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Upper lip frenotomy for neonatal breastfeeding problems.
Int J Pediatr Otorhinolaryngol 2019; 124:190-192IJ

Abstract

OBJECTIVES

Upper lip tie, without concomitant tongue tie, can prevent proper flanging of the upper lip during breastfeeding, resulting in a poor seal and suck for the infant with nipple pain and maternal dissatisfaction. Due to the lack of published studies on this subject, we report our technique and outcomes for in-office release of isolated upper lip tie.

METHODS

Using CPT Code 40,806 for 'incision of labial frenulum', 22 mother-infant dyads with infant age under 60 days with breastfeeding problems and a restrictive upper lip frenum were identified. These infants underwent in-office release of upper lip tie as detailed below. Outcomes of the procedure were assessed by a telephone survey to mothers within the 4-week period post-procedure.

RESULTS

82% of mothers reported an improved latch and 73% noted increased satisfaction with breastfeeding. Lip pain, if present, resolved within 24 h for most children. Recurrence was reported by 9% of mothers; no infection or other complications occurred.

CONCLUSION

Upper lip frenotomy, in properly selected infants, has favorable short-term outcomes with mild transient discomfort and a low rate of recurrence. Since our study was short-term and did not include a control group, we are unable to comment on procedure efficacy or long-term impact.

Authors+Show Affiliations

Department of Otolaryngology, SUNY Downstate Medical Center, 450 Clarkson Avenue, MSC 126, Brooklyn, NY, 11203, USA.Department of Otolaryngology, SUNY Downstate Medical Center, 450 Clarkson Avenue, MSC 126, Brooklyn, NY, 11203, USA.Department of Otolaryngology, SUNY Downstate Medical Center, 450 Clarkson Avenue, MSC 126, Brooklyn, NY, 11203, USA.Department of Otolaryngology, SUNY Downstate Medical Center, 450 Clarkson Avenue, MSC 126, Brooklyn, NY, 11203, USA. Electronic address: richard.rosenfeld@downstate.edu.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31202037

Citation

Patel, Prayag S., et al. "Upper Lip Frenotomy for Neonatal Breastfeeding Problems." International Journal of Pediatric Otorhinolaryngology, vol. 124, 2019, pp. 190-192.
Patel PS, Wu DB, Schwartz Z, et al. Upper lip frenotomy for neonatal breastfeeding problems. Int J Pediatr Otorhinolaryngol. 2019;124:190-192.
Patel, P. S., Wu, D. B., Schwartz, Z., & Rosenfeld, R. M. (2019). Upper lip frenotomy for neonatal breastfeeding problems. International Journal of Pediatric Otorhinolaryngology, 124, pp. 190-192. doi:10.1016/j.ijporl.2019.06.008.
Patel PS, et al. Upper Lip Frenotomy for Neonatal Breastfeeding Problems. Int J Pediatr Otorhinolaryngol. 2019;124:190-192. PubMed PMID: 31202037.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Upper lip frenotomy for neonatal breastfeeding problems. AU - Patel,Prayag S, AU - Wu,Derek B, AU - Schwartz,Ziv, AU - Rosenfeld,Richard M, Y1 - 2019/06/10/ PY - 2019/05/13/received PY - 2019/06/04/revised PY - 2019/06/06/accepted PY - 2019/6/16/pubmed PY - 2019/6/16/medline PY - 2019/6/16/entrez KW - Breastfeeding difficulty KW - Frenotomy KW - Neonate KW - Upper lip tie SP - 190 EP - 192 JF - International journal of pediatric otorhinolaryngology JO - Int. J. Pediatr. Otorhinolaryngol. VL - 124 N2 - OBJECTIVES: Upper lip tie, without concomitant tongue tie, can prevent proper flanging of the upper lip during breastfeeding, resulting in a poor seal and suck for the infant with nipple pain and maternal dissatisfaction. Due to the lack of published studies on this subject, we report our technique and outcomes for in-office release of isolated upper lip tie. METHODS: Using CPT Code 40,806 for 'incision of labial frenulum', 22 mother-infant dyads with infant age under 60 days with breastfeeding problems and a restrictive upper lip frenum were identified. These infants underwent in-office release of upper lip tie as detailed below. Outcomes of the procedure were assessed by a telephone survey to mothers within the 4-week period post-procedure. RESULTS: 82% of mothers reported an improved latch and 73% noted increased satisfaction with breastfeeding. Lip pain, if present, resolved within 24 h for most children. Recurrence was reported by 9% of mothers; no infection or other complications occurred. CONCLUSION: Upper lip frenotomy, in properly selected infants, has favorable short-term outcomes with mild transient discomfort and a low rate of recurrence. Since our study was short-term and did not include a control group, we are unable to comment on procedure efficacy or long-term impact. SN - 1872-8464 UR - https://www.unboundmedicine.com/medline/citation/31202037/Upper_lip_frenotomy_for_neonatal_breastfeeding_problems L2 - https://linkinghub.elsevier.com/retrieve/pii/S0165-5876(19)30282-4 DB - PRIME DP - Unbound Medicine ER -