Quality of Information on Lip Tie in YouTube Videos: A Content Analysis

Objective "Lip tie" is a term that has become commonly used to refer to a prominent or short maxillary frenulum and is controversially associated with difficulties in breastfeeding. There has been a rise in the popularity of lip tie division without clear expert agreement on the indications and benefits of treatment. Our study aims to determine the quality of information on YouTube about lip ties. Methods A YouTube search for "lip tie" was performed in February 2023, and the top 50 English language results were viewed and evaluated. Viewer interest parameters, such as the number of video views, likes, and page subscribers, were recorded at the time of viewing. Information about video content was also recorded. The included videos were analyzed by two independent reviewers for quality using modified DISCERN criteria and Journal of the American Medical Association (JAMA) scoring. Results There was a median of 12779 (IQR: 3129-31318) views, 86 (IQR: 17-262) likes, and 1950 (IQR: 462-38300) subscribers. Videos were available online for a mean of 3.72 years. Video authors consisted of 21 (42%) dentists, six (12%) United States (US)-based otolaryngologists, 12 (24%) YouTube influencers, four (8%) US-based MD/DO non-otolaryngologists, four (8%) lactation consultants, two (4%) laser companies, two (4%) myo-functional therapists, and one (2%) chiropractor. The total mean modified DISCERN score was 2.2 ± 1.0 out of 5, and the mean JAMA score was 1.8 ± 0.5 out of 4. Otolaryngologists had the highest modified DISCERN score, followed by dentists and non-otolaryngologist physicians. Non-otolaryngologist physicians had the highest mean JAMA score. Educational videos had a significantly higher mean modified DISCERN score than testimonials (p=0.007). Conclusions When parents refer to YouTube for information about lip ties, search results yield low-quality information overall. Most videos are from dentists and YouTube influencers in support of frenotomy, and this information may lead parents to seek unnecessary surgery for their children.