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BackgroundControversy 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.ObjectiveTo determine the associated effects of frenotomy on breastfeeding variables in infants with ankyloglossia.MethodsA 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.ResultsNinety-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).ConclusionsThis 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.Electronic supplementary materialThe online version of this article (doi: 10.1186/s12884-017-1561-8) contains supplementary material, which is available to authorized users.

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IntroductionPrader-Willi Syndrome (PWS) is a genetically determined neurodevelopmental disorder which occurs in approximately 1 in 22000 births.MethodsParents of subjects with genetically confirmed PWS (participating in the First National Irish PWS study) were asked to fill in a demographic questionnaire, The Child Behaviour Checklist 6–18 (CBCL/6–18), Brief Symptom Inventory (BSI). The age, gender and IQ matched control group was collected through Special Schools.ResultsBoth groups (PWS and Controls) were comprised of 24 children. Internalizing problems score was higher in children with PWS than controls (T mean score (62.02 (SD = 10.17) vs. 58.13 (SD = 7.53) p < . 05). The comparison of PWS and control group along CBCL/6–18 syndromes profiles indicated that children with PWS had more sever somatic problems (mean T 63.50 SD = 8.41 vs. 56.13 SD = 6.31, p< .05), social problems (mean T 64.71 SD = 8.95 vs. 58.79 SD = 9.41, p < .05), thoughts problems (mean T 67.71 SD = 9.71 vs. 58.04 SD = 7.17, p < .05) and were more withdrawn/depressed (mean T 64.04 SD = 9.11 vs. 55.46 SD = 6.48, p < .05). Borderline difficulties were detected for the affective, somatic and ADHD CBCL DSM orientated subscales in PWS group with PWS children having significantly more somatic (mean T 63.05 SD = 8.33 vs. 52.00 SD = 6.48, P < .05) and affective (mean T 66.22 SD = 8.51, vs. 60.08 SD = 6.829 P < .05) problems than controls. The analysis of BSI scales revealed that parents of PSW children in comparison to controls had more somatization, phobic anxiety, obsessive compulsion, and anxiety problems.ConclusionsPWS represents a complex psychological disorder with multiple areas of disturbances.

BackgroundBreastfeeding initiation rates in some developed countries are high (98 % in Sweden and 96 % in Australia) whereas in others, they are not as favourable (46 % to 55 % in Ireland). Although the World Health Organization recommends exclusively breastfeeding for six months, 15 % of Australian women, 11 % of Swedish women and less than 7 % of Irish women achieve this goal. Awareness of what women in different countries perceive as essential breastfeeding support is a gap in our knowledge.MethodsOur aim was to explore Australian, Irish and Swedish women’s perceptions of what assisted them to continue breastfeeding for six months. An exploratory design using critical incident techniques was used. Recruitment occurred through advertisements in local newspapers and on social networking platforms. Initial sampling was purposive, followed by snowball sampling. Telephone interviews were conducted with 64 Irish, 139 Swedish and 153 Australian women who responded to one question “what has assisted you to continue breastfeeding for at least six months?” Content analysis was conducted and common categories determined to allow comparison of frequencies and priority ranking.ResultsCategories reflected the individual mother, her inner social network, her outer social network (informal support either face to face or online), and societal support (health professionals, work environment and breastfeeding being regarded as the cultural norm). Categories ranked in the top five across the three countries were ‘informal face to face support’ and ‘maternal determination’. Swedish and Australian women ranked “health professional support” higher (first and third respectively) than Irish women who ranked ‘informal online support’ as second compared to ninth and tenth for Swedish and Australian women.ConclusionsThe support required to assist breastfeeding women is complex and multi-faceted. Although common international categories were revealed, the ranking of these supportive categories varied. We must recognize how the cultural context of breastfeeding support can vary for women in differing countries and acknowledge the resourcefulness of women who embrace innovations such as social media where face to face formal and informal support are not as accessible.