A Holistic Supplementation Regimen for Tongue-Tied Babies With Slow Weight Gain and Failure to Thrive

Abstract

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.

Treatment modalities in breastfeeding babies with marasmus and kwashiorkor associated with ankyloglossia

“…This approach was successful, and supplementation with feeding tube devices could later be stopped after improvements with breastfeeding and complementary feeding. 3 Here we presented two infants who suffered from Ankyloglossia, which hindered the baby's ability to breastfeed and eat solid food. These babies were diagnosed with marasmus and kwashiorkor.…”

“…All doctors were trained by Perinasia (The Indonesian Society of Perinatology). 3 During daily observation in the lactation clinic, some difficulties exist which can interfere with the latching of the baby's mouth and sucking on the breast. The position of the baby during pregnancy in the mother's stomach or the difficult and traumatic process of labor can inhibit the baby's suction reflex.…”

“…And all holy books of these religions include breastfeeding in their sentences. 3 In case one, baby Hn's parents were so thrilled with the treatment and they were committed to continue breastfeeding for up to two years, first with a supplemental nursing system filled with human milk donors then early complementary feeding. In case two, baby Hf was receiving bottles from the age of 1-month-old, so that when she came at 9 months of age she was already in a state of nipple confusion, her mother was pregnant at that time and there was no milk supply.…”

Tethered Oral Tissue Release Among Breastfed Infants: Maternal Sources of Information and Treatment

“…Importantly, poor latch may result in maternal pain, insufficient milk transfer, and an undernourished infant, all of which are reasons for premature weaning (Hornsby et al, 2019; Morrison et al, 2019). Infants' tethered oral tissue(s) may contribute to poor latch via ineffective suckling (Merritt, 2019; Praborini et al, 2018), although according to Douglass and Geddes (2018) the issue is likely to be far more nuanced and complex than is generally understood (e.g., nipple positioning/ elongation, intra-oral vacuum creation, poor initial attachment). Regardless of underlying causes, this ineffective suckling may also result in nipple trauma, further increasing the likelihood of weaning.…”