state. Methodology:This is a cross-sectional descriptive study using a quantitative approach. Included in the research were public and philanthropic maternity hospitals in statethat perform obstetric procedures and provide maternal and child care. The information about lingual frenulum assessment in newborns and characterization of these health services was collected via an electronic questionnaire. The data were stored in Excel spreadsheets and analyzed using the SPSS version 23.0 program, where analyses of the variables investigated were carried out. Results:A total of 23 public and maternity hospitalsparticipated, only 7 of which (30.44%) assessed the lingual frenulum of newborns on site, while the others referred them to other medical facilities. The examination was implemented in maternity hospitals between 2014 and 2018. The number of professionals who performed this assessment varied between 1 and 9 per institution, and included speech therapists, and dentists. The prevalence of ankyloglossia ranged from 3.7 to 14.5%. Most of the maternity hospitals performed frenotomy, where the procedure was conducted by a doctor or dentist. Conclusions:On-site lingual frenulum assessment of newborns was low in the institutions, and does not occur universally, mainly in the rural areas of the state (AU).

Introducción: La anquiloglosia se caracteriza por la alteración del frenillo lingual que resulta en la restricción de los movimientos de la lengua. La evaluación del frenillo lingual en neonatos es importante para un diagnóstico precoz de este trastorno.Objetivo: Delinear un perfil de servicios que realizanevaluación del frenillo lingual en neonatos en hospitales públicos y maternidades del estado de Rio Grande do Norte.Metodología: Se trata de un estudio observacional y transversal con enfoque cuantitativo. Se incluyeron en la investigación las maternidades públicas y filantrópicas del estadoque realizan procedimientos obstétricos y de atención materno-infantil. La información sobre la evaluación del frenillo lingual en neonatos y la caracterización de estos servicios fui recogido por medio de un cuestionario electrónico. Los datos fueron almacenados en hojas Excel y analizados utilizando el programa estadístico SPSSversión 23.0, donde se realizaron análisis de las variables investigadas. Resultados: Un total de 23 hospitales públicos y maternidades participaron del estudio, en el que se constató que solo 7 (30,44%) evalúan el frenillo lingual en neonatos en establecimiento propio, mientras los demás refieren a otros servicios. El examen se implementó en las maternidades entre 2014 y 2018. El número de profesionales que realizan esta evaluación varió entre 1 y 9 por institución, y los profesionales involucrados fueron terapeutas del habla y odontólogos. La prevalencia de anquiloglosia varió entre 3,7 y 14,5 %. La mayoría de las maternidades realizan la frenotomía y el profesional que la realiza es el médico u odontólogo. Conclusiones: Hubo una baja oferta de avaluación del frenillo lingual en neonatos en el propio establecimiento. Además, esta oferta aún no es universal, especialmente en el interior del estado (AU).