PURPOSE: Ankyloglossia (commonly referred to as tongue-tie), is increasingly being reported as a significant contributory factor to difficulties experienced in establishing the mother–infant breastfeeding relationship. Frenotomy as a management option is contributing to international interest and interdisciplinary controversy. The aim of this article was to identify and examine the evidence in relation to frenotomy to inform practice for newborns diagnosed with symptomatic ankyloglossia.DESIGN: An integrated literature review, informed by Whittemore and Knafl (2005) was used to identify and evaluate contemporary evidence.MAJOR FINDINGS: There is a marked difference in opinion between health disciplines regarding frenotomy as a treatment option for ankyloglossia. There is agreement that support from a trained professional such as a lactation consultant prior to undergoing any invasive procedures to treat ankyloglossia is essential. Controversy persists however as to whether the condition will resolve spontaneously without treatment.CONCLUSION: Although frenotomy does seem to resolve breastfeeding difficulties, little is known regarding long-term consequences for the baby and optimal timing for the procedure. This review indicates a need for education of professionals and standardization of assessment processes along with ongoing research to identify efficacy and optimal timing of frenotomy when used.