Outcome of a frenotomy in infants with ankyloglossia on maternal LATCH score

Authors

  • Panuwat Wongwattana Department of Otolaryngology, Faculty of Medicine, Srinakharinwirot University
  • Pannipa Wiriyaamornchai
  • Thanatcha Panyasin Medical Degree Program, Faculty of Medicine, Srinakharinwirot University
  • Apisara Phuawongphat Medical Degree Program, Faculty of Medicine, Srinakharinwirot University
  • Chaladporn Punpongpipat Medical Degree Program, Faculty of Medicine, Srinakharinwirot University
  • Panachai Huntrakul Medical Degree Program, Faculty of Medicine, Srinakharinwirot University

Keywords:

Tongue tie, Frenotomy, Release tongue tie, LATCH score, Exclusive breastfeeding

Abstract

Abstract

Ankyloglossia is a common problem in newborns which results in unsuccessful suckling effort. The benefits of frenotomy in the postpartum period to solve suckling problems are still controversial. Therefore, this study was conducted using the LATCH scoring system comparing before and after surgery. The objective was to compare pre-and post-frenotomy LATCH scores among infants with ankyloglossia. A cross-sectional descriptive study was performed at HRH Princess Maha Chakri Sirindhorn Medical Center between January 1, 2018 and December 31, 2020. The maternal and infant data were diagnosed with ankyloglossia, based on Kotlow's assessment, were classified and collected. Infants with moderate and more severe ankyloglossia who underwent a frenotomy were included. Comparison LATCH scores before and after surgery used Wilcoxon matched pairs signed ranks test. A total of 166 newborns diagnosed with ankyloglossia were included in this study. There were 110 males (66.27%) with an average age of 4.06±4.30 days. A comparison of pre-and postoperative LATCH scores showed a postoperative median of seven (the interquartile range 7-8) significantly better than preoperative ones with a median of six (the interquartile range 4-6) (p-value < 0.001).  After surgery, 34 mothers with LATCH scores over eight (20.48%) were found. The overall complications in the frenotomy procedure, including any minor bleeding, which was only found in two cases (1.2%).  There were 42 cases of mothers who were exclusively breastfeeding over a six-month period (25.30%). It was found that the level of education of mothers at the secondary school level and above affected the success of exclusive breastfeeding over a period of six months. In conclusion, a frenotomy during the early postpartum period in infants with moderate to more severe ankyloglossia with breastfeeding difficulties can improve breastfeeding and be evaluated with a LATCH score.

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References

Chowdhury R, Sinha B, Sankar MJ, et al. Breastfeeding and maternal health outcomes: a systematic review and meta-analysis. Acta Paediatr 2015;104:96-113.

Pinho-Gomes AC, Morelli G, Jones A, et al. Association of lactation with maternal risk of type 2 diabetes: a systematic review and meta-analysis of observational studies. Diabetes Obes Metab 2021;23(8):1902-16.

Tschiderer L, Seekircher L, Kunutsor SK, et al. Breastfeeding is associated with a reduced maternal cardiovascular risk: systematic review and meta-analysis involving data from 8 studies and 1,192,700 parous women. J Am Heart Assoc 2022;11(2):e022746.

Ware JL, Chen A, Morrow AL, et al. Associations between breastfeeding initiation and infant mortality in an urban population. Breastfeed Med 2019;14(7):465-74.

Ip S, Chung M, Raman G, et al. Breastfeeding and maternal and infant health outcomes in developed countries. Evid Rep Technol Assess 2007(153):1-186.

Victora CG, Bahl R, Barros AJ, et al. Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect. Lancet 2016;387(10017):475-90.

World Health Organization. Infant and young child feeding 2021. Available from: https://www.who.int/news-room/fact-sheets/detail/infant-and-young-child-feeding. Accessed 1 Aug 2020.

Meek JY, Noble L. Policy statement: breastfeeding and the use of human milk. Pediatrics 2022;150(1):e2022057988.

Williams J, Namazova-Baranova L, Weber M, et al. The importance of continuing breastfeeding during coronavirus disease-2019: in support of the World Health Organization statement on breastfeeding during the pandemic. J Pediatr 2020;223:234-6.

Daggumati S, Cohn JE, Brennan MJ, et al. Speech and language outcomes in patients with ankyloglossia undergoing frenulectomy: a retrospective pilot study. OTO Open 2019;3(1):2473974X19826943.

Webb 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(5):635-46.

Kupietzky A, Botzer E. Ankyloglossia in the infant and young child: clinical suggestions for diagnosis and management. Pediatr Dent 2005;27(1):40-6.

Ngerncham S, Laohapensang M, Wongvisutdhi T, et al. Lingual frenulum and effect on breastfeeding in Thai newborn infants. Paediatr Int Child Health 2013;33(2):86-90.

Ballard JL, Auer CE, Khoury JC. Ankyloglossia: assessment, incidence, and effect of frenuloplasty on the breastfeeding dyad. Pediatrics 2002;110(5):e63.

Kumar SP, Mooney R, Wieser LJ, et al. The LATCH scoring system and prediction of breastfeeding duration. J Hum Lact 2006;22(4):391-7.

Jensen D, Wallace S, Kelsay P. LATCH: a breastfeeding charting system and documentation tool. J Obstet Gynecol Neonatal Nurs 1994;23(1):27-32.

Riordan J, Bibb D, Miller M, et al. Predicting breastfeeding duration using the LATCH breastfeeding assessment tool. J Hum Lact 2001;17(1):20-3.

O'Shea JE, Foster JP, O'Donnell CP, et al. Frenotomy for tongue-tie in newborn infants. Cochrane Database Syst Rev 2017;11;3(3):CD011065.

Donati-Bourne J, Batool Z, Hendrickse C, et al. Tongue-tie assessment and division: a time-critical intervention to optimise breastfeeding. J Neonatal Surg 2015;4(1):3

Purnamasari H. Early frenotomy improves breastfeeding outcomes for tongue-tied infants. Clin Lact 2015;6(1):1-15.

Todd DA, Hogan MJ. Tongue-tie in the newborn: early diagnosis and division prevents poor breastfeeding outcomes. Breastfeed Rev 2015;23(1):11-6.

Kotlow LA. Ankyloglossia (tongue-tie): a diagnostic and treatment quandary. Quintessence Int 1999;30(4).

Walsh J, Links A, Boss E, et al. Ankyloglossia and lingual frenotomy: national trends in inpatient diagnosis and management in the United States, 1997-2012. Otolaryngol Head Neck Surg 2017;156(4):735-40.

Francis DO, Krishnaswami S, McPheeters M. Treatment of ankyloglossia and breastfeeding outcomes: a systematic review. Pediatrics 2015;135(6):1458-66.

Chusilp K. Breastfeeding Assessment. In: Muttamara S, Chusilp K, Suthutvoravut U, Sangtawesin V, Hangchawanich Y, editors. Breastfeeding . Bangkok: Aiyara Publichino Company Limited; 2555:163-71.

Puapornpong P, Raungrongmorakot K, Hamontri S, et al. Latch score and exclusive breastfeeding during the first six months postpartum. J Med Health Sci 2016;23(1):8-14.

Srinivasan A, Al Khoury A, Puzhko S, et al. Frenotomy in infants with tongue-tie and breastfeeding problems. J Hum Lact 2019;35(4):706-12.

Khoo A, Dabbas N, Sudhakaran N, et al. Nipple pain at presentation predicts success of tongue-tie division for breastfeeding problems. Eur J Pediatr Surg 2009;19 (6):370-3.

Brookes A, Bowley DM. Tongue tie: the evidence for frenotomy. Early Hum Dev 2014;90(11):765-8.

Puapornpong P, Raungrongmorakot K, Mahasitthiwat V, et al. Comparisons of the latching on between newborns with tongue-tie and normal newborns. J Med Assoc Thai 2014;97(3):255-9.

Puapornpong P, Paritakul P, Suksamarnwong M, et al. Nipple pain incidence, the predisposing factors, the recovery period after care management, and the exclusive breastfeeding outcome. Breastfeed Med 2017;12(3):169-73.

Wongwattana P. The effect of frenotomy on long-term breastfeeding in infants with ankyloglossia. Int J Pediatr Otorhinolaryngol 2022;152:110983.

Messner AH, Lalakea ML, Aby J, et al. Ankyloglossia: incidence and associated feeding difficulties. Arch Otolaryngol Head Neck Surg 2000;126(1):36-9.

Semenic S, Loiselle C, Gottlieb L. Predictors of the duration of exclusive breastfeeding among first-time mothers. Res Nurs Health 2008;31(5):428-41.

Fu I, Fong D, Heys M, et al. Professional breastfeeding support for first-time mothers: a multicentre cluster randomised controlled trial. Int J Obstet Gynaecol 2014;121(13):1673-83.

Wagner EA, Chantry CJ, Dewey KG, et al. Breastfeeding concerns at 3 and 7 days postpartum and feeding status at 2 months. Pediatrics 2013;132(4):865-75.

Mettias B, O’Brien R, Khatwa MMA, et al. Division of tongue tie as an outpatient procedure. Technique, efficacy and safety. Int J Pediatr Otorhinolaryngol 2013;77(4):550-2.

Shah MH, Roshan R, Parikh T, et al. LATCH score at discharge: a predictor of weight gain and exclusive breastfeeding at 6 weeks in term healthy babies. J Pediatr Gastroenterol Nutr 2021;72(2):48-52.

Sowjanya S, Venugopalan L. LATCH score as a predictor of exclusive breastfeeding at 6 weeks postpartum: a prospective cohort study. Breastfeeding Med 2018;13(6):444-9.

Buryk M, Bloom D, Shope T. Efficacy of neonatal release of ankyloglossia: a randomized trial. Pediatrics 2011;128(2):280-8.

Kenny-Scherber AC, Newman J. Office-based frenotomy for ankyloglossia and problematic breastfeeding. Can Fam Physician 2016;62(7):570-1.

National Statistical Office; United Nation Children’s Fund. Thailand multiple indicator cluster survey in 2019: the summary of key indicators. National statistical office Bangkok, Thailand; 2020.

World Health Organization. Global breastfeeding scorecard, 2019: increasing commitment to breastfeeding through funding and improved policies and programmes; World Health Organization: Geneva, Switzerland, 2019.

UNICEF. Breastfeeding: a mother’s gift, for every child. New York:UNICEF; 2018.

Riva E, Banderali G, Agostoni C, , et al. Factors associated with initiation and duration of breastfeeding in Italy. Acta Paediatr 1999;88(4):411-5.

Li J, Nguyen TT, Wang X, et al. Breastfeeding practices and associated factors at the individual, family, health facility and environmental levels in China. Matern Child Nutr 2020;16:e13002.

Topothai C, Topothai T, Suphanchaimat R, et al. Exclusive breastfeeding experiences of Thai mothers in metropolitan Bangkok. Int J Womens Health 2022;14:155-66.

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Published

2022-12-29

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Original Article (บทความวิจัย)