Relationship Between Infant Tongue-Tie and Maternal Wellbeing

Abstract

Background: Tongue-tie is a mild oral anomaly that can cause feeding challenges, especially for breastfeeding mothers and infants. Delayed diagnosis may place mothers at increased risk of stress and impaired mother-infant bonding when feeding does not go as planned. The purpose of this study was to explore the risk for altered maternal wellbeing (e.g., stress and maternal-infant bonding) in mothers of infants with tongue-tie-using-a mixed-methods, cross-sectional study. Methods: We recruited mothers from two sites to participate in a survey about their experiences with tongue-tie: Facebook TM tongue-tie support group and a local pediatric dental offi ce where frenotomy is commonly performed. Inclusion criteria were mothers 18 or older; able to read, write, and understand English. Infants were under the age of 1 year when diagnosed with tongue-tie. The survey contained both selection and open-text entry questions. Maternal-infant bonding was assessed using the Postpartum Bonding Questionnaire and maternal stress was measured using the Parental Stress Scale. Results: N = 113 mothers participated. Findings suggest that mothers of infants with tongue-tie report increased stress, especially when a diagnosis of tongue-tie is delayed. After correction, maternal wellbeing, the breastfeeding relationship, and maternal report of infant temperament improved. Clinical Implications: Early assessment, diagnosis, and management of tongue-tie are important. Partner support is helpful in fostering the mother-infant relationship. Future research is needed to understand barriers to appropriate referrals and delay in treatment of tongue-tie.

Severity and prevalence of ankyloglossia‐associated breastfeeding symptoms: A systematic review and meta‐analysis

“…The systematic review included three qualitative studies of maternal perspectives on breastfeeding infants with ankyloglossia 16,17,47 . Emergent themes included aspects of maternal well‐being: physical pain; 16,17,47 desperation, guilt/shame, and disappointment; 16,17 and strained interpersonal relationships, especially partner resentment 16 .…”

“…After automated duplicate removal, 1328 records were screened, and 39 studies were included in the systematic review (Figure 1). 16,17,27–63 The studies included 5730 infants with ankyloglossia. Meta‐analyses used data from 16 studies 27–42 …”

“…Table 1 summarises study characteristics; Table S2 provides individual characteristics of all included studies 16,17,27–63 . The systematic review included 5 randomised controlled trials (RCTs), 19 pre‐post intervention studies, 10 observational cohort and cross‐sectional studies, 2 case–control studies, and 3 qualitative studies.…”

“…The systematic review included three qualitative studies of maternal perspectives on breastfeeding infants with ankyloglossia. 16,17,47 Emergent themes included aspects of maternal well-being: physical pain; 16,17,47 desperation, guilt/shame, and disappointment; 16,17 and strained interpersonal relationships, especially partner resentment. 16 Emergent themes also included frustration with the health care system (distrust, dismissal, and a desire for greater consistency in referral, assessment, and management); 16,17 maternal resilience or persistence; 16,17,47 and relief after frenotomy.…”

“…16 Emergent themes also included frustration with the health care system (distrust, dismissal, and a desire for greater consistency in referral, assessment, and management); 16,17 maternal resilience or persistence; 16,17,47 and relief after frenotomy. 17,47 Six studies 28,31,[34][35][36]39 were combined in a Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF) meta-analysis (Table 5).…”