Good assessment and selection are important because 50% of breastfeeding babies with ankyloglossia will not encounter any problems. We recommend 2 to 3 weeks as reasonable timing for intervention. Frenotomy appears to improve breastfeeding in infants with tongue-tie, but the placebo effect is difficult to quantify. Complications are rare, but it is important that it is carried out by a trained professional.

This article provides a summary of the main outcome measures currently available and in use within modern cleft care. The fact that there are such a diverse range, including surgical, orthodontic, dental, speech and patient satisfaction measures, is a reflection of the complex, multidisciplinary and longitudinal nature of the care provided. The use of such measures of outcome is essential in the auditing and drive for continued improvements in the standards of care for patients affected with cleft lip and palate.

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