Duc-Minh Lam-Do

University of Montreal Faculty of Dental Medicine, Canada

Abstract Title: Breastfeeding Outcomes with Tongue-Ties (and Other Restrictives Tethered Oral Tissues)

Biography:

Dr. Duc-Minh Lam-Do has completed his DMD in 2004 at University of Montreal, Canada. He is a Fellow with the Academy of General Dentistry, the American Laser Study Club, a Master of the American Academy of Dental Sleep Medicine, and is actively involved with the International Consortium of oral Ankylofrenula Professionals (ICAP). He is the director and co-founder of the Montreal Tongue-Tie Institute, the first comprehensive clinic in Quebec to treat patients of all ages with tongue-ties and other tethered oral tissues. He has lectured internationally, mentored dentists who want to get into this field, and is currently working on research publications.

Research Interest:

Breastfeeding success depends on effective infant oral function and maternal comfort, both of which may be compromised by restrictive tethered oral tissues (TOTs), including ankyloglossia (tongue-tie), lip-tie, and buccal ties. This abstract reviews current evidence on the association between TOTs and breastfeeding outcomes. Infants with tongue-tie may exhibit impaired latch, reduced tongue mobility, inefficient milk transfer, prolonged feeding times, and maternal nipple pain or trauma. These challenges can contribute to early breastfeeding cessation, inadequate weight gain, and decreased maternal confidence.
Diagnosis of TOTs remains variable due to inconsistent definitions and assessment tools, complicating clinical decision-making. While some infants with anatomical restrictions breastfeed effectively without intervention, others benefit from targeted management. Conservative approaches include lactation support, positioning techniques, and oral motor therapy. When functional impairment is significant, frenotomy or frenectomy may be considered.
Evidence suggests that frenotomy can reduce maternal nipple pain and improve latch. Outcomes are influenced by factors such as timing of intervention, provider expertise, and availability of comprehensive lactation support. Overdiagnosis and unnecessary procedures remain concerns, emphasizing the need for careful functional assessment rather than reliance on anatomy alone.
Overall, a multidisciplinary approach integrating lactation consultants, pediatricians, and, when appropriate, surgical providers is recommended to optimize breastfeeding outcomes. Further high-quality, standardized research is needed to clarify diagnostic criteria, identify which dyads benefit most from intervention, and evaluate long-term effects on feeding and development.