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The prevalence of ankyloglossia in children aged <1 year: a systematic review and meta-analysis



Despite the low level of evidence supporting the correction of tongue-tie for breastfeeding problems, recognition and treatment has increased substantially over the past 15 years. Prevalence reporting of tongue-tie is variable. The purpose of this study was to quantitatively synthesize the prevalence of tongue-tie in children aged <1 year and to examine the psychometric properties of the assessment tools used for diagnosing tongue-tie in these studies.


PRISMA and MOOSE guidelines were followed, with selection of studies and data extraction verified by two authors. Random-effects meta-analyses were performed to determine an overall prevalence rate, prevalence by infant sex, and prevalence by diagnostic method.


There were 15 studies that met inclusion criteria. Overall prevalence of tongue-tie (N = 24,536) was 8% (95% CI 6–10%, p < 0.01). Prevalence was 7% in males and 4% in females. Prevalence was 10% when using a standardized assessment tool compared to 7% when using visual examination alone (p = 0.16). Available assessment tools for diagnosis of tongue-tie do not have adequate psychometric properties.


Tongue-tie is a common anomaly, which has the potential to impact infant feeding. Development of a psychometrically sound assessment of tongue-tie is needed.


  • The overall prevalence of tongue-tie in infants aged <1 year is 8%.

  • Available diagnostic tools for tongue-tie do not have adequate psychometric testing.

  • Prevalence data can assist health care providers in the recognition of tongue-tie as a potential barrier to infant feeding to promote maternal breastfeeding success.

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Fig. 1: PRISMA 2009 flow diagram.
Fig. 2: Overall prevalence of tongue-tie (N = 24,536).
Fig. 3: Prevalence of tongue-tie by diagnostic method (N = 24,536).
Fig. 4: A funnel plot of standard error by logit event rate.
Fig. 5: Prevalence estimates by year of publication.


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Author information




R.R.H. contributed to the conception and design; acquisition and interpretation of data; and drafting, revising, and approving the version of the manuscript to be published. C.S.L. conducted the statistical analyses, contributed to the interpretation of data, and revising and approving the version of the manuscript to be published. B.F.P. contributed to the design; acquisition and interpretation of data; and drafting, revising, and approving the version of the manuscript to be published.

Corresponding author

Correspondence to Rebecca R. Hill.

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Hill, R.R., Lee, C.S. & Pados, B.F. The prevalence of ankyloglossia in children aged <1 year: a systematic review and meta-analysis. Pediatr Res 90, 259–266 (2021).

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