Introduction: The literature refers to ankyloglossia as anterior, when the lingual frenulum is visible, and posterior, when the frenulum is not visible. Posterior ankyloglossia is sometimes referred to as a submucosal tongue-tie. The anatomical variations of the posterior ankyloglossia and its interference with tongue movements are poorly described in the literature. Aim: The aim of this study is to verify the occurrence of posterior lingual frenulum in infants and its interference with sucking and swallowing during breastfeeding. Methods: This clinical study included 1084 newborns, who were assessed at 30 days of life, using the Lingual Frenulum Protocol for Infants (LFPI). This study included healthy full-term infants, who were being exclusively breastfed. Prematurity, perinatal complications, craniofacial anomalies, neurological disorders, and visible genetics syndromes were the exclusion criteria. The LFPI was administered to the infants, and the assessments were registered and videotaped. Tongue movements, sucking rhythm, sucking/swallowing/ breathing coordination, nipple chewing, and/or tongue clicking were assessed during nutritive and non-nutritive sucking evaluations. Descriptive statistics were performed. Results: Of the 1084 newborns, 479 (44.2%) had normal lingual frenulum; 380 (35%) had posterior lingual frenulum; and 225 (20.8%) had lingual frenulum alterations. Infants with posterior lingual frenulum did not have any restrictive tongue movement during sucking and swallowing. Conclusion: The occurrence of posterior frenulum in this sample was 35%. The posterior frenulum did not interfere with sucking and swallowing during breastfeeding; therefore, surgery was not recommended for any of the subjects in this sample.


lingual frenum, frenotomy, breastfeeding, speech language and hearing sciences, clinical protocols