Tethered Oral Tissue Release Among Breastfed Infants: Maternal Sources of Information and Treatment

Abstract

Background: Despite limited clinical consensus regarding surgery for tethered oral tissues (“tongue-tie”) for resolving breastfeeding-related issues, the procedure has been increasing in the United States. Greater understanding of maternal experiences with obtaining surgical release may help to improve breastfeeding outcomes. Research Aim: To explore experiences of breastfeeding mothers with infants having undergone “tongue-tie” surgery. Method: This online, cross-sectional, observational survey occurred between August and September 2020. Eligibility included being ≥ 18 years of age and previously or currently breastfeeding an infant with ≥ 1 tissue surgically released. Of 463 screens, 318 mothers were eligible and 115 consented. The final sample was 90. Results: The sample was predominantly white ( n = 86; 95%), non-Hispanic ( n = 84; 93%), married/cohabitating ( n = 85; 94%), and currently providing their own milk ( n = 81; 89%). Difficult latch was the primary reason for seeking help. Participants reported lingual ( n = 84; 93%), labial ( n = 79; 88%), and buccal ( n = 16; 17%) tissue-release, with 80% ( n = 73) reporting > 1 released. For each tissue released, > 80% ( n = 72) of participants felt “very confident” in their ability to correctly identify it and 97% ( n = 87) felt “very involved” and “strongly agreed” with surgical release. International Board Certified Lactation Consultants® were the most frequently identified source of information ( n = 45; 50%) and referrals ( n = 38; 42%), while pediatric dentists most frequently performed interventions ( n = 60; 67%). Conclusions: Participants reported being confident, involved, and in agreement with surgical release and lactation support professionals were frequent information and referral sources.

Ankyloglossia as a Barrier to Breastfeeding: A Literature Review

“…Since ankyloglossia affects many aspects of a child's life, many professionals from different specialties are involved in consultation and management in clinical practice. These professionals can be, among others, pediatricians, lactation consultants, otolaryngologists, pediatric surgeons, speech therapists, dentists, and orthodontists, and each one approaches tongue-tied infants, near-toddlers, and children from their own professional perspective [22]. This is probably the reason why there are more controversies on this matter and fewer agreements.…”