Revision Lingual Frenotomy Improves Patient-Reported Breastfeeding Outcomes: A Prospective Cohort Study

Abstract

We demonstrated that besides nipple pain, measures of infant reflux symptoms and maternal breastfeeding self-confidence can improve following full release of the lingual frenulum. Additionally, a patient population was identified that could benefit from increased scrutiny of infant tongue function when initial frenotomy fails to improve breastfeeding symptoms.

What is a tongue tie? Defining the anatomy of the in‐situ lingual frenulum

“…Some practitioners believe that there are deep attachments of the frenulum, warranting a deeper incision (Fabbie et al, ). Heated debates take place in social media bringing into question the “completeness” of a frenotomy procedure, particularly when improvement does not occur after a procedure (Ghaheri, ) and in these circumstances it is not uncommon for babies to be considered for a second or multiple frenotomies (Ghaheri et al, ).…”

Symptoms of problematic feeding in infants under 1 year of age undergoing frenotomy: A review article

“…The median sample size of the studies was 58 (range support, [22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38] and four of the studies screened all infants born during the study period. 22,25,39,40 Not all studies listed explicit inclusion or exclusion criteria.…”

“…22,25,39,40 Not all studies listed explicit inclusion or exclusion criteria. Beyond breastfeeding difficulties, some studies restricted inclusion to certain infant age ranges, 27,28,[34][35][36][37]41 specific tongue tie severity 22,31,41 or baseline LATCH score. 41 Exclusion criteria included the presence of other oral anomalies, 25,28,32,40,41 prematurity, 25,[33][34][35]41 medical co-morbidities, 25,34,35,40 maternal breast surgery 34,35 and delivery complications.…”

“…One study did not report infant age, 22 and sex was reported in 14 of the studies. 22,[26][27][28][30][31][32][34][35][36][37]39,40,42 Birth weight was reported in four studies, 28,30,37,38 and current infant weight was reported in one. 30 Only three reported infant ethnicities.…”

“…In all three, the majority of infants were white. [34][35][36] One study discussed how maternal TA B L E 1 (Continued) ethnicity, education level and socioeconomic status differed between the overall population at the hospital and those that enrolled in the study but did not report the actual data comparing the sample to the overall population. 41 None of the other 19 studies reported maternal ethnicity, socioeconomic status or education level.…”