Fit to be Tied: Detecting Ankyloglossia Significance Statement Name, Title Cohort #2 2016 Significance Statement Key Findings Key Practice Recommended References 24x48 The tongue is an organ that affects nutrition and swallowing.¹ Newborns that do not breastfeed may have undiagnosed ankyloglossia.³ Ankyloglossia may cause interference and decreased oxygen due to the tongue resting in the airway.⁴ Ankyloglossia restricts the mobility of the tongue which can lead to breastfeeding difficulties and failure to thrive in the infant as well as maternal nipple and breast pain and a decreased milk supply.² Tongue ties may contribute to speech difficulties during the growth and development of children. 69 percent of International Board Certified Lactation Consultants feel that ankyloglossia causes breastfeeding problems. ² Though some children learn how to compensate for their decreased tongue mobility, many benefit from surgical intervention. ¹ Of bottle and breastfeeding infants that were frenotomized 96 percent had improved feedings.³ Neonates admitted to Blessed Beginnings Newborn Nursery will be assessed using the BTAT assessment tool to identify normal tongue anatomy compared to ankyloglossia to determine the need for further follow up and intervention. P- Neonates admitted to Blessed Beginnings Newborn Nursery. I- Using the BTAT assessment tool C- Identify normal tongue anatomy compared to ankyloglossia O- Determine the need for further follow up and intervention Newborn infants should be examined upon admission to newborn nursery (for ankyloglossia) using the BTAT Assessment Tool.⁴ Data collected during the admission examination will be verbally communicated to the newborn’s admitting physician, documented in the newborn assessment in BAR, and written in the newborn nursery log. The initial tongue-tie assessment should alert the infant’s mother and physician if feeding difficulties or pain arises within the first 24 to 48 hours, the infant’s attachment may need revision. ³ 1.Bhattad, M. S., Baliga, M., & Kriplani, R. (2013). Clinical guidelines and management of ankyloglossia with 1- year followup: Report of 3 cases. Case Reports in Dentistry, 2013(). http://dx.doi.org/10.1155/2013/185803 2.Francis, D. O., Chinnadurai, S., Morad, A., Epstein, R. A., Kohanim, S., Krishnaswami, S., ... McPheeters, M. L. (2015). Treatments for ankyloglossia and ankyloglossia with concomitant lip-tie. Retrieved from http://www.effectivehealthcare.ahrq.gov/search-for-guides-reviews-and-reports/?pageaction=displayproduct&productID=2074 3.Ingram, J., Johnson, D., Copeland, M., Churchill, C., Taylor, H., & Emond, A. (2015, April 15). The development of a tongue assessment tool to assist with tongue-tie identification. Archives of Disease in Childhood - Fetal and Neonatal Edition, F344-348. http://dx.doi.org/10.1136/archdischild-2014-307503 4.Kotlow, L. (2015, March). TOTS-Tethered oral tissues The assessment and diagnosis of the tongue and upper lip ties in breastfeeding. oralhealth, 64-70. Retrieved from http://www.oralhealthgroup.com/features/tots-tethered-oral-tissues-the-assessment-and-diagnosis-of-the-tongue-and-upper-lip-ties-in/ 5.Aby,j. (2015, 5 11). Mater Mothers Hospital Patient information brochures. Retrieved from Mater Mothers Hospital: http://brochures.mater.org.au/brochures/mater-mothers-hospital/tongue-tie Key Methodology Observational study using assessment tool. ³ Exploratory study evaluating infant latching and sucking ability. ⁴ Retrospective study explaining the clinical significance of ankyloglossia.¹ Systematic review describing benefits of treating ankyloglossia.²