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Int. J. Pediatr. Otorhinolaryngol. · May 2013
The effects of office-based frenotomy for anterior and posterior ankyloglossia on breastfeeding.
- Cliff O'Callahan, Susan Macary, and Stephanie Clemente.
- Family Practice Residency Program, Middlesex Hospital, Middletown, CT, United States. cliff.o'callahan@midhosp.org
- Int. J. Pediatr. Otorhinolaryngol. 2013 May 1; 77 (5): 827-32.
ObjectivesThe objectives of this study were to assess the effect of office-based frenotomy on reversing breastfeeding difficulties among infants with problematic ankyloglossia, and to examine characteristics associated with anterior and posterior ankyloglossia.MethodsMother's of infants who underwent a frenotomy for ankyloglossia from December 2006 through March 2011 completed a post-intervention web-based survey about breastfeeding difficulties they experienced before and after the frenotomy. Maternal-infant dyads had been referred from health providers to a primary care practice for assessment of ankyloglossia. Infants were subsequently classified as having no ankyloglossia, anterior (Type I or Type II) or posterior (Type III or Type IV).ResultsThere were 311 infants evaluated for ankyloglossia and 299 (95%) underwent a frenotomy. Most infants were classified as having Type III (36%) or IV (49%) ankyloglossia compared to only 16% with anterior (Type I and Type II combined). Differences by classification type were found for gender (P=.016), age (P=.017), and maxillary tie (P=.005). Among survey respondents (n=157), infant latching significantly improved (P<.001) from pre- to post-intervention for infants with posterior ankyloglossia. Both the presence and severity of nipple pain decreased from pre- to post-intervention among all classifications (P<.001). Additionally, 92% of respondents breastfed exclusively post-intervention. The mean breastfeeding duration of 14 months did not differ significantly by classification.ConclusionsBreastfeeding difficulties associated with ankyloglossia in infants, particularly posterior, can be improved with a simple office-based procedure in most cases. The diagnosis and treatment of ankyloglossia should be a basic competency for all primary care providers and pediatric otorhinolaryngologists.Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.
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