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The effects of office-based frenotomy for anterior and posterior ankyloglossia on breastfeeding.
Int J Pediatr Otorhinolaryngol 2013; 77(5):827-32IJ

Abstract

OBJECTIVES

The objectives of this study were to assess the effect of office-based frenotomy on reversing breastfeeding difficulties among infants with problematic ankyloglossia, and to examine characteristics associated with anterior and posterior ankyloglossia.

METHODS

Mother's of infants who underwent a frenotomy for ankyloglossia from December 2006 through March 2011 completed a post-intervention web-based survey about breastfeeding difficulties they experienced before and after the frenotomy. Maternal-infant dyads had been referred from health providers to a primary care practice for assessment of ankyloglossia. Infants were subsequently classified as having no ankyloglossia, anterior (Type I or Type II) or posterior (Type III or Type IV).

RESULTS

There were 311 infants evaluated for ankyloglossia and 299 (95%) underwent a frenotomy. Most infants were classified as having Type III (36%) or IV (49%) ankyloglossia compared to only 16% with anterior (Type I and Type II combined). Differences by classification type were found for gender (P=.016), age (P=.017), and maxillary tie (P=.005). Among survey respondents (n=157), infant latching significantly improved (P<.001) from pre- to post-intervention for infants with posterior ankyloglossia. Both the presence and severity of nipple pain decreased from pre- to post-intervention among all classifications (P<.001). Additionally, 92% of respondents breastfed exclusively post-intervention. The mean breastfeeding duration of 14 months did not differ significantly by classification.

CONCLUSIONS

Breastfeeding difficulties associated with ankyloglossia in infants, particularly posterior, can be improved with a simple office-based procedure in most cases. The diagnosis and treatment of ankyloglossia should be a basic competency for all primary care providers and pediatric otorhinolaryngologists.

Authors+Show Affiliations

Family Practice Residency Program, Middlesex Hospital, Middletown, CT, United States. cliff.o'callahan@midhosp.orgNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

23523198

Citation

O'Callahan, Cliff, et al. "The Effects of Office-based Frenotomy for Anterior and Posterior Ankyloglossia On Breastfeeding." International Journal of Pediatric Otorhinolaryngology, vol. 77, no. 5, 2013, pp. 827-32.
O'Callahan C, Macary S, Clemente S. The effects of office-based frenotomy for anterior and posterior ankyloglossia on breastfeeding. Int J Pediatr Otorhinolaryngol. 2013;77(5):827-32.
O'Callahan, C., Macary, S., & Clemente, S. (2013). The effects of office-based frenotomy for anterior and posterior ankyloglossia on breastfeeding. International Journal of Pediatric Otorhinolaryngology, 77(5), pp. 827-32. doi:10.1016/j.ijporl.2013.02.022.
O'Callahan C, Macary S, Clemente S. The Effects of Office-based Frenotomy for Anterior and Posterior Ankyloglossia On Breastfeeding. Int J Pediatr Otorhinolaryngol. 2013;77(5):827-32. PubMed PMID: 23523198.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The effects of office-based frenotomy for anterior and posterior ankyloglossia on breastfeeding. AU - O'Callahan,Cliff, AU - Macary,Susan, AU - Clemente,Stephanie, Y1 - 2013/03/22/ PY - 2012/12/15/received PY - 2013/02/17/revised PY - 2013/02/24/accepted PY - 2013/3/26/entrez PY - 2013/3/26/pubmed PY - 2013/12/18/medline SP - 827 EP - 32 JF - International journal of pediatric otorhinolaryngology JO - Int. J. Pediatr. Otorhinolaryngol. VL - 77 IS - 5 N2 - OBJECTIVES: The objectives of this study were to assess the effect of office-based frenotomy on reversing breastfeeding difficulties among infants with problematic ankyloglossia, and to examine characteristics associated with anterior and posterior ankyloglossia. METHODS: Mother's of infants who underwent a frenotomy for ankyloglossia from December 2006 through March 2011 completed a post-intervention web-based survey about breastfeeding difficulties they experienced before and after the frenotomy. Maternal-infant dyads had been referred from health providers to a primary care practice for assessment of ankyloglossia. Infants were subsequently classified as having no ankyloglossia, anterior (Type I or Type II) or posterior (Type III or Type IV). RESULTS: There were 311 infants evaluated for ankyloglossia and 299 (95%) underwent a frenotomy. Most infants were classified as having Type III (36%) or IV (49%) ankyloglossia compared to only 16% with anterior (Type I and Type II combined). Differences by classification type were found for gender (P=.016), age (P=.017), and maxillary tie (P=.005). Among survey respondents (n=157), infant latching significantly improved (P<.001) from pre- to post-intervention for infants with posterior ankyloglossia. Both the presence and severity of nipple pain decreased from pre- to post-intervention among all classifications (P<.001). Additionally, 92% of respondents breastfed exclusively post-intervention. The mean breastfeeding duration of 14 months did not differ significantly by classification. CONCLUSIONS: Breastfeeding difficulties associated with ankyloglossia in infants, particularly posterior, can be improved with a simple office-based procedure in most cases. The diagnosis and treatment of ankyloglossia should be a basic competency for all primary care providers and pediatric otorhinolaryngologists. SN - 1872-8464 UR - https://www.unboundmedicine.com/medline/citation/23523198/The_effects_of_office_based_frenotomy_for_anterior_and_posterior_ankyloglossia_on_breastfeeding_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0165-5876(13)00082-7 DB - PRIME DP - Unbound Medicine ER -