The effects of frenotomy on breastfeeding

Abstract

Although the interference of tongue-tie with breastfeeding is a controversial subject, The use of lingual frenotomy has been widely indicated by health professionals. Objective: To observe changes in breastfeeding patterns after lingual frenotomy concerning the number of sucks, pause length between groups of sucking and mother's complaints.Material and Methods : Oral yes/no questions about breastfeeding symptoms and sucking/swallowing/breathing coordination were answered by the mothers of 109, 30 day old infants. On the same day the infants had their lingual frenulum assessed by administering a lingual frenulum protocol. After the assessment, all tongue-tied infants were referred for frenotomy; nevertheless, only 14 underwent the surgery. Of the 109 infants, 14 infants who did not have frenulum alterations were included as controls. Birth order and gender were the criteria for recruiting the control group. The tongue-tied infants underwent lingual frenotomy at 45 days of age. At the conclusion of the frenotomy, the infants were breastfed. At 75 days old, both groups – control and post-frenotomy – were reassessed. Before the reassessment the same oral yes/no questions were answered by the mothers of the 14 infants who underwent frenotomy. The mothers of the control group answered the questionnaire only at the time of the first assessment. Data were subjected to statistical analysis.Results : After frenotomy, the number of sucks increased and the pause length between sucking decreased during breastfeeding. The controls maintained the same patterns observed in the first assessment. From the questionnaire answered by the mothers of the 14 tongue-tied infants, at 30 days and 75 days, we observed that the symptoms concerning breastfeeding and sucking/swallowing/breathing coordination were improved after lingual frenotomyConclusions : after lingual frenotomy, changes were observed in the breastfeeding patterns of the the tongue-tied infants while the control group maintained the same patterns. Moreover, all symptoms reported by the mothers of the tongue-tied infants had improved after frenotomy.

Management of Ankyloglossia and Breastfeeding Difficulties in the Newborn: Breastfeeding Sessions, Myofunctional Therapy, and Frenotomy

“…Martinelli et al in 2015 demonstrated that, after a lingual frenotomy, babies with a short lingual frenulum show changes that favour the appropriate standards of breastfeeding and all the symptoms reported by the mothers improved [2]. Furthermore, Power and Murphy in 2015 conclude that 50% of the breastfed babies with ankyloglossia will not encounter any problems [5].…”

“…The limitation in lingual mobility in newborns is another one of the reasons that can compromise sucking and latching on to the breast during the breastfeed [2, 4–7]. …”

Surface Electromyographic Analysis of the Suprahyoid Muscles in Infants Based on Lingual Frenulum Attachment during Breastfeeding

“…The nipple is compressed from the tip to the base when the tongue is high, and, when it lowers, the nipple expands by approaching the hard palate with the soft palate and increases in diameter, causing a vacuum and allowing the milk to flow into the intraoral space [8][9][10][11]. Alterations of the lingual frenulum may limit its mobility [8,[12][13][14][15]33,34], resulting in inadequate catching and potentially leading to changes in sucking function, especially in the dynamic of sucking/removal of milk. The main problems identified in cases of an altered lingual frenulum in relation to breastfeeding in the mother's womb are difficulties in catching, nipple pain and cracking, prolonged feeding times, reduced milk intake by the infant, the loss of weight [12,14,[34][35][36][37], dehydration, and growth deficiency [9,[32][33][34].…”

“…After apoptosis, the remaining residual embryonic tissue (lingual frenulum) may limit tongue movements to varying degrees. This congenital oral anomaly is referred to as ankyloglossia [9] and may cause reduced mouth opening, imprecision, and restriction of isolated tongue movements, a heart-shaped tip, downward protrusion [13], the tongue to rest on the floor of the mouth, and difficulties in sucking, chewing, swallowing, and speech functions, among others [12][13][14][15].…”

Elaboração e desenvolvimento de um website sobre o teste da linguinha

“…The conceptualization stage included the following definitions: the target audience, the aim, the analysis and the definition of the content based on a literature review on tongue-tie, infants' lingual frenulum assessment, and frenotomy 2,3; [13][14][15][16][17][18][19] . Subsequently, the website content was defined and organized.…”