Severity and prevalence of ankyloglossia‐associated breastfeeding symptoms: A systematic review and meta‐analysis

Abstract

Aim:To evaluate breastfeeding symptoms associated with ankyloglossia/tongue-tie.Methods: Databases 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-varianceweighted random-effects models. Results:Of 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. Conclusion:Ankyloglossia is adversely associated with breastfeeding success and maternal well-being.

Lingual Frenotomy in Pediatric Ankyloglossia: A Diode Laser Approach in Two Case Reports

“…A recent systematic review and meta-analysis have demonstrated that pediatric ankyloglossia is associated with suboptimal breastfeeding, infant gastroesophageal reflux, low maternal breastfeeding self-efficacy, and moderately intense nipple pain. This can deter mothers from practicing exclusive breastfeeding [ 3 ] for impeding a great breast milk transfer by the infant, thus being considered a risk factor for premature breastfeeding cessation [ 4 , 14 ]. In the presence of a restrictive lingual frenulum, frenotomy can increase maternal and infant comfort, improve breast milk transfer, and prevent cessation of breastfeeding.…”

“…Alterations in the lingual frenulum [ 1 ] can have an impact on breast or bottle feeding since birth and can persist during the child's developmental stages, hindering activities such as speech, chewing, swallowing, malocclusion, and gingival recession [ 2 ]. This anatomic and functional alteration, termed ankyloglossia (tongue-tie), is classified as a congenital condition that involves a short, tight, or thick lingual frenulum [ 3 ].…”

Ankyloglossia as an interdisciplinary problem

“…Studies have shown that less than 50% of infants with ankyloglossia have problems with breastfeeding [29]. It should be noted that in recent years there has been a high variability and overdiagnosis of ankyloglossia in many countries, and too frequent, hasty referrals for frenotomy [23,[30][31][32].…”

Posterior tongue tie: that is a thing?

“…Slagter speculates that improving the latch decreases the air swallowed and therefore decreases the amount of reflux produced. Nipple pain also decreased significantly and LATCH scores (a verified method of assessing breast feeding [12]) improving a week after the procedure was performed [13 ▪ ]. Tongue tie release showed a medium improvement or infant reflux severity [13 ▪ ].…”