Minimizing Risk Associated With Vitamin K Deficiency Bleeding During Ankyloglossia Release of Infants

Crystal Robyn Abramczyk, Joyce Pye Funston, Jessica Hartson Morse, Robert A. Convissar


The practice of releasing restrictive oral frenula, more commonly known as tongue or lip ties has increased markedly in recent years. Providers who perform release of restrictive frenula include otolaryngologists, pediatricians, family practitioners, dentists, and nurse practitioners. It has been documented in the literature that training and protocols vary among providers regarding diagnosis, education, and auxiliary care. In this post-coronavirus disease 2019 (COVID-19) world, resistance to vaccinations of newborns may also lead to resistance to administration of vitamin K immediately after delivery. Vitamin K deficiency bleeding (VKDB) is a potentially fatal sequela of ankyloglossia release if vitamin K has not been administered to the infant. This paper focuses on and proposes a protocol to mitigate or eliminate the risk of VKDB during infant tongue tie release based on the standards of care established by the American Academy of Pediatrics and the College of Family Physicians of Canada and the principle of primum non nocere (first, do no harm), one of the principal precepts of the Hippocratic Oath.

Int J Clin Pediatr. 2024;13(1):1-7


Ankyloglossia; Tongue tie release; Vitamin K deficiency bleeding

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International Journal of Clinical Pediatrics, quarterly, ISSN 1927-1255 (print), 1927-1263 (online), published by Elmer Press Inc.                     
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