Original articleImmediate nipple pain relief after frenotomy in breast-fed infants with ankyloglossia: a randomized, prospective study
Section snippets
Methods
Institutional review board permission for conducting the study was granted, and written informed parental consent was obtained for each of the participants. We recruited 25 full-term healthy, appropriate-for-gestational age infants aged 1 to 21 days. This number of patients was initially designed as a pilot that would help to calculate sample size of a larger study. All patients had been referred to the lactation clinic at the Lis Maternity Hospital because of nipple pain. On physical
Results
The study was successfully completed in 25 infants between December 1, 2001, and September 30, 2004. An additional infant had been excluded because upon breast-feeding, a few drops of blood were seen by the mother at the corner of his mouth, which cancelled blinding. The 25 remaining infants had a mean ± SD gestational age of 39.8 ± 1.2 weeks and birth weight of 3205 ± 830 g. In only 3 of the infants did the tongue protruded beyond the alveolar ridge, whereas in 22 it did not. Fifteen of the
Discussion
In this prospective randomized masked study, we studied frenotomy or sham in infants with ankyloglossia and maternal nipple pain. We found that after frenotomy, there was an immediate and significant nipple pain relief as judged by a significant decrease in pain score after frenotomy than after sham. We also found a concomitant improvement in infant's latch to the breast in this group.
The design of our study allowed overcoming several biases. As stated in a recent, nonrandomized study, maternal
References (12)
- et al.
LATCH: a breastfeeding charting system and documentation tool
J Obstet Gynecol Neonatal Nurs
(1994) - et al.
Ankyloglossia. Incidence and associated feeding difficulties
Arch Otolaryngol Head Neck Surg
(2000) The importance of the identification of ankyloglossia (short lingual frenulum) as a cause of breastfeeding problems
J Hum Lact
(1990)- et al.
Neonatal hypernatremic dehydration associated with breast-feeding malnutrition: a retrospective survey
Can Med Assoc J
(2000) - et al.
Neonatal frenotomy may be necessary to correct breastfeeding problems
J Hum Lact
(1990) - et al.
Congenital tongue-tie and its impact on breastfeeding. Newsletter of the American Academy of Pediatrics, section of breastfeeding
Cited by (133)
The development of a specialist tongue tie assessment clinic for neonates
2024, International Journal of Pediatric OtorhinolaryngologyAnkyloglossia and Tethered Oral Tissue: An Evidence-Based Review
2022, Pediatric Clinics of North AmericaABM Clinical Protocol #26: Persistent Pain with Breastfeeding
2022, Breastfeeding: A Guide for the Medical ProfessionThe effect of frenotomy on long-term breastfeeding in infants with ankyloglossia
2022, International Journal of Pediatric OtorhinolaryngologyAnkyloglossia and Tight Maxillary Frenula
2021, Cummings Pediatric OtolaryngologyQuantitative impact of frenotomy on breastfeeding: a systematic review and meta-analysis
2024, Pediatric Research