Lingual Frenotomy for Breastfeeding Difficulties: A Prospective Follow-Up Study

Dollberg, Shaul; Marom, Ronella; Botzer, Eyal

doi:10.1089/bfm.2014.0010

Cited by 28 publications

(50 citation statements)

References 5 publications

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“…37,43,[55][56][57][58] The panel agreed that informed consent for lingual frenotomy should include mention of the possibility of failure to experience improvement in breastfeeding ( Table 4). While much evidence in the literature supports the idea that lingual frenotomy can lead to improvement in breastfeeding, 43,44,46,50,51,54,[59][60][61][62][63][64][65][66][67][68][69][70][71][72] it is also important to recognize that not all infant-mother dyads experience breastfeeding improvement after the procedure. 5,45,51,62 The panel also reached consensus that patients and caregivers of patients with ankyloglossia should be counseled about nonsurgical options, including observation, lactation consultation, and/or speech-language pathology consultation ( Table 4).…”

Section: Frenotomy Indications and Informed Consentmentioning

confidence: 99%

Clinical Consensus Statement: Ankyloglossia in Children

Messner

Walsh

Rosenfeld

et al. 2020

Otolaryngol.--head neck surg.

107

157

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Objective To identify and seek consensus on issues and controversies related to ankyloglossia and upper lip tie in children by using established methodology for American Academy of Otolaryngology–Head and Neck Surgery clinical consensus statements. Methods An expert panel of pediatric otolaryngologists was assembled with nominated representatives of otolaryngology organizations. The target population was children aged 0 to 18 years, including breastfeeding infants. A modified Delphi method was used to distill expert opinion into clinical statements that met a standardized definition of consensus, per established methodology published by the American Academy of Otolaryngology–Head and Neck Surgery. Results After 3 iterative Delphi method surveys of 89 total statements, 41 met the predefined criteria for consensus, 17 were near consensus, and 28 did not reach consensus. The clinical statements were grouped into several categories for the purposes of presentation and discussion: ankyloglossia (general), buccal tie, ankyloglossia and sleep apnea, ankyloglossia and breastfeeding, frenotomy indications and informed consent, frenotomy procedure, ankyloglossia in older children, and maxillary labial frenulum. Conclusion This expert panel reached consensus on several statements that clarify the diagnosis, management, and treatment of ankyloglossia in children 0 to 18 years of age. Lack of consensus on other statements likely reflects knowledge gaps and lack of evidence regarding the diagnosis, management, and treatment of ankyloglossia. Expert panel consensus may provide helpful information for otolaryngologists treating patients with ankyloglossia.

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Section: Frenotomy Indications and Informed Consentmentioning

confidence: 99%

Clinical Consensus Statement: Ankyloglossia in Children

Messner

Walsh

Rosenfeld

et al. 2020

Otolaryngol.--head neck surg.

107

157

View full text Add to dashboard Cite

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“…Among studies reporting harms, bleeding was most frequently reported. 8,16,19,33,37 Bleeding was typically described as minor and limited, and would be expected with a minor surgical intervention. Few studies described what specific methods were used to collect harms data.…”

Section: Harmsmentioning

confidence: 99%

“…Forty-six studies reported that they looked for harms; either reporting actual harms or reporting that they found none. These included 5 RCTs, 7-11 1 cohort study, 12 25 case series, 13,15,16,[18][19][20][21][24][25][26][27][28][29][30]32,33,[35][36][37][38][39][40][41][42][43] and 15 case reports. [44][45][46][47][48][49][50][51][52][53][54][55][56][57][58] Most studies reporting harms information explicitly noted that no significant harms were observed (n = 17) 7,[9][10][11]13,15,18,20,24,…”

mentioning

confidence: 99%

Treatment of Ankyloglossia and Breastfeeding Outcomes: A Systematic Review

Krishnaswami²,

2015

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OBJECTIVE: Ankyloglossia is a congenital condition characterized by an abnormally short, thickened, or tight lingual frenulum that restricts tongue mobility. The objective of this study was to systematically review literature on surgical and nonsurgical treatments for infants with ankyloglossia.METHODS: Medline, PsycINFO, Cumulative Index of Nursing and Allied Health Literature, and Embase were searched up to August 2014. Two reviewers independently assessed studies against predetermined inclusion/exclusion criteria. Two reviewers independently extracted data regarding participant and intervention characteristics and outcomes and assigned quality and strength-of-evidence ratings.RESULTS: Twenty-nine studies reported breastfeeding effectiveness outcomes (5 randomized controlled trials [RCTs], 1 retrospective cohort, and 23 case series). Four RCTs reported improvements in breastfeeding efficacy by using either maternally reported or observer ratings, whereas 2 RCTs found no improvement with observer ratings. Although mothers consistently reported improved effectiveness after frenotomy, outcome measures were heterogeneous and short-term. Based on current literature, the strength of the evidence (confidence in the estimate of effect) for this issue is low. We included comparative studies published in English. The evidence base is limited, consisting of small studies, short-term outcomes, and little information to characterize participants adequately. No studies addressed nonsurgical interventions, longerterm breastfeeding or growth outcomes, or surgical intervention compared with other approaches to improve breastfeeding, such as lactation consultation.CONCLUSIONS: A small body of evidence suggests that frenotomy may be associated with motherreported improvements in breastfeeding, and potentially in nipple pain, but with small, shortterm studies with inconsistent methodology, strength of the evidence is low to insufficient. Dr Francis conceptualized and designed the study, and drafted the initial manuscript; Dr McPheeters conceptualized and designed the study, carried out the initial analyses, and reviewed and revised the manuscript; Dr Krishnaswami carried out the initial analyses, and reviewed and revised the manuscript; and all authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work. Despite these studies, consensus on the role of ankyloglossia in breastfeeding difficulties is lacking. A minority of surveyed pediatricians (10%) and otolaryngologists (30%) believe ankyloglossia commonly affects feeding, whereas 69% of lactation consultants feel that it frequently causes breastfeeding problems. 3 Therefore, depending on the audience, enthusiasm for its treatment varies. Currently, the National Health Service and the Canadian Pediatric Society recommend treatment if ankyloglossia interferes with breastfeeding. 4 However, a standard definition of "interference" with breastfeeding is not provided, leaving room for interpretation and variation in treatment thr...

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“…Argiris et al, Srinivasan et al and Hogan et al reported 89% breastfeeding at 6 week follow-up, 77.8% at 3 months and 60% at 4 months respectively [5,18,23]. Berry et al described rates of 65% at 3 months and 51% at 4.5 months [14] and Dollberg et al reported continued breastfeeding in 89% at 2 weeks, 68% at 3 months and 56% at 6 months [31]. When comparing these rates with the national rates it is important to consider that the studies are likely to select for motivated individuals however the sizeable difference between the rates strongly suggests a positive influence with frenotomy.…”

Section: Effect On Breastfeedingmentioning

confidence: 96%