Tags

Type your tag names separated by a space and hit enter

Randomised controlled trial of early frenotomy in breastfed infants with mild-moderate tongue-tie.
Arch Dis Child Fetal Neonatal Ed 2014; 99(3):F189-95AD

Abstract

TRIAL DESIGN

A randomised, parallel group, pragmatic trial.

SETTING

A large UK maternity hospital.

PARTICIPANTS

Term infants <2 weeks old with a mild or moderate degree of tongue-tie, and their mothers who were having difficulties breastfeeding.

OBJECTIVES

To determine if immediate frenotomy was better than standard breastfeeding support.

INTERVENTIONS

Participants were randomised to an early frenotomy intervention group or a 'standard care' comparison group.

OUTCOMES

Primary outcome was breastfeeding at 5 days, with secondary outcomes of breastfeeding self-efficacy and pain on feeding. Final assessment was at 8 weeks; 20 also had qualitative interviews. Researchers assessing outcomes, but not participants, were blinded to group assignment.

RESULTS

107 infants were randomised, 55 to the intervention group and 52 to the comparison group. Five-day outcome measures were available for 53 (96%) of the intervention group and 52 (100%) of the comparison group, and intention-to-treat analysis showed no difference in the primary outcome-Latch, Audible swallowing, nipple Type, Comfort, Hold score. Frenotomy did improve the tongue-tie and increased maternal breastfeeding self-efficacy. At 5 days, there was a 15.5% increase in bottle feeding in the comparison group compared with a 7.5% increase in the intervention group. After the 5-day clinic, 44 of the comparison group had requested a frenotomy; by 8 weeks only 6 (12%) were breastfeeding without a frenotomy. At 8 weeks, there were no differences between groups in the breastfeeding measures or in the infant weight. No adverse events were observed.

CONCLUSIONS

Early frenotomy did not result in an objective improvement in breastfeeding but was associated with improved self-efficacy. The majority in the comparison arm opted for the intervention after 5 days.

Authors+Show Affiliations

University of Bristol, , Bristol, UK.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Pragmatic Clinical Trial
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

24249695

Citation

Emond, Alan, et al. "Randomised Controlled Trial of Early Frenotomy in Breastfed Infants With Mild-moderate Tongue-tie." Archives of Disease in Childhood. Fetal and Neonatal Edition, vol. 99, no. 3, 2014, pp. F189-95.
Emond A, Ingram J, Johnson D, et al. Randomised controlled trial of early frenotomy in breastfed infants with mild-moderate tongue-tie. Arch Dis Child Fetal Neonatal Ed. 2014;99(3):F189-95.
Emond, A., Ingram, J., Johnson, D., Blair, P., Whitelaw, A., Copeland, M., & Sutcliffe, A. (2014). Randomised controlled trial of early frenotomy in breastfed infants with mild-moderate tongue-tie. Archives of Disease in Childhood. Fetal and Neonatal Edition, 99(3), pp. F189-95. doi:10.1136/archdischild-2013-305031.
Emond A, et al. Randomised Controlled Trial of Early Frenotomy in Breastfed Infants With Mild-moderate Tongue-tie. Arch Dis Child Fetal Neonatal Ed. 2014;99(3):F189-95. PubMed PMID: 24249695.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Randomised controlled trial of early frenotomy in breastfed infants with mild-moderate tongue-tie. AU - Emond,Alan, AU - Ingram,Jenny, AU - Johnson,Debbie, AU - Blair,Peter, AU - Whitelaw,Andrew, AU - Copeland,Marion, AU - Sutcliffe,Alastair, Y1 - 2013/11/18/ PY - 2013/11/20/entrez PY - 2013/11/20/pubmed PY - 2014/8/6/medline KW - Infant Feeding KW - Neonatology KW - Nutrition SP - F189 EP - 95 JF - Archives of disease in childhood. Fetal and neonatal edition JO - Arch. Dis. Child. Fetal Neonatal Ed. VL - 99 IS - 3 N2 - TRIAL DESIGN: A randomised, parallel group, pragmatic trial. SETTING: A large UK maternity hospital. PARTICIPANTS: Term infants <2 weeks old with a mild or moderate degree of tongue-tie, and their mothers who were having difficulties breastfeeding. OBJECTIVES: To determine if immediate frenotomy was better than standard breastfeeding support. INTERVENTIONS: Participants were randomised to an early frenotomy intervention group or a 'standard care' comparison group. OUTCOMES: Primary outcome was breastfeeding at 5 days, with secondary outcomes of breastfeeding self-efficacy and pain on feeding. Final assessment was at 8 weeks; 20 also had qualitative interviews. Researchers assessing outcomes, but not participants, were blinded to group assignment. RESULTS: 107 infants were randomised, 55 to the intervention group and 52 to the comparison group. Five-day outcome measures were available for 53 (96%) of the intervention group and 52 (100%) of the comparison group, and intention-to-treat analysis showed no difference in the primary outcome-Latch, Audible swallowing, nipple Type, Comfort, Hold score. Frenotomy did improve the tongue-tie and increased maternal breastfeeding self-efficacy. At 5 days, there was a 15.5% increase in bottle feeding in the comparison group compared with a 7.5% increase in the intervention group. After the 5-day clinic, 44 of the comparison group had requested a frenotomy; by 8 weeks only 6 (12%) were breastfeeding without a frenotomy. At 8 weeks, there were no differences between groups in the breastfeeding measures or in the infant weight. No adverse events were observed. CONCLUSIONS: Early frenotomy did not result in an objective improvement in breastfeeding but was associated with improved self-efficacy. The majority in the comparison arm opted for the intervention after 5 days. SN - 1468-2052 UR - https://www.unboundmedicine.com/medline/citation/24249695/Randomised_controlled_trial_of_early_frenotomy_in_breastfed_infants_with_mild_moderate_tongue_tie_ L2 - http://fn.bmj.com/cgi/pmidlookup?view=long&amp;pmid=24249695 DB - PRIME DP - Unbound Medicine ER -