AbstractAimTo evaluate breastfeeding symptoms associated with ankyloglossia/tongue‐tie.MethodsDatabases included PubMed, Embase, CINAHL, PsycINFO, Web of Science, and Google Scholar. Eligible studies reported baseline breastfeeding symptoms/severity from tongue‐tied infants. Two reviewers independently screened studies, extracted data, and assessed quality. Low‐quality studies were excluded. Main outcomes were weighted mean severity scores for dyads with ankyloglossia relative to reference values for successful breastfeeding. Meta‐analyses used inverse‐variance‐weighted random‐effects models.ResultsOf 1328 screened studies, 39 were included (5730 infants with ankyloglossia). The mean LATCH score for patients with untreated ankyloglossia, 7.1 (95% CI: 6.7–7.4), was significantly below the good‐breastfeeding threshold. The mean Infant Breastfeeding Assessment Tool score, 10.0 (8.2–11.7), was not significantly below the good‐breastfeeding threshold. The mean Infant‐Gastroesophageal Reflux Questionnaire‐Revised score, 18.2 (10.5–26.0), was consistent with gastroesophageal reflux disease. The mean Breastfeeding Self‐Efficacy Scale‐Short Form score, 43.7 (39.3–48.1), indicated significant risk of cessation of exclusive breastfeeding within 1–3 months. Mean nipple pain was 4.9 (4.1–5.7) on a 0–10 scale, greater than typical scores for breastfeeding mothers without nipple damage. Total prevalence of breastfeeding difficulties was 49.3% (95% CI: 47.3–51.4%). Early, undesired weaning occurred in 20.3% (18.5–22.2%) of cases before intervention.ConclusionAnkyloglossia is adversely associated with breastfeeding success and maternal well‐being.