The study will be conducted in Outpatient Department of Pediatrics  at D.Y. Patil Hospital, Nerul, Navi Mumbai   . A informed consent will be taken from parents before assessment.

Examination will be carried out in good lighting . Before beginning, hands will be washed thoroughly and clean gloves will be worn to maintain hygiene and minimize any risk of infection.

The infant should be positioned securely, either on the caregiver’s lap or in a supine position and will ensure that the infant is calm and at ease to facilitate a thorough and accurate evaluation. Using a gloved finger ; infant’s tongue will be gently lifted to visualize the frenulum located underneath. Structure and attachment of the frenulum will be observed and any potential abnormalities such as tightness, restrictions will be noted .Additionally ; assessment of  tongue’s range of motion by observing its movements when stimulated or gently manipulated.

The functional assessment includes observing the infant during feeding . Feeding difficulties, such as an inability to maintain a latch, frequent interruptions, or frustration during feeding, will  be noted.The sucking reflex will be assessed by placing a gloved finger in the infant’s mouth to determine the tongue’s ability to form a proper seal.

Assessment tool

The Coryllos Classification of Tongue-Tie was introduced by Dr. Evelyn Coryllos and colleagues in the 2004. This system categorizes ankyloglossia (tongue-tie) into four types based on the anatomical location and severity of the frenulum’s attachment to the tongue. It is commonly used to evaluate the impact of tongue-tie on feeding, speech, and oral functions

The Hazelbaker Assessment Tool for Lingual Frenulum Function (HATLFF) was developed by Dr. Alison Hazelbaker and published in 1993. It is designed to evaluate both the functional movement and anatomical characteristics of the lingual frenulum in infants. This tool is widely used to diagnose tongue-tie and assess its impact on breastfeeding. It uses a scoring system to classify tongues into one of three categories: functionally impaired, acceptable or perfect.

The LATCH score, developed by Jensen, Wallace, and Kelsay in 1994, is a breastfeeding assessment tool that evaluates five key components: Latch, Audible swallowing, Type of nipple, Comfort, and Hold/positioning. Each is scored from 0 to 2, with a maximum score of 10 indicating effective breastfeeding. It helps healthcare providers identify challenges like poor latch or discomfort and guide interventions to improve breastfeeding outcomes