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Effect of frenotomy on breastfeeding variables in infants with ankyloglossia (tongue-tie): a prospective before and after cohort study.
BMC Pregnancy Childbirth 2017; 17(1):373BP

Abstract

BACKGROUND

Controversy exists regarding ankyloglossia (tongue-tie) and its clinical impact on breastfeeding, including the benefits, or otherwise, of tongue-tie release (frenotomy). As exclusive breastfeeding rates in Ireland are already considerably low (46% on discharge home from the maternity unit following birth in 2014), it is imperative to protect and support breastfeeding, including identifying the associated effects that frenotomy might have on breastfeeding variables.

OBJECTIVE

To determine the associated effects of frenotomy on breastfeeding variables in infants with ankyloglossia.

METHODS

A prospective before and after cohort study was conducted. Following ethical approval, two self-reported questionnaires were administered to women whose infants were undergoing frenotomy at seven healthcare clinics in the Republic of Ireland. Data on breastfeeding variables prior to the frenotomy procedure and at 1-month post-frenotomy were collected and compared. Descriptive statistics (frequencies and proportions) were used to analyse, separately, the pre- and post-frenotomy data. Inferential statistics (z-test scores for differences between proportions (alpha <0.05) and mean differences (MD) with 95% confidence intervals (CI)) were used for pre- and post-frenotomy comparative analyses.

RESULTS

Ninety-eight women returned the baseline questionnaire, and, of these, 89 returned the follow-up questionnaire. The most common reason for seeking a frenotomy was difficulty with latch (38%). Private lactation consultants were the main person recommending a frenotomy (31%). Rates of exclusive breastfeeding remained similar pre- and post-frenotomy (58% versus 58%), although rates of formula feeding increased two-fold at follow-up. Infants' ability to extend their tongues to the lower lip after frenotomy was significantly increased (p < 0.0001). Almost all participants (91%) reported an overall improvement in breastfeeding post-frenotomy. Pain on breastfeeding was significantly reduced post-frenotomy (MD 2.90, 95% CI 3.75 to 2.05) and overall LATCH scale scores were significantly increased (MD -0.50, 95% CI -0.67 to -0.33).

CONCLUSIONS

This study supports the hypothesis that frenotomy has a positive effect on breastfeeding variables in infants with ankyloglossia. These findings, however, are based on a relatively small number of participants from one country only where breastfeeding rates are low. Further, larger studies are required to substantiate these findings.

Authors+Show Affiliations

School of Nursing & Midwifery, Trinity College Dublin, 24 D'Olier Street, Dublin, D02 T283, Ireland.School of Nursing & Midwifery, Trinity College Dublin, 24 D'Olier Street, Dublin, D02 T283, Ireland.School of Nursing & Midwifery, Trinity College Dublin, 24 D'Olier Street, Dublin, D02 T283, Ireland.School of Nursing & Midwifery, Trinity College Dublin, 24 D'Olier Street, Dublin, D02 T283, Ireland. smithv1@tcd.ie.

Pub Type(s)

Journal Article
Multicenter Study

Language

eng

PubMed ID

29132414

Citation

Muldoon, Kathryn, et al. "Effect of Frenotomy On Breastfeeding Variables in Infants With Ankyloglossia (tongue-tie): a Prospective Before and After Cohort Study." BMC Pregnancy and Childbirth, vol. 17, no. 1, 2017, p. 373.
Muldoon K, Gallagher L, McGuinness D, et al. Effect of frenotomy on breastfeeding variables in infants with ankyloglossia (tongue-tie): a prospective before and after cohort study. BMC Pregnancy Childbirth. 2017;17(1):373.
Muldoon, K., Gallagher, L., McGuinness, D., & Smith, V. (2017). Effect of frenotomy on breastfeeding variables in infants with ankyloglossia (tongue-tie): a prospective before and after cohort study. BMC Pregnancy and Childbirth, 17(1), p. 373. doi:10.1186/s12884-017-1561-8.
Muldoon K, et al. Effect of Frenotomy On Breastfeeding Variables in Infants With Ankyloglossia (tongue-tie): a Prospective Before and After Cohort Study. BMC Pregnancy Childbirth. 2017 Nov 13;17(1):373. PubMed PMID: 29132414.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effect of frenotomy on breastfeeding variables in infants with ankyloglossia (tongue-tie): a prospective before and after cohort study. AU - Muldoon,Kathryn, AU - Gallagher,Louise, AU - McGuinness,Denise, AU - Smith,Valerie, Y1 - 2017/11/13/ PY - 2017/02/11/received PY - 2017/11/03/accepted PY - 2017/11/15/entrez PY - 2017/11/15/pubmed PY - 2018/7/11/medline KW - Ankyloglossia KW - Breastfeeding KW - Frenotomy KW - Tongue-tie SP - 373 EP - 373 JF - BMC pregnancy and childbirth JO - BMC Pregnancy Childbirth VL - 17 IS - 1 N2 - BACKGROUND: Controversy exists regarding ankyloglossia (tongue-tie) and its clinical impact on breastfeeding, including the benefits, or otherwise, of tongue-tie release (frenotomy). As exclusive breastfeeding rates in Ireland are already considerably low (46% on discharge home from the maternity unit following birth in 2014), it is imperative to protect and support breastfeeding, including identifying the associated effects that frenotomy might have on breastfeeding variables. OBJECTIVE: To determine the associated effects of frenotomy on breastfeeding variables in infants with ankyloglossia. METHODS: A prospective before and after cohort study was conducted. Following ethical approval, two self-reported questionnaires were administered to women whose infants were undergoing frenotomy at seven healthcare clinics in the Republic of Ireland. Data on breastfeeding variables prior to the frenotomy procedure and at 1-month post-frenotomy were collected and compared. Descriptive statistics (frequencies and proportions) were used to analyse, separately, the pre- and post-frenotomy data. Inferential statistics (z-test scores for differences between proportions (alpha <0.05) and mean differences (MD) with 95% confidence intervals (CI)) were used for pre- and post-frenotomy comparative analyses. RESULTS: Ninety-eight women returned the baseline questionnaire, and, of these, 89 returned the follow-up questionnaire. The most common reason for seeking a frenotomy was difficulty with latch (38%). Private lactation consultants were the main person recommending a frenotomy (31%). Rates of exclusive breastfeeding remained similar pre- and post-frenotomy (58% versus 58%), although rates of formula feeding increased two-fold at follow-up. Infants' ability to extend their tongues to the lower lip after frenotomy was significantly increased (p < 0.0001). Almost all participants (91%) reported an overall improvement in breastfeeding post-frenotomy. Pain on breastfeeding was significantly reduced post-frenotomy (MD 2.90, 95% CI 3.75 to 2.05) and overall LATCH scale scores were significantly increased (MD -0.50, 95% CI -0.67 to -0.33). CONCLUSIONS: This study supports the hypothesis that frenotomy has a positive effect on breastfeeding variables in infants with ankyloglossia. These findings, however, are based on a relatively small number of participants from one country only where breastfeeding rates are low. Further, larger studies are required to substantiate these findings. SN - 1471-2393 UR - https://www.unboundmedicine.com/medline/citation/29132414/Effect_of_frenotomy_on_breastfeeding_variables_in_infants_with_ankyloglossia__tongue_tie_:_a_prospective_before_and_after_cohort_study_ L2 - https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-017-1561-8 DB - PRIME DP - Unbound Medicine ER -