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Breastfeeding improvement following tongue-tie and lip-tie release: A prospective cohort study.
Laryngoscope 2017; 127(5):1217-1223L

Abstract

OBJECTIVES/HYPOTHESIS

Numerous symptoms may arise that prevent mother-infant dyads from maintaining desired breastfeeding intervals. Investigations into treatments that positively influence breastfeeding outcomes allow for improved patient counseling for treatment decisions to optimize breastfeeding quality. This investigation aimed to determine the impact of surgical tongue-tie/lip-tie release on breastfeeding impairment.

STUDY DESIGN

Prospective, cohort study from June 2014 to April 2015 in a private practice setting.

METHODS

Study participants consisted of breastfeeding mother-infant (0-12 weeks of age) dyads with untreated ankyloglossia and/or tethered maxillary labial frenula who completed preoperative, 1 week, and 1 month postoperative surveys consisting of the Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF), visual analog scale (VAS) for nipple pain severity, and the revised Infant Gastroesophageal Reflux Questionnaire (I-GERQ-R). Breastmilk intake was measured preoperatively and 1 week postoperatively.

RESULTS

A total of 237 dyads were enrolled after self-electing laser lingual frenotomy and/or maxillary labial frenectomy. Isolated posterior tongue-tie was identified in 78% of infants. Significant postoperative improvements were reported between mean preoperative scores compared to 1 week and 1 month scores of the BSES-SF (F(2) = 212.3; P < .001), the I-GERQ-R (F(2) = 85.3; P < .001), and VAS pain scale (F(2) = 259.8; P < .001). Average breastmilk intake improved 155% from 3.0 (2.9) to 4.9 (4.5) mL/min (P < .001).

CONCLUSIONS

Surgical release of tongue-tie/lip-tie results in significant improvement in breastfeeding outcomes. Improvements occur early (1 week postoperatively) and continue to improve through 1 month postoperatively. Improvements were demonstrated in both infants with classic anterior tongue-tie and less obvious posterior tongue-tie. This study identifies a previously under-recognized patient population that may benefit from surgical intervention if abnormal breastfeeding symptoms exist.

LEVEL OF EVIDENCE

2c Laryngoscope, 127:1217-1223, 2017.

Authors+Show Affiliations

Division of Otolaryngology-Head and Neck Surgery, The Oregon Clinic, Portland, Oregon, U.S.A.Luna Lactation, Portland, Oregon, U.S.A.School of Medicine, Oregon Health and Science University, Portland, Oregon, U.S.A.School of Medicine, Oregon Health and Science University, Portland, Oregon, U.S.A.Department of Otolaryngology-Head and Neck Surgery, Division of Rhinology and Skull Base Surgery, Oregon Health and Science University, Portland, Oregon, U.S.A.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27641715

Citation

Ghaheri, Bobak A., et al. "Breastfeeding Improvement Following Tongue-tie and Lip-tie Release: a Prospective Cohort Study." The Laryngoscope, vol. 127, no. 5, 2017, pp. 1217-1223.
Ghaheri BA, Cole M, Fausel SC, et al. Breastfeeding improvement following tongue-tie and lip-tie release: A prospective cohort study. Laryngoscope. 2017;127(5):1217-1223.
Ghaheri, B. A., Cole, M., Fausel, S. C., Chuop, M., & Mace, J. C. (2017). Breastfeeding improvement following tongue-tie and lip-tie release: A prospective cohort study. The Laryngoscope, 127(5), pp. 1217-1223. doi:10.1002/lary.26306.
Ghaheri BA, et al. Breastfeeding Improvement Following Tongue-tie and Lip-tie Release: a Prospective Cohort Study. Laryngoscope. 2017;127(5):1217-1223. PubMed PMID: 27641715.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Breastfeeding improvement following tongue-tie and lip-tie release: A prospective cohort study. AU - Ghaheri,Bobak A, AU - Cole,Melissa, AU - Fausel,Sarah C, AU - Chuop,Maria, AU - Mace,Jess C, Y1 - 2016/09/19/ PY - 2016/03/29/received PY - 2016/07/18/revised PY - 2016/08/04/accepted PY - 2016/9/20/pubmed PY - 2017/5/10/medline PY - 2016/9/20/entrez KW - Breastfeeding KW - ankyloglossia KW - gastroesophageal reflux KW - outcome assessment (healthcare) KW - patient outcome assessment KW - visual analog scale SP - 1217 EP - 1223 JF - The Laryngoscope JO - Laryngoscope VL - 127 IS - 5 N2 - OBJECTIVES/HYPOTHESIS: Numerous symptoms may arise that prevent mother-infant dyads from maintaining desired breastfeeding intervals. Investigations into treatments that positively influence breastfeeding outcomes allow for improved patient counseling for treatment decisions to optimize breastfeeding quality. This investigation aimed to determine the impact of surgical tongue-tie/lip-tie release on breastfeeding impairment. STUDY DESIGN: Prospective, cohort study from June 2014 to April 2015 in a private practice setting. METHODS: Study participants consisted of breastfeeding mother-infant (0-12 weeks of age) dyads with untreated ankyloglossia and/or tethered maxillary labial frenula who completed preoperative, 1 week, and 1 month postoperative surveys consisting of the Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF), visual analog scale (VAS) for nipple pain severity, and the revised Infant Gastroesophageal Reflux Questionnaire (I-GERQ-R). Breastmilk intake was measured preoperatively and 1 week postoperatively. RESULTS: A total of 237 dyads were enrolled after self-electing laser lingual frenotomy and/or maxillary labial frenectomy. Isolated posterior tongue-tie was identified in 78% of infants. Significant postoperative improvements were reported between mean preoperative scores compared to 1 week and 1 month scores of the BSES-SF (F(2) = 212.3; P < .001), the I-GERQ-R (F(2) = 85.3; P < .001), and VAS pain scale (F(2) = 259.8; P < .001). Average breastmilk intake improved 155% from 3.0 (2.9) to 4.9 (4.5) mL/min (P < .001). CONCLUSIONS: Surgical release of tongue-tie/lip-tie results in significant improvement in breastfeeding outcomes. Improvements occur early (1 week postoperatively) and continue to improve through 1 month postoperatively. Improvements were demonstrated in both infants with classic anterior tongue-tie and less obvious posterior tongue-tie. This study identifies a previously under-recognized patient population that may benefit from surgical intervention if abnormal breastfeeding symptoms exist. LEVEL OF EVIDENCE: 2c Laryngoscope, 127:1217-1223, 2017. SN - 1531-4995 UR - https://www.unboundmedicine.com/medline/citation/27641715/Breastfeeding_improvement_following_tongue_tie_and_lip_tie_release:_A_prospective_cohort_study_ L2 - https://doi.org/10.1002/lary.26306 DB - PRIME DP - Unbound Medicine ER -