School of Nursing & Midwifery, Trinity College Dublin, 24 D'Olier Street, Dublin, D02 T283, Ireland.
BMC Pregnancy Childbirth. 2017 Nov 13;17(1):373. doi: 10.1186/s12884-017-1561-8.
Controversy exists regarding ankyloglossia (tongue-tie) and its clinical impact on breastfeeding, including the benefits, or otherwise, of tongue-tie release (frenotomy). As exclusive breastfeeding rates in Ireland are already considerably low (46% on discharge home from the maternity unit following birth in 2014), it is imperative to protect and support breastfeeding, including identifying the associated effects that frenotomy might have on breastfeeding variables.
To determine the associated effects of frenotomy on breastfeeding variables in infants with ankyloglossia.
A prospective before and after cohort study was conducted. Following ethical approval, two self-reported questionnaires were administered to women whose infants were undergoing frenotomy at seven healthcare clinics in the Republic of Ireland. Data on breastfeeding variables prior to the frenotomy procedure and at 1-month post-frenotomy were collected and compared. Descriptive statistics (frequencies and proportions) were used to analyse, separately, the pre- and post-frenotomy data. Inferential statistics (z-test scores for differences between proportions (alpha <0.05) and mean differences (MD) with 95% confidence intervals (CI)) were used for pre- and post-frenotomy comparative analyses.
Ninety-eight women returned the baseline questionnaire, and, of these, 89 returned the follow-up questionnaire. The most common reason for seeking a frenotomy was difficulty with latch (38%). Private lactation consultants were the main person recommending a frenotomy (31%). Rates of exclusive breastfeeding remained similar pre- and post-frenotomy (58% versus 58%), although rates of formula feeding increased two-fold at follow-up. Infants' ability to extend their tongues to the lower lip after frenotomy was significantly increased (p < 0.0001). Almost all participants (91%) reported an overall improvement in breastfeeding post-frenotomy. Pain on breastfeeding was significantly reduced post-frenotomy (MD 2.90, 95% CI 3.75 to 2.05) and overall LATCH scale scores were significantly increased (MD -0.50, 95% CI -0.67 to -0.33).
This study supports the hypothesis that frenotomy has a positive effect on breastfeeding variables in infants with ankyloglossia. These findings, however, are based on a relatively small number of participants from one country only where breastfeeding rates are low. Further, larger studies are required to substantiate these findings.
关于舌系带（俗称舌筋）及其对母乳喂养的临床影响存在争议，包括舌系带切开术（俗称剪舌筋）的益处或其他影响。由于爱尔兰的纯母乳喂养率已经相当低（2014 年在妇产医院分娩后出院回家时为 46%），因此保护和支持母乳喂养至关重要，包括确定舌系带切开术可能对母乳喂养变量产生的相关影响。
确定舌系带切开术对患有舌系带的婴儿母乳喂养变量的相关影响。
进行了一项前瞻性的前后队列研究。在获得伦理批准后，在爱尔兰共和国的七家医疗保健诊所对接受舌系带切开术的婴儿的母亲进行了两次自我报告的问卷调查。收集并比较了在舌系带切开术之前和之后 1 个月的母乳喂养变量数据。分别使用描述性统计（频率和比例）分析了术前和术后的数据。使用推断统计学（差异比例的 z 检验分数（alpha<0.05）和均值差异（MD）与 95%置信区间（CI））进行了术前和术后的比较分析。
98 位女性返回了基线问卷，其中 89 位女性返回了随访问卷。寻求舌系带切开术的最常见原因是哺乳困难（38%）。私人哺乳顾问是主要推荐舌系带切开术的人（31%）。在舌系带切开术前和术后，纯母乳喂养的比例相似（58%对 58%），尽管在随访时配方奶喂养的比例增加了两倍。舌系带切开术后，婴儿将舌头伸到下唇的能力明显增加（p<0.0001）。几乎所有参与者（91%）报告舌系带切开术后母乳喂养总体得到改善。舌系带切开术后哺乳疼痛明显减轻（MD 2.90，95%CI 3.75 至 2.05），总体 LATCH 评分明显增加（MD-0.50，95%CI-0.67 至-0.33）。
这项研究支持舌系带切开术对患有舌系带的婴儿的母乳喂养变量有积极影响的假设。然而，这些发现仅基于一个国家的相对较少数量的参与者，而且该国家的母乳喂养率较低。此外，需要更大规模的研究来证实这些发现。
