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Does frenotomy improve breast-feeding difficulties in infants with ankyloglossia?
Pediatr Int 2014; 56(4):497-505PI

Abstract

The aim of this systematic review was to critically examine the existing literature regarding the effectiveness of tongue-tie division in infants with ankyloglossia, using the new grades of recommendations, assessment, development, and evaluation (GRADE) rating system. A clinical question was structured according to patient, intervention, comparison, and outcome, as follows: in infants with poor breast-feeding and ankyloglossia (patient), does frenotomy (intervention), compared to lactation support alone (comparison), improve feeding (outcome)? An electronic literature search was systematically conducted from databases including PubMed, Japana Centra Revuo Medicina (Igaku Chuo Zasshi), CINAHL, and Cochrane Library using the key words "ankyloglossia," "tongue-tie," "frenotomy," and/or "breast-feeding" in English and equivalent terms in Japanese. The literature search yielded four randomized clinical trials, and 12 observational studies for analysis. The quality of the literature was rated in regard to the two most important outcomes (sucking/latching, and nipple pain) and five less important outcomes (milk supply/milk production, continuation of breast-feeding, weight gain, adverse events, and dyad distress) in accordance with the GRADE system. Evidence levels of the most important outcomes were rated either A (strong evidence) or B (moderate evidence), and less important outcomes were rated C (weak evidence); every outcome consistently showed a favorable effect of frenotomy on breast-feeding. The literature review supported an overall moderate quality of evidence for the effectiveness of frenotomy for the treatment of breast-feeding difficulties in infants with ankyloglossia. No major complications from frenotomy were reported.

Authors+Show Affiliations

Department of Pediatrics and Pediatric Surgery, International University of Health and Welfare, Atami Hospital, Atami, Japan.

Pub Type(s)

Comparative Study
Journal Article
Review
Systematic Review

Language

eng

PubMed ID

24978831

Citation

Ito, Yasuo. "Does Frenotomy Improve Breast-feeding Difficulties in Infants With Ankyloglossia?" Pediatrics International : Official Journal of the Japan Pediatric Society, vol. 56, no. 4, 2014, pp. 497-505.
Ito Y. Does frenotomy improve breast-feeding difficulties in infants with ankyloglossia? Pediatr Int. 2014;56(4):497-505.
Ito, Y. (2014). Does frenotomy improve breast-feeding difficulties in infants with ankyloglossia? Pediatrics International : Official Journal of the Japan Pediatric Society, 56(4), pp. 497-505. doi:10.1111/ped.12429.
Ito Y. Does Frenotomy Improve Breast-feeding Difficulties in Infants With Ankyloglossia. Pediatr Int. 2014;56(4):497-505. PubMed PMID: 24978831.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Does frenotomy improve breast-feeding difficulties in infants with ankyloglossia? A1 - Ito,Yasuo, PY - 2014/02/19/received PY - 2014/04/30/revised PY - 2014/06/02/accepted PY - 2014/7/1/entrez PY - 2014/7/1/pubmed PY - 2016/9/7/medline KW - GRADE KW - ankyloglossia KW - breast-feeding KW - frenotomy KW - systematic review SP - 497 EP - 505 JF - Pediatrics international : official journal of the Japan Pediatric Society JO - Pediatr Int VL - 56 IS - 4 N2 - The aim of this systematic review was to critically examine the existing literature regarding the effectiveness of tongue-tie division in infants with ankyloglossia, using the new grades of recommendations, assessment, development, and evaluation (GRADE) rating system. A clinical question was structured according to patient, intervention, comparison, and outcome, as follows: in infants with poor breast-feeding and ankyloglossia (patient), does frenotomy (intervention), compared to lactation support alone (comparison), improve feeding (outcome)? An electronic literature search was systematically conducted from databases including PubMed, Japana Centra Revuo Medicina (Igaku Chuo Zasshi), CINAHL, and Cochrane Library using the key words "ankyloglossia," "tongue-tie," "frenotomy," and/or "breast-feeding" in English and equivalent terms in Japanese. The literature search yielded four randomized clinical trials, and 12 observational studies for analysis. The quality of the literature was rated in regard to the two most important outcomes (sucking/latching, and nipple pain) and five less important outcomes (milk supply/milk production, continuation of breast-feeding, weight gain, adverse events, and dyad distress) in accordance with the GRADE system. Evidence levels of the most important outcomes were rated either A (strong evidence) or B (moderate evidence), and less important outcomes were rated C (weak evidence); every outcome consistently showed a favorable effect of frenotomy on breast-feeding. The literature review supported an overall moderate quality of evidence for the effectiveness of frenotomy for the treatment of breast-feeding difficulties in infants with ankyloglossia. No major complications from frenotomy were reported. SN - 1442-200X UR - https://www.unboundmedicine.com/medline/citation/24978831/Does_frenotomy_improve_breast_feeding_difficulties_in_infants_with_ankyloglossia L2 - https://doi.org/10.1111/ped.12429 DB - PRIME DP - Unbound Medicine ER -