Hostname: page-component-6766d58669-kl59c Total loading time: 0 Render date: 2026-05-20T08:27:49.115Z Has data issue: false hasContentIssue false
  • English
  • Français

Tongue-tie division to treat breastfeeding difficulties: our experience

Published online by Cambridge University Press:  28 August 2015

S D Sharma  and
S Jayaraj
S D Sharma*
Affiliation:
Department of Otorhinolaryngology, Whipps Cross Hospital, London, UK
S Jayaraj
Affiliation:
Department of Otorhinolaryngology, Whipps Cross Hospital, London, UK
*
Address for correspondence: Mr Sunil D Sharma, Department of Otorhinolaryngology, Whipps Cross Hospital, Whipps Cross Road, London E11 1NR, UK Fax: +44 207 791 9670 E-mail: sunilsharma@doctors.org.uk
Get access Rights & Permissions [Opens in a new window]

Abstract

Objectives:

To assess the benefits of frenotomy on breastfeeding in infants, and determine the influence of age.

Methods:

A telephone questionnaire of all patients diagnosed with tongue-tie over 12 months was conducted pre-intervention and 1-month post-intervention. The Infant Breastfeeding Assessment Tool was used to assess breastfeeding.

Results:

Of 54 infants diagnosed with tongue-tie, 78 per cent of mothers participated in the survey. Eighty-six per cent of patients underwent frenotomy, with no surgical complications. In the frenotomy group, 81 per cent of mothers reported improvement in breastfeeding, versus 17 per cent in the non-surgical group (p = 0.0074). In the frenotomy group, the mean (±standard deviation) Infant Breastfeeding Assessment Tool score was 3.33 ± 1.51 pre-intervention, versus 9.19 ± 2.44 post-intervention (p = 0.0001). In the non-surgical intervention group, the mean score (±standard deviation) was 4.17 ± 0.75 pre-intervention, versus 6.00 ± 1.73 post-intervention (p = 0.16). For infants who underwent frenotomy, there was a reported improvement in 94 per cent of those aged less than 30 days, versus 68 per cent in infants aged over 30 days (p = 0.092).

Conclusion:

Frenotomy is a safe, short procedure that improves breastfeeding outcomes, and is best performed at an early age.

Keywords

AnkyloglossiaBreast FeedingTongue Tie

Information

Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 129 , Issue 10 , October 2015 , pp. 986 - 989
Copyright
Copyright © JLO (1984) Limited 2015 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Article purchase

Temporarily unavailable

References

1Brookes, A, Bowley, DM. Tongue tie: the evidence for frenotomy. Early Hum Dev 2014;90:765–8CrossRefGoogle ScholarPubMed
2Notestine, GE. The importance of the identification of ankyloglossia (short lingual frenulum) as a cause of breastfeeding problems. J Hum Lact 1990;6:113–15CrossRefGoogle ScholarPubMed
3Steehler, MW, Steehler, MK, Harley, EH. A retrospective review of frenotomy in neonates and infants with feeding difficulties. Int J Pediatr Otorhinolaryngol 2012;76:1236–40CrossRefGoogle ScholarPubMed
4Ito, Y. Does frenotomy improve breast-feeding difficulties in infants with ankyloglossia? Pediatr Int 2014;56:497–505CrossRefGoogle ScholarPubMed
5Messner, AH, Lalakea, ML, Aby, J, Macmahon, J, Bair, E. Ankyloglossia: incidence and associated feeding difficulties. Arch Otolaryngol Head Neck Surg 2000;126:36–9CrossRefGoogle ScholarPubMed
6Ricke, LA, Baker, NJ, Madlon-Kay, DJ, DeFor, TA. Newborn tongue-tie: prevalence and effect on breast-feeding. J Am Board Fam Pract 2005;18:1–7CrossRefGoogle ScholarPubMed
7Hogan, M, Westcott, C, Griffiths, M. Randomized, controlled trial of division of tongue-tie in infants with feeding problems. J Paediatr Child Health 2005;41:246–50CrossRefGoogle ScholarPubMed
8Dollberg, S, Botzer, E, Grunis, E, Mimouni, FB. Immediate nipple pain relief after frenotomy in breast-fed infants with ankyloglossia: a randomized, prospective study. J Pediatr Surg 2006;41:1598–600CrossRefGoogle ScholarPubMed
9Buryk, M, Bloom, D, Shope, T. Efficacy of neonatal release of ankyloglossia: a randomised trial. Pediatrics 2011;128:280–8CrossRefGoogle Scholar
10Berry, J, Griffiths, M, Westcott, C. A double-blind, randomized, controlled trial of tongue-tie division and its immediate effect on breastfeeding. Breastfeed Med 2012;7:189–93CrossRefGoogle ScholarPubMed
11Division of ankyloglossia (tongue-tie) for breastfeeding, NICE interventional procedure guidance [IPG149]. In: http://www.nice.org.uk/guidance/IPG149/chapter/1-guidance [22 December 2014]Google Scholar
12Matthews, MK. Developing an instrument to assess infant breastfeeding behaviour in the early neonatal period. Midwifery 1988;4:154–65CrossRefGoogle ScholarPubMed
13GraphPad Software QuikCalcs: Linear regression calculator. In: http://www.graphpad.com/quickcalcs/linear1/ [22 December 2014]Google Scholar
14Edmunds, J, Miles, S, Fulbrook, P. Tongue-tie and breastfeeding: a review of the literature. Breastfeed Rev 2011;19:19–26Google ScholarPubMed
15Argiris, K, Vasani, S, Wong, G, Stimpson, P, Gunning, E, Caulfield, H. Audit of tongue-tie division in neonates with breastfeeding difficulties: how we do it. Clin Otolaryngol 2011;36:256–60CrossRefGoogle ScholarPubMed
16Geddes, DT, Langton, DB, Gollow, I, Jacobs, LA, Hartmann, PE, Simmer, K. Frenulotomy for breastfeeding infants with ankyloglossia: effect on milk removal and sucking mechanism as imaged by ultrasound. Pediatrics 2008;122:188–94CrossRefGoogle ScholarPubMed
17Ballard, JL, Auer, CE, Khoury, JC. Ankyloglossia: assessment, incidence, and effect of frenuloplasty on the breastfeeding dyad. Paediatrics 2002;110:e63CrossRefGoogle ScholarPubMed
18Webb, AN, Hao, W, Hong, P. The effect of tongue-tie division on breastfeeding and speech articulation: a systematic review. Int J Pediatr Otorhinolaryngol 2013;77:635–46CrossRefGoogle ScholarPubMed