-
Breastfeeding Medicine : the Official... Feb 2020Ankyloglossia is characterized by abnormal tongue movements that can possibly interfere with breastfeeding due to incorrect latching, pain, nipple fissure, and...
Ankyloglossia is characterized by abnormal tongue movements that can possibly interfere with breastfeeding due to incorrect latching, pain, nipple fissure, and ineffective suction. To determine the prevalence of ankyloglossia in newborns and its association with exclusive breastfeeding and early breastfeeding difficulties. This is an analytical cross-sectional study conducted in seven public maternity hospitals in the city of Recife, PE, Brazil. The study sample consisted of 822 mothers/newborns of both genders. The diagnosis of ankyloglossia was confirmed by comparing two previously standardized and validated lingual frenulum assessment tools. Information on the mother's socioeconomic profile and breastfeeding difficulties were also collected. The data were analyzed using bivariate and multivariate logistic regression models. The prevalence of ankyloglossia was 2.6% when using the Bristol Tool and 11.7% with the Assessment Tool for Lingual Frenulum Function (Neonatal Tongue Screening Test-NTST). The agreement between the two assessment tools was 2.2%, with a significant difference between them ( < 0.001). There was an association between the occurrence of ankyloglossia and breastfeeding difficulties (odds ratio = 1.99), but no association with exclusive breastfeeding practice was found. The diagnostic tools used herein revealed different prevalence rates of ankyloglossia in newborns. This condition was associated with breastfeeding difficulties, and the NTST was more effective in determining such an association.
Topics: Adolescent; Adult; Ankyloglossia; Brazil; Breast Feeding; Cross-Sectional Studies; Diagnostic Tests, Routine; Female; Hospitals, Public; Humans; Infant, Newborn; Infant, Newborn, Diseases; Male; Prevalence; Young Adult
PubMed: 31916855
DOI: 10.1089/bfm.2019.0199 -
Journal of Perinatology : Official... Mar 2020Examination of the oral cavity should be an essential part of the newborn assessment. Early detection of congenital disorders is essential to begin appropriate medical... (Review)
Review
Examination of the oral cavity should be an essential part of the newborn assessment. Early detection of congenital disorders is essential to begin appropriate medical or surgical therapy and to prevent complications that could profoundly affect a child's life. The present review aims to describe the main anomalies of the oral cavity in infants and provide images in order to help the physician in current clinical practice.
Topics: Ankyloglossia; Early Diagnosis; Humans; Infant, Newborn; Mouth; Mouth Abnormalities; Mouth Diseases; Neonatal Screening
PubMed: 31925320
DOI: 10.1038/s41372-019-0585-5 -
Global Challenges (Hoboken, NJ) Oct 2021Breastfeeding, as a unique behavior of the postpartum period and an ideal source of nourishment, is profoundly impacted by the physiology and behavior of both mothers... (Review)
Review
Breastfeeding, as a unique behavior of the postpartum period and an ideal source of nourishment, is profoundly impacted by the physiology and behavior of both mothers and infants. For more than three-quarters of a century, there has been an ongoing advancement of instruments that permit insight into the complex process of latching during breastfeeding, which includes coordinating sucking, swallowing, and breathing. Despite the available methodologies for understanding latching dynamics, there continues to be a large void in the understanding of infant latching and feeding. The causes for many breastfeeding difficulties remain unclear, and until a clearer understanding of the mechanics involved is achieved, the struggle will continue in the attempts to aid infants and mothers who struggle to breastfeed. In this review, the history of development for the most prominent tools employed to analyze breastfeeding dynamics is presented. Additionally, the importance of the most advanced instruments and systems used to understand latching dynamics is highlighted and how medical practitioners utilize them is reported. Finally, a controversial argument amongst pediatric otolaryngolo gists concerning breastfeeding difficulties is reviewed and the urgent need for quantification of latching dynamics in conjunction with milk removal rate through prospective controlled studies is discussed.
PubMed: 34631150
DOI: 10.1002/gch2.202100019 -
Boletin Medico Del Hospital Infantil de... 2021Ankyloglossia is a condition present in some newborns and can be associated with breastfeeding difficulties, leading to symptoms in the child and the mother. This study... (Observational Study)
Observational Study
BACKGROUND
Ankyloglossia is a condition present in some newborns and can be associated with breastfeeding difficulties, leading to symptoms in the child and the mother. This study aimed to analyze the characteristics of newborns with tongue-tie and the symptoms reported by their mothers, and the short and long-term outcomes of frenotomy.
METHODS
We conducted a prospective and observational 7-month study in a Baby-Friendly Hospital (BFH). We included all the breastfed newborns without comorbidities that underwent a frenotomy.
RESULTS
A total of 33 frenotomies were performed. The most common findings before the procedure were maternal breastfeeding pain (29/33), ineffective latch (18/33), and maternal nipple lesions (18/33). We observed that newborns surgically intervened later showed a high incidence of jaundice (p = 0.03), weight loss greater than 10% at hospital discharge (p = 0.004), and their mothers experienced pain more often (p = 0.004). At one month of age, there was an improvement in breastfeeding-related pain (p = 0.012) and its intensity (p = 0.016), the presence of maternal cracked nipples (p < 0.01), and latching on (p < 0.01).
CONCLUSIONS
Ankyloglossia can prevent the correct establishment of breastfeeding. Frenotomy is associated with few complications, and when appropriately indicated, may have a positive impact on breastfeeding, reducing maternal pain, the presence of nipple lesions, and latching problems.
Topics: Ankyloglossia; Child; Female; Hospitals; Humans; Infant, Newborn; Lingual Frenum; Prevalence; Prospective Studies; Treatment Outcome
PubMed: 34571520
DOI: 10.24875/BMHIM.20000391 -
International Journal of Pediatric... Nov 2020Anecdotally, there has been an increase in ankyloglossia referrals and frenotomy procedures performed in recent years. Many studies have characterized frenotomy...
OBJECTIVES
Anecdotally, there has been an increase in ankyloglossia referrals and frenotomy procedures performed in recent years. Many studies have characterized frenotomy indications and outcomes, but none have quantified how the frequency of referrals and interventions have changed over time in the outpatient setting. This study analyzes temporal trends in the diagnosis and intervention of ankyloglossia in a pediatric otolaryngology practice to further clarify how patterns of management of this condition have changed over time.
METHODS
This study was a retrospective chart review of patients evaluated for ankyloglossia in an outpatient pediatric otolaryngology clinic between 2008 and 2018. The chi-square test for trend was used to assess yearly changes in the referral numbers, surgical interventions, and procedure indication prevalence proportions of interest.
RESULTS
Referral numbers and frenotomy procedures increased as a percentage of total office visits from 2008 to 2018 (P = 0.0026, P < 0.0001). The trend in frenotomies was especially pronounced in the 0 to 2-month age group (P < 0.0001) but was not observed in the 2 months to 1-year (P = 0.30) or 1- to 4-year (P = 0.40) age groups. Frenotomy performed for concerns of feeding (P < 0.0001) increased over the study period, but there was no significant increase in procedures performed for speech concerns (P = 0.13).
CONCLUSION
Significant increases in referrals for frenotomy and number of frenotomy procedures performed are demonstrated, especially in young infants for feeding concerns. It is unlikely representative of a true increase in the incidence of ankyloglossia, but rather the result of cultural and clinical factors driving referrals and intervention.
Topics: Ankyloglossia; Breast Feeding; Child; Female; Humans; Infant; Infant, Newborn; Lingual Frenum; Outpatients; Retrospective Studies; Speech
PubMed: 33152977
DOI: 10.1016/j.ijporl.2020.110386 -
CoDAS 2021To diagnose ankyloglossia in newborns and compare two lingual frenulum assessment instruments.
PURPOSE
To diagnose ankyloglossia in newborns and compare two lingual frenulum assessment instruments.
METHODS
This cross-sectional study was carried out in Recife, Pernambuco, Brazil, in 2018, with 147 mothers/newborns aged up to 30 days. The Bristol Tongue Assessment Tool and the Lingual Frenulum Evaluation Protocol for Infants were the instruments used. Sociodemographic data were also recorded. The two ankyloglossia diagnostic methods were compared using the McNemar test, obtaining the kappa agreement value and the confidence interval.
RESULTS
Ankyloglossia was present in 4.8% when diagnosed with the Bristol Tongue Assessment Tool, and in 17.0% with the Tongue-Tie Test. Regarding sex, 53.1% of the newborns were males and 46.9% were females; however, there was no association between ankyloglossia and the newborn's sex in either of the assessment methods.
CONCLUSION
The ankyloglossia diagnosis in newborns varied depending on the assessment instrument used.
Topics: Aged; Ankyloglossia; Brazil; Breast Feeding; Cross-Sectional Studies; Female; Humans; Infant; Infant, Newborn; Lingual Frenum; Male; Tongue
PubMed: 33950147
DOI: 10.1590/2317-1782/20202019209 -
The Laryngoscope Dec 2022Assess current frenotomy practice patterns of pediatric otolaryngologists via a cross-sectional survey.
OBJECTIVES
Assess current frenotomy practice patterns of pediatric otolaryngologists via a cross-sectional survey.
STUDY DESIGN
Survey study.
METHODS
A 31-question electronic survey assessing frenotomy practice patterns was distributed to all American Society of Pediatric Otolaryngology (ASPO) members. Descriptive statistics were used to summarize responses and demographics of respondents.
RESULTS
Of all ASPO members, 41% (240/588) completed the survey. Most respondents, 185 (77%), reported increased frenotomy referrals over the last 5 years and 144 (60%) described the current number of referrals as "too many." The two primary lingual frenotomy indications identified in infants were: breastfeeding/nipple pain (92%) and inability to latch (83%). For older children, speech difficulty (87%) was the primary indication. Maxillary frenotomy indications in infants varied amongst respondents. For analgesia during in-office frenotomy procedures, respondents used glucose/sucrose drops (48%), topical lidocaine (29%), or no pain control measure (27%). For post-procedure care, respondents recommended continuing lactation support (45%), massaging/stretching the wound (38%), or none (40%). Most respondents, 143 (60%), reported having seen a complication from frenotomy, and the most reported frenotomy complications were frenulum re-attachment and excessive bleeding.
CONCLUSIONS
In the last 5 years, otolaryngologists have seen an increase in referrals for frenotomy. Pediatric otolaryngologists have varying practice patterns with regards to ankyloglossia diagnosis and treatment. The reported indications for frenotomy varied amongst pediatric otolaryngologists especially with respect to maxillary frenotomy. Practice patterns also varied with respect to procedural pain control and frenotomy aftercare recommendations. More frenotomy research is needed to establish a standard of care for patients with ankyloglossia.
LEVEL OF EVIDENCE
4 Laryngoscope, 132:2505-2512, 2022.
Topics: Infant; Female; Humans; Child; Adolescent; Ankyloglossia; Cross-Sectional Studies; Treatment Outcome; Lingual Frenum; Breast Feeding; Surveys and Questionnaires; Otolaryngology
PubMed: 35319112
DOI: 10.1002/lary.30102 -
American Journal of Speech-language... Jul 2023To deepen our understanding of the effects of ankyloglossia on articulation, the purpose of this study is to examine consonant production and the perceived accuracy of...
PURPOSE
To deepen our understanding of the effects of ankyloglossia on articulation, the purpose of this study is to examine consonant production and the perceived accuracy of Mandarin-speaking children with ankyloglossia.
METHOD
Ten tongue-tie (TT) and 10 typically developing (TD) children produced nine Mandarin sibilants that contrast in three places of articulation. Their speech productions were analyzed from six acoustic measurements. To further examine the perceptual consequences, an auditory transcription task ( = 21) was conducted.
RESULTS
The acoustic analyses discovered that the TT children failed to distinguish the three-way place contrast and produced significant acoustic deviations compared with the TD peers. The perceptual transcription results found that TT children's production was significantly misidentified, suggesting severely affected intelligibility.
CONCLUSIONS
The preliminary findings provide strong support for a correlation between ankyloglossia and distorted speech signals and suggest important interactions between sound errors and linguistic experience. We also propose that ankyloglossia should not be a purely appearance-based diagnosis and that speech production is a crucial index of tongue function in clinical decision making and monitoring.
Topics: Humans; Child; Ankyloglossia; Speech; Acoustics; Linguistics; Clinical Decision-Making; Phonetics
PubMed: 37195693
DOI: 10.1044/2023_AJSLP-22-00231 -
Pediatric Dentistry Jan 2022Ankyloglossia is a congenital anomaly that restricts tongue movements and can interfere in breastfeeding. The purpose of this study was to compare two protocols for...
Ankyloglossia is a congenital anomaly that restricts tongue movements and can interfere in breastfeeding. The purpose of this study was to compare two protocols for ankyloglossia diagnosis: (1) the Neonatal Tongue Screening Test (NTST); and (2) the Bristol Tongue Assessment Tool (BTAT). This was a cohort study involving live births at the University Hospital of Brasilia, Brasilia, Brazil, from August 2017 to July 2018. The gathered data were based on clinical examinations and interviews with mothers. The Stata software program was applied to conduct the analyses using the chi-square test, Spearman's correlation and the receiver operating characteristic (ROC) curve, and sensitivity, specificity, and positive and negative predictive values. A total of 972 mother-baby dyads were evaluated. The protocols showed agreement (P ≤ 0.001) for an ankyloglossia diagnosis, according to Spearman's correlation. The prevalence of ankyloglossia was 5.5 percent (NTST) and 5.1 percent (BTAT) and was greater in the male gender in both protocols. According to the ROC curve, the four cutoff point showed better sensitivity and specificity (98.4 percent and 64.2 percent, respectively). The BTAT was highly accurate in comparison with the NTST. Both protocols showed similar low ankyloglossia prevalence. The Bristol Tongue Assessment Tool protocol is potentially more viable as a screening instrument than the Neonatal Tongue Screening Test protocol because it is simpler and more concise.
Topics: Ankyloglossia; Breast Feeding; Cohort Studies; Female; Humans; Infant; Infant, Newborn; Lingual Frenum; Male; Tongue
PubMed: 35232537
DOI: No ID Found -
Children (Basel, Switzerland) Nov 2022Ankyloglossia is a condition of limited tongue mobility caused by a short lingual frenulum. The diagnosis and treatment of ankyloglossia are still controversial. The...
Ankyloglossia is a condition of limited tongue mobility caused by a short lingual frenulum. The diagnosis and treatment of ankyloglossia are still controversial. The main clinical problems encountered during breastfeeding are difficulty in sucking and its clinical reflections. This study aims to evaluate the infant population born with ankyloglossia and to determine the results of frenotomy. We conducted an observational, cross-sectional study among infants born in a tertiary hospital. We included all infants born between 1 January and 30 June 2022. The neonatal follow-up protocol for ankyloglossia was determined before the defined dates, and data were recorded during the screening period. The recorded data were retrospectively collected from the files. Within six months, 705 infants were born. Due to additional problems and other conditions that prevent breastfeeding, evaluable data of 207 (29.3%) infants could not be provided. Of the remaining 498 infants, 234 (33.2%) had ankyloglossia. While none of the infants without ankyloglossia had a breastfeeding problem after appropriate training, 28.6% of the ankyloglossia group had a breastfeeding problem (p < 0.001). The need for frenotomy differed significantly between Coryllos groups (p < 0.001). Breastfeeding was unsuccessful before frenotomy in 12 Coryllos type-1 patients, and all had difficulty in sucking. Frenotomy was performed within the three-month follow-up period in all patients with complaints of inability to firmly grasp the breast, nipple slipping from the mouth, and nipple biting during the first 24 h. In terms of breastfeeding problems, regardless of the anatomical typology, frenotomy can be performed safely in early life with successful results. If deficiencies or difficulties in breastfeeding are noticed in ankyloglossia patients even at the first control, frenotomy should be recommended in clinical conditions.
PubMed: 36553304
DOI: 10.3390/children9121860