Keywords
Ankyloglossia
Lingual frenum
Infant
How to Cite
Abstract
To evaluate breastfeeding in babies up to six months of age before and after frenotomy surgery in a reference hospital in a city from Santa Catarina state. Methods: An observational quality improvement study, carried out with babies up to six months of age undergoing frenotomy and their mothers in a reference hospital in southern Santa Catarina state. A questionnaire was applied to the mothers in two moments (before and after the surgery), with information regarding breastfeeding, sociodemographic, anthropometric and behavioral characteristics of them and of the babies. Descriptive analyzes were performed and the association between breastfeeding and the independent variables was assessed through Pearson’s chi-square and Fisher’s exact tests, using a 5% significance level. Results: A total of 74 children were studied, with 48 of them returning after surgery. 83.8% were breastfed before surgery and 64.9% after surgery. Before surgery, 58.1% of children effectively took the breast at once. After surgery, this prevalence was 83.3% (p=0.015). Before surgery, 75.9% of the mothers reported not feeling pain, while, after surgery, almost all of them (95.8%) reported this (p=0.004). Most mothers reported improvement in grip (83.3%), increase in the duration of breastfeeding (69.0%), improvement of baby’s breathing (75.0%), and an increase in the frequency of breastfeeding (51.7%). Conclusions: There was a decrease in the prevalence of breastfeeding after frenotomy. However, there was an improvement in the babies ‘grip and breathing and a reduction in the mothers’ pain when breastfeeding. It is emphasized the need to implement multidisciplinary actions in both primary and hospital care to assist mothers in order to prolong the duration of exclusive breastfeeding.
References
Carvalho MR, Gomes CF. [Breastfeeding: scientific bases]. 4.ed. Rio de Janeiro: Guanabara Koogan; 2016. Portuguese.
Brazilian Ministry of Health. [Food guide for children under 2 years old]. Brasília: Ministry of Health; 2019. Portuguese.
Alves VGS, Mota MC, Pagliari C. Sociodemographic characteristics related to knowing the benefits of breastfeeding. Rev Paul Pediatr. 2021 Apr;39:e2020101. doi: 10.1590/1984-0462/2021/39/2020101.
Brazilian Ministry of Health. [Child health : breastfeeding and complementary feeding]. 2.ed. [Primary Care Notebooks, n.23]; 2015. Portuguese.
Moraes BA, Strada JKR, Gasparin VA, Espirito-Santo LCD, Gouveia HG, Gonçalves AC. Breastfeeding in the first six months of life for babies seen by Lactation Consulting. Rev Lat Am Enfermagem. 2021 Apr;29:e3412. doi: 10.1590/1518-8345.3538.3412.
Walsh J, Tunkel D. Diagnosis and treatment of ankyloglossia in newborns and infants: a review. jAMA Otolaryngol Head Neck Surg. 2017 Oct;143(10):1032-9. doi: 10.1001/jamaoto.2017.0948.
Brzęcka D, Garbacz M, Micał M, Zych B, Lewandowski B. Diagnosis, classification and management of ankyloglossia including its influence on breastfeeding. Dev Period Med. 2019;23(1):79-87. doi: 10.34763/devperiodmed.20192301.7985.
Kotlow LA. Ankyloglossia (tongue-tie): a diagnostic and treatment quandary. Quintessence Int. 1999 Apr;30(4):259-62.
Coryllo E, Genna CW, Salloum AC. Congenital tongue-tie and its impacts on breastfeeding. American Academy of Pediatrics; 2004 [cited 2022 May 6]. Available from: http://breastfeedingmadesimple.com/wp-content/uploads/2016/02/tonguetie.pdg_.pdf.
Amir LH, James JP, Donath SM. Reliability of the hazelbaker assessment tool for lingual frenulum function. Int Breastfeed J. 2006 Mar 9;1(1):3. doi: 10.1186/1746-4358-1-3.
Brazilian Ministry of Health. [Law n. 13,002, of June 2014. It requires the performance of the Assessment Protocol for the Frenulum of the Tongue in Babies]. 2014 [2022 May 10]. Available from: https://www.conass.org.br/ci-n-172-publicada-a-lei-n-13002-que-obriga-a-realizacao-do-protocolo-de-avaliacao-do-frenulo-da-lingua-em-bebes. Portuguese.
Fraga MRBA, Barreto KA, Lira TCB, Celerino PRRP, Tavares ITS, Menezes VA. Ankyloglossia and breastfeeding: what is the evidence of association between them? Rev CEFAC. 2020;22(3):e12219. doi: 10.1590/1982-0216/202022312219.
Silva PI, Vilela JER, Rank RCLC, Rank MS. [Lingual frenectomy in babies: case report]. Revi Bahiana Odontol. 2016;7(3):220-7. Portuguese. doi: 10.17267/2596-3368dentistry.v7i3.1006.
Muldoon K, Gallagher L, McGuinness D, Smith V. Effect of frenotomy on breastfeeding variables in infants with ankyloglossia (tongue-tie): a prospective before and after cohort study. BMC Pregnancy Childbirth. 2017 Nov;17(1):373. doi: 10.1186/s12884-017-1561-8.
Ingram J, Johnson D, Copeland M, Churchill C, Taylor H, Emond A. The development of a tongue assessment tool to assist with tongue-tie identification. Arch Dis Child Fetal Neonatal Ed. 2015 Jul;100(4):F344-8. doi: 10.1136/archdischild-2014-307503.
Brazilian Institute of Geography and Statistics. [Discover cities and states in Brazil: Içara]. 2021 [cited 2020 Sep 23]. Available from: https://cidades.ibge.gov.br/brasil/sc/icara/panorama. Portuguese.
Martinelli RLC, Marchesan IQ, Rodrigues AC, Berretin-Felix G. [Tongue frenulum evaluation protocol in babies]. Rev CEFAC. 2012 Jan-Feb;14(1):138-45. Potuguese.
Martinelli RLC, Marchesan IQ, Berretin-Felix G. [Lingual frenulum evaluation protocol for infants: relationship between anatomic and functional aspects]. Rev CEFAC. 2013 May-Jun;15(3):599-610. Portuguese.
Matthews MK. Developing an instrument to assess infant breastfeeding behaviour in the early neonatal period. Midwifery. 1988 Dec;4(4):154-65. doi: 10.1016/s0266-6138(88)80071-8.
Melzack R. The short-form McGill Pain Questionnaire. Pain. 1987 Aug;30(2):191-7. doi: 10.1016/0304-3959(87)91074-8.
Billington J, Yardley I, Upadhyaya M. Long-term efficacy of a tongue tie service in improving breast feeding rates: A prospective study. J Pediatr Surg. 2018 Feb;53(2):286-8. doi: 10.1016/j.jpedsurg.2017.11.014.
Dixon B, Gray J, Elliot N, Shand B, Lynn A. A multifaceted programme to reduce the rate of tongue-tie release surgery in newborn infants: Observational study. Int J Pediatr Otorhinolaryngol. 2018 Oct;113:156-63. doi: 10.1016/j.ijporl.2018.07.045.
Bistaffa AGI, Giffoni TCR, Franzin LCDS. [Lingual frenotomy in baby]. Rev Uningá Rev. 2017 Jan-Mar;29(2):18-22. Portuguese.
Lima ALX, Dutra MRP. Influence of frenotomy on breastfeeding in newborns with ankyloglossia. Codas. 2021 May;33(1):e20190026. doi: 10.1590/2317-1782/20202019026.
Berry J, Griffiths M, Westcott C. A double-blind, randomized, controlled trial of tongue-tie division and its immediate effect on breastfeeding. Breastfeed Med. 2012 Jun;7(3):189-93. doi: 10.1089/bfm.2011.0030.
Araujo MDCM, Freitas RL, Lima MGS, Kozmhinsky VMDR, Guerra CA, Lima GMS, et al. Evaluation of the lingual frenulum in newborns using two protocols and its association with breastfeeding. J Pediatr (Rio J). 2020 May-Jun;96(3):379-385. doi: 10.1016/j.jped.2018.12.013.
Susiloretni KA, Hadi H, Blakstad MM, Smith ER, Shankar AH. Does exclusive breastfeeding relate to the longer duration of breastfeeding? A prospective cohort study. Midwifery. 2019 Feb;69:163-71. doi: 10.1016/j.midw.2018.11.008.
Francis DO, Krishnaswami S, McPheeters M. Treatment of ankyloglossia and breastfeeding outcomes: a systematic review. Pediatrics. 2015 Jun;135(6):e1458-66. doi: 10.1542/peds.2015-0658.
Batista CLC, Ribeiro VS, Nascimento MDDSB, Rodrigues VP. Association between pacifier use and bottle-feeding and unfavorable behaviors during breastfeeding. J Pediatr (Rio J). 2018 Nov-Dec;94(6):596-601. doi: 10.1016/j.jped.2017.10.005.
Jasny E, Amor H, Baali A. Mothers' knowledge and intentions of breastfeeding in Marrakech, Morocco. Arch Pediatr. 2019 Jul;26(5):285-9. doi: 10.1016/j.arcped.2019.05.007.
Venancio SI, Toma TS, Buccini GS, Sanches MTC, Araújo CL, Figueró MF. [Ankyloglossia and breastfeeding: evidence on the magnitude of the problem, evaluation protocols, safety and efficacy of frenotomy - technical-scientific opinion]. São Paulo Instituto de Saúde; 2015. Portuguese.
This work is licensed under a Creative Commons Attribution 4.0 International License.
Copyright (c) 2022 Camila Fontanella Possamai, Antônio Augusto Schäfer, Micaela Rabelo Quadra; Carla Damasio Martins; Fernanda Oliveira Meller
Downloads
