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


  • 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


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



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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Original Article (บทความวิจัย)