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Revision Lingual Frenotomy Improves Patient-Reported Breastfeeding Outcomes: A Prospective Cohort Study.
J Hum Lact 2018; 34(3):566-574JH

Abstract

BACKGROUND

Lingual frenotomy improves patient-reported outcome measures, including infant reflux and maternal nipple pain, and prolongs the nursing relationship; however, many mother-infant dyads continue to experience breastfeeding difficulty despite having had a frenotomy. Research aim: The aim of this study was to determine how incomplete release of the tethered lingual frenulum may result in persistent breastfeeding difficulties.

METHODS

A one-group, observational, prospective cohort study was conducted. The sample consisted of breastfeeding mother-infant (0-9 months of age) dyads (N = 54) after the mothers self-elected completion lingual frenotomy and/or maxillary labial frenectomy following prior lingual frenotomy performed elsewhere. Participants completed surveys preoperatively, 1-week postoperatively, and 1-month postoperatively 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).

RESULTS

Significant postoperative improvements were reported between mean preoperative scores compared with 1-week and 1-month scores of the BSES-SF, F(2) = 41.2, p < .001; the I-GERQ-R, F(2) = 22.7, p < .001; and VAS pain scale, F(2) = 46.1, p < .001.

CONCLUSION

We demonstrated that besides nipple pain, measures of infant reflux symptoms and maternal breastfeeding self-confidence can improve following full release of the lingual frenulum. Additionally, a patient population was identified that could benefit from increased scrutiny of infant tongue function when initial frenotomy fails to improve breastfeeding symptoms.

Authors+Show Affiliations

1 Division of Otolaryngology/Head and Neck Surgery, The Oregon Clinic, Portland, OR, USA.2 Luna Lactation, Portland, OR, USA.3 Division of Rhinology and Skull Base Surgery, Department of Otolaryngology-Head and Neck Surgery, Oregon Health & Science University, Portland, OR, USA.

Pub Type(s)

Journal Article
Observational Study

Language

eng

PubMed ID

29787680

Citation

Ghaheri, Bobak A., et al. "Revision Lingual Frenotomy Improves Patient-Reported Breastfeeding Outcomes: a Prospective Cohort Study." Journal of Human Lactation : Official Journal of International Lactation Consultant Association, vol. 34, no. 3, 2018, pp. 566-574.
Ghaheri BA, Cole M, Mace JC. Revision Lingual Frenotomy Improves Patient-Reported Breastfeeding Outcomes: A Prospective Cohort Study. J Hum Lact. 2018;34(3):566-574.
Ghaheri, B. A., Cole, M., & Mace, J. C. (2018). Revision Lingual Frenotomy Improves Patient-Reported Breastfeeding Outcomes: A Prospective Cohort Study. Journal of Human Lactation : Official Journal of International Lactation Consultant Association, 34(3), pp. 566-574. doi:10.1177/0890334418775624.
Ghaheri BA, Cole M, Mace JC. Revision Lingual Frenotomy Improves Patient-Reported Breastfeeding Outcomes: a Prospective Cohort Study. J Hum Lact. 2018;34(3):566-574. PubMed PMID: 29787680.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Revision Lingual Frenotomy Improves Patient-Reported Breastfeeding Outcomes: A Prospective Cohort Study. AU - Ghaheri,Bobak A, AU - Cole,Melissa, AU - Mace,Jess C, Y1 - 2018/05/22/ PY - 2018/5/23/pubmed PY - 2019/10/1/medline PY - 2018/5/23/entrez KW - ankyloglossia KW - breastfeeding KW - breastfeeding assessment KW - health services research KW - tongue-tie SP - 566 EP - 574 JF - Journal of human lactation : official journal of International Lactation Consultant Association JO - J Hum Lact VL - 34 IS - 3 N2 - BACKGROUND: Lingual frenotomy improves patient-reported outcome measures, including infant reflux and maternal nipple pain, and prolongs the nursing relationship; however, many mother-infant dyads continue to experience breastfeeding difficulty despite having had a frenotomy. Research aim: The aim of this study was to determine how incomplete release of the tethered lingual frenulum may result in persistent breastfeeding difficulties. METHODS: A one-group, observational, prospective cohort study was conducted. The sample consisted of breastfeeding mother-infant (0-9 months of age) dyads (N = 54) after the mothers self-elected completion lingual frenotomy and/or maxillary labial frenectomy following prior lingual frenotomy performed elsewhere. Participants completed surveys preoperatively, 1-week postoperatively, and 1-month postoperatively 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). RESULTS: Significant postoperative improvements were reported between mean preoperative scores compared with 1-week and 1-month scores of the BSES-SF, F(2) = 41.2, p < .001; the I-GERQ-R, F(2) = 22.7, p < .001; and VAS pain scale, F(2) = 46.1, p < .001. CONCLUSION: We demonstrated that besides nipple pain, measures of infant reflux symptoms and maternal breastfeeding self-confidence can improve following full release of the lingual frenulum. Additionally, a patient population was identified that could benefit from increased scrutiny of infant tongue function when initial frenotomy fails to improve breastfeeding symptoms. SN - 1552-5732 UR - https://www.unboundmedicine.com/medline/citation/29787680/Revision_Lingual_Frenotomy_Improves_Patient_Reported_Breastfeeding_Outcomes:_A_Prospective_Cohort_Study_ L2 - http://journals.sagepub.com/doi/full/10.1177/0890334418775624?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -