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Frenulotomy for breastfeeding infants with ankyloglossia: effect on milk removal and sucking mechanism as imaged by ultrasound.
Pediatrics 2008; 122(1):e188-94Ped

Abstract

OBJECTIVE

There is evidence that infants with ankyloglossia can experience breastfeeding difficulties including poor attachment to the breast, suboptimal weight gain, and maternal nipple pain, which may lead to early weaning of the infant. No studies have investigated the cause of these breastfeeding difficulties. The objective of this study was to determine the effectiveness of frenulotomy in infants experiencing persistent breastfeeding difficulties despite professional assistance by measuring changes in milk transfer and tongue movement during breastfeeding before and after frenulotomy.

PATIENTS AND METHODS

Twenty-four mother-infant dyads (infant age: 33 +/- 28 days) that were experiencing persistent breastfeeding difficulties despite receiving professional advice were recruited. Submental ultrasound scans (Acuson XP10) of the oral cavity were performed both before and >or=7 days after frenulotomy. Milk transfer, pain, and LATCH (latch, audible swallowing, type of nipple, comfort, and hold) scores were recorded before and after frenulotomy. Infant milk intake was measured by using the test-weigh method.

RESULTS

For all of the infants, milk intake, milk-transfer rate, LATCH score, and maternal pain scores improved significantly postfrenulotomy. Two groups of infants were identified on ultrasound. One group compressed the tip of the nipple, and the other compressed the base of the nipple with the tongue. These features either resolved or lessened in all except 1 infant after frenulotomy.

CONCLUSIONS

Infants with ankyloglossia experiencing persistent breastfeeding difficulties showed less compression of the nipple by the tongue postfrenulotomy, which was associated with improved breastfeeding defined as better attachment, increased milk transfer, and less maternal pain. In the assessment of breastfeeding difficulties, ankyloglossia should be considered as a potential cause.

Authors+Show Affiliations

School of Biomedical, Biomolecular, and Chemical Sciences, University of Western Australia, Pert, West Australia, Australia. donna.geddes@uwa.edu.auNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

18573859

Citation

Geddes, Donna T., et al. "Frenulotomy for Breastfeeding Infants With Ankyloglossia: Effect On Milk Removal and Sucking Mechanism as Imaged By Ultrasound." Pediatrics, vol. 122, no. 1, 2008, pp. e188-94.
Geddes DT, Langton DB, Gollow I, et al. Frenulotomy for breastfeeding infants with ankyloglossia: effect on milk removal and sucking mechanism as imaged by ultrasound. Pediatrics. 2008;122(1):e188-94.
Geddes, D. T., Langton, D. B., Gollow, I., Jacobs, L. A., Hartmann, P. E., & Simmer, K. (2008). Frenulotomy for breastfeeding infants with ankyloglossia: effect on milk removal and sucking mechanism as imaged by ultrasound. Pediatrics, 122(1), pp. e188-94. doi:10.1542/peds.2007-2553.
Geddes DT, et al. Frenulotomy for Breastfeeding Infants With Ankyloglossia: Effect On Milk Removal and Sucking Mechanism as Imaged By Ultrasound. Pediatrics. 2008;122(1):e188-94. PubMed PMID: 18573859.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Frenulotomy for breastfeeding infants with ankyloglossia: effect on milk removal and sucking mechanism as imaged by ultrasound. AU - Geddes,Donna T, AU - Langton,Diana B, AU - Gollow,Ian, AU - Jacobs,Lorili A, AU - Hartmann,Peter E, AU - Simmer,Karen, Y1 - 2008/06/23/ PY - 2008/6/25/pubmed PY - 2008/8/1/medline PY - 2008/6/25/entrez SP - e188 EP - 94 JF - Pediatrics JO - Pediatrics VL - 122 IS - 1 N2 - OBJECTIVE: There is evidence that infants with ankyloglossia can experience breastfeeding difficulties including poor attachment to the breast, suboptimal weight gain, and maternal nipple pain, which may lead to early weaning of the infant. No studies have investigated the cause of these breastfeeding difficulties. The objective of this study was to determine the effectiveness of frenulotomy in infants experiencing persistent breastfeeding difficulties despite professional assistance by measuring changes in milk transfer and tongue movement during breastfeeding before and after frenulotomy. PATIENTS AND METHODS: Twenty-four mother-infant dyads (infant age: 33 +/- 28 days) that were experiencing persistent breastfeeding difficulties despite receiving professional advice were recruited. Submental ultrasound scans (Acuson XP10) of the oral cavity were performed both before and >or=7 days after frenulotomy. Milk transfer, pain, and LATCH (latch, audible swallowing, type of nipple, comfort, and hold) scores were recorded before and after frenulotomy. Infant milk intake was measured by using the test-weigh method. RESULTS: For all of the infants, milk intake, milk-transfer rate, LATCH score, and maternal pain scores improved significantly postfrenulotomy. Two groups of infants were identified on ultrasound. One group compressed the tip of the nipple, and the other compressed the base of the nipple with the tongue. These features either resolved or lessened in all except 1 infant after frenulotomy. CONCLUSIONS: Infants with ankyloglossia experiencing persistent breastfeeding difficulties showed less compression of the nipple by the tongue postfrenulotomy, which was associated with improved breastfeeding defined as better attachment, increased milk transfer, and less maternal pain. In the assessment of breastfeeding difficulties, ankyloglossia should be considered as a potential cause. SN - 1098-4275 UR - https://www.unboundmedicine.com/medline/citation/18573859/Frenulotomy_for_breastfeeding_infants_with_ankyloglossia:_effect_on_milk_removal_and_sucking_mechanism_as_imaged_by_ultrasound_ L2 - http://pediatrics.aappublications.org/cgi/pmidlookup?view=long&pmid=18573859 DB - PRIME DP - Unbound Medicine ER -