Ankyloglossia in Australia: Are we making the cut or missing the mark?

Abstract

Ankyloglossia can significantly disrupt infant feeding, yet its diagnosis and management in Australia remain inconsistent and poorly understood. Despite increasing international attention, Australian research is limited, with no prior comprehensive investigation examining how ankyloglossia is identified, managed, and experienced across metropolitan, rural, and remote settings. Existing studies are narrow in scope, contributing to clinical variability, professional uncertainty, and inequitable access to care.

This thesis provides the first integrated examination of ankyloglossia care in Australia, incorporating the perspectives of health professionals and parents, and examining the influence of geography, workforce variability, and the absence of national clinical guidelines. Using a mixed-methods design, it investigates prevalence and clinical practice.

Study One used a retrospective clinical file audit to examine prevalence and management pathways for infants in Central Australia, providing world-first evidence from a remote setting and highlighting diagnostic variability and service gaps. Study Two employed a national mixed-methods survey of health professionals, identifying professional differences, low diagnostic confidence, and limited use of formal assessment tools. Studies Three and Four explored parental experiences, revealing inconsistent information, delayed access to knowledgeable clinicians, contradictory advice, and emotional and practical burdens. Qualitative analysis highlighted challenges parents face when navigating conflicting recommendations and decisions about frenotomy.

The final chapter synthesises findings across studies and proposes recommendations to improve clinical consistency, workforce training, and guideline development. Together, this thesis offers the first holistic account of ankyloglossia care in Australia and provides a foundation for policy and practice improvements to support infants and families nationwide.