Systematic review of the evidence for resolution of common breastfeeding problems—Ankyloglossia (Tongue Tie)

Abstract

Aim Tongue tie is a common problem affecting breastfeeding due to poor infant latch and/or maternal pain. Evidence of whether treatment improves breastfeeding outcomes is conflicting. We conducted a systematic review and meta‐analysis to examine the effectiveness of tongue‐tie treatment on breastfeeding difficulties. Methods We searched peer‐reviewed and grey literature in MEDLINE (OVID), PubMed, CINAHL Plus, EMBASE and PsycINFO, from 01/1970 to 09/2019. Inclusion: randomised and non‐randomised clinical trials, and quasi‐experimental study designs, involving breastfeeding interventions for full‐term singleton infants, using standardised measure of breastfeeding difficulty. Exclusion: qualitative and purely observational studies, lacked operational definition of breastfeeding difficulty, lacked control/comparison group. We assessed risk of bias, summarised study quality and results and conducted meta‐analysis using random effects modelling. Results Six studies on tongue‐tie division were included (4 randomised and 2 non‐randomised). Meta‐analysis of standardised mean differences in breastfeeding difficulty scores in four studies showed statistically significant differences in favour of frenotomy (Pooled SMD +2.12, CI:(0.17–4.08)p = 0.03). Similarly, a statistically significant difference in favour of frenotomy was observed for pain (Pooled SMD −1.68, 95% CI: (−2.87‐ −0.48). Conclusion Results support that infant frenotomy is effective for improving standardised scores on breastfeeding difficulty and maternal pain scales and could improve breastfeeding outcomes.

Effects of lingual frenotomy on breastfeeding and electrical activity of the masseter and suprahyoid muscles

“…The median in all categories (general observation of the mother, position of the baby, latch, and sucking) was a favorable behavior after the surgery. Similar results were also found in other studies ( 22 - 27 ) , which made it possible to obtain a prognosis favorable to maintaining breastfeeding in babies without lingual frenum changes.…”

Ankyloglossie (frein lingual anormalement court) chez le nourrisson

“…Le diagnostic est fonctionnel : les professionnels de la santé doivent évaluer l’amplitude des mouvements de la langue du nourrisson (élévation et protrusion) et l’efficacité de l’allaitement maternel. L’incidence de l’ankyloglossie est d’environ 4 % 1 .…”

Craniofacial Sleep Medicine: The Important Role of Dental Providers in Detecting and Treating Sleep Disordered Breathing in Children

“…Enlarged tongue muscles (and obstructive) may be seen resulting from tongue tie or from compensatory work demanded of it in response to the posturing of the jaw (aberrant tongue posture). This affects optimal function as demonstrated by the release of the tongue tie to improve breastfeeding in infants [ 23 , 24 , 25 , 26 , 27 , 28 ] and myofunctional therapy improving OSA in children and adults [ 29 , 30 ]. The tongue tie has been shown to be a root cause of maxillary deficiency and linked to obstructive sleep apnea in children based on the work of Dr. Christian Guilleminault [ 15 ].…”