Reliability of the Hazelbaker Assessment Tool for Lingual Frenulum Function

Abstract

Background: About 3% of infants are born with a tongue-tie which may lead to breastfeeding problems such as ineffective latch, painful attachment or poor weight gain. The Hazelbaker Assessment Tool for Lingual Frenulum Function (HATLFF) has been developed to give a quantitative assessment of the tongue-tie and recommendation about frenotomy (release of the frenulum). The aim of this study was to assess the inter-rater reliability of the HATLFF.

Management of Ankyloglossia and Breastfeeding Difficulties in the Newborn: Breastfeeding Sessions, Myofunctional Therapy, and Frenotomy

“…Validation studies have been carried out in recent years with reproducible items that are both anatomical and functional [6, 7]. …”

“…Amir et al in 2006 affirmed that the classification of Hazelbacker is highly reliable in the recommendation of a frenotomy in newborns [6]. Martinelli et al in 2015 demonstrated that, after a lingual frenotomy, babies with a short lingual frenulum show changes that favour the appropriate standards of breastfeeding and all the symptoms reported by the mothers improved [2].…”

“…Around 3% of infants are born with a short lingual frenulum which can lead to breastfeeding problems [6, 8, 9]. The most important problems are those related to poor weight gain, excessively long feeds, and nipple pain of the mother while breastfeeding [4, 6].…”

“…The most important problems are those related to poor weight gain, excessively long feeds, and nipple pain of the mother while breastfeeding [4, 6]. …”

Breastfeeding problems should be the only relevant criteria for deciding whether to carry out a frenotomy in infancy

“…A clinical classification was introduced in 1993 by Hazelbaker, who proposed the Hazelbaker Assessment Tool for Lingual Frenulum Function score. This score consists of morphological and functional aspects (4), but the relevance of this score has been a source of controversy (5,6).…”