Breastfeeding is the best way to feed infants, but optimal milk transfer and weight gain depend on good latching. Tongue- and lip-tie can prevent successful latching and prevent adequate nutrition. Tongue- and lip-tied babies can either have slow weight gain (SWG) or failure to thrive (FTT). We examine the effect of a holistic supplementation regimen on tongue-tied babies with SWG and FTT. This was a descriptive, cross-sectional study of 55 tongue- and lip-tied babies with SWG and FTT at KMC Hospital, Jakarta, Indonesia. All babies underwent frenotomy and received supplementation with formula (64%) or pasteurized donor breast milk, using either a modified lactation aid (78%) or the Medela Supplemental Nursing System (22%). All mothers received domperidone and acupuncture to improve milk supply. A majority of babies had type 3 tongue-tie (46%) and class 3 upper lip-tie. Twenty-five subjects (45%) had SWG, and 30 subjects (55%) had FTT. All mothers had low milk supply. At-the-breast supplementation improved the nutritional status of 44/55 subjects (80%,p< .001), whereas 11 subjects received early complementary feeding at 4 months of age. By the end of the study, all subjects were solely breastfed without at-the-breast supplementation. The holistic management of tongue- and lip-tied babies with SWG or FTT consisting of frenotomy, at-the-breast supplementation, domperidone, and acupuncture improved infant nutritional status and the mother’s milk supply. Babies could breastfeed without supplementation after treatment and gained weight.

Background Recurrent abdominal pain is 2-4% of all cases encountered by pediatricians. Risk factors vary among countries. There is no data on prevalence and risk factors of recurrent abdominal pain in adolescents in Indonesia. Objective To evaluate prevalence and risk factors of recurrent abdominal pain in junior high school students. Methods A cross-sectional study was performed among junior high school students in South Jakarta who experienced recurrent abdominal pain according to Roma III criteria. Students allowed by their parents to participate to this study were asked to complete a Roma III questionnaire. Data about sociodemographic and history of recurrent abdominal pain among the parents were also collected using a questionnaire. ResultsThree hundred ninety-six adolescents participated in this study, 17.2% among them  experiencing recurrentabdominal pain. Irritable bowel syndrome (IBS) was the most common type (42.6%), followed by functional dyspepsia (30.9%), functional abdominal pain syndrome (11.8%), functional abdominal pain (10.3%), and abdominal migraine (4.4%). The risk factor most responsible was anxious personality (OR 3.86; 95%CI 2.05 to 7.29, P<0.001). Other risk factors that contribute were female, age > 13 years, and middle to lower family income. Conclusions Prevalence of recurrent abdominal pain in adolescents is 17.2%. Irritable bowel syndrome is the most common type. The risk factors are anxious personality, female, age > 13 years, and middle to lower family income.