Department of Obstetrics & Gynecology and Women's Health, Montefiore Medical Center, The University Hospital of Albert Einstein College of Medicine, Bronx, NY, USA.
Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
Acta Paediatr. 2022 May;111(5):940-947. doi: 10.1111/apa.16289. Epub 2022 Feb 21.
Tongue tie is a common problem affecting breastfeeding due to poor infant latch and/or maternal pain. Evidence of whether treatment improves breastfeeding outcomes is conflicting. We conducted a systematic review and meta-analysis to examine the effectiveness of tongue-tie treatment on breastfeeding difficulties.
We searched peer-reviewed and grey literature in MEDLINE (OVID), PubMed, CINAHL Plus, EMBASE and PsycINFO, from 01/1970 to 09/2019.
randomised and non-randomised clinical trials, and quasi-experimental study designs, involving breastfeeding interventions for full-term singleton infants, using standardised measure of breastfeeding difficulty.
qualitative and purely observational studies, lacked operational definition of breastfeeding difficulty, lacked control/comparison group. We assessed risk of bias, summarised study quality and results and conducted meta-analysis using random effects modelling.
Six studies on tongue-tie division were included (4 randomised and 2 non-randomised). Meta-analysis of standardised mean differences in breastfeeding difficulty scores in four studies showed statistically significant differences in favour of frenotomy (Pooled SMD +2.12, CI:(0.17-4.08)p = 0.03). Similarly, a statistically significant difference in favour of frenotomy was observed for pain (Pooled SMD -1.68, 95% CI: (-2.87- -0.48).
Results support that infant frenotomy is effective for improving standardised scores on breastfeeding difficulty and maternal pain scales and could improve breastfeeding outcomes.
舌系带过紧是一种常见的问题，会影响母乳喂养，因为婴儿的衔乳不良和/或母亲疼痛。关于治疗是否能改善母乳喂养结果的证据存在争议。我们进行了一项系统评价和荟萃分析，以检查舌系带治疗对母乳喂养困难的有效性。
我们在 MEDLINE（OVID）、PubMed、CINAHL Plus、EMBASE 和 PsycINFO 中检索了同行评审和灰色文献，检索时间为 1970 年 1 月至 2019 年 9 月。
随机和非随机临床试验，以及准实验研究设计，涉及母乳喂养干预措施，对象为足月单胎婴儿，使用标准化的母乳喂养困难测量方法。
定性和纯粹观察性研究，缺乏母乳喂养困难的操作性定义，缺乏对照/比较组。我们评估了偏倚风险，总结了研究质量和结果，并使用随机效应模型进行荟萃分析。
纳入了 6 项关于舌系带切开术的研究（4 项随机研究和 2 项非随机研究）。四项研究中母乳喂养困难评分的标准化均数差的荟萃分析显示，切开术组具有统计学意义的优势（汇总 SMD +2.12，CI：(0.17-4.08)，p = 0.03）。同样，切开术组在疼痛方面也观察到具有统计学意义的优势（汇总 SMD -1.68，95% CI：(-2.87- -0.48)）。
结果支持婴儿舌系带切开术在改善母乳喂养困难和母亲疼痛评分的标准化评分方面是有效的，并且可以改善母乳喂养结果。
