Children's Healthcare of Atlanta, Atlanta, Georgia, USA.
Department of Otolaryngology-Head and Neck Surgery, Emory University School of Medicine, Atlanta, Georgia, USA.
Acta Paediatr. 2023 Mar;112(3):347-357. doi: 10.1111/apa.16609. Epub 2022 Dec 9.
To evaluate breastfeeding symptoms associated with ankyloglossia/tongue-tie.
Databases included PubMed, Embase, CINAHL, PsycINFO, Web of Science, and Google Scholar. Eligible studies reported baseline breastfeeding symptoms/severity from tongue-tied infants. Two reviewers independently screened studies, extracted data, and assessed quality. Low-quality studies were excluded. Main outcomes were weighted mean severity scores for dyads with ankyloglossia relative to reference values for successful breastfeeding. Meta-analyses used inverse-variance-weighted random-effects models.
Of 1328 screened studies, 39 were included (5730 infants with ankyloglossia). The mean LATCH score for patients with untreated ankyloglossia, 7.1 (95% CI: 6.7-7.4), was significantly below the good-breastfeeding threshold. The mean Infant Breastfeeding Assessment Tool score, 10.0 (8.2-11.7), was not significantly below the good-breastfeeding threshold. The mean Infant-Gastroesophageal Reflux Questionnaire-Revised score, 18.2 (10.5-26.0), was consistent with gastroesophageal reflux disease. The mean Breastfeeding Self-Efficacy Scale-Short Form score, 43.7 (39.3-48.1), indicated significant risk of cessation of exclusive breastfeeding within 1-3 months. Mean nipple pain was 4.9 (4.1-5.7) on a 0-10 scale, greater than typical scores for breastfeeding mothers without nipple damage. Total prevalence of breastfeeding difficulties was 49.3% (95% CI: 47.3-51.4%). Early, undesired weaning occurred in 20.3% (18.5-22.2%) of cases before intervention.
Ankyloglossia is adversely associated with breastfeeding success and maternal well-being.
评估与舌系带过紧/舌系带短相关的母乳喂养症状。
数据库包括 PubMed、Embase、CINAHL、PsycINFO、Web of Science 和 Google Scholar。合格的研究报告了舌系带过紧婴儿的基线母乳喂养症状/严重程度。两位审查员独立筛选研究、提取数据并评估质量。低质量的研究被排除在外。主要结局是舌系带过紧的母婴对成功母乳喂养的参考值的加权平均严重程度评分。Meta 分析采用逆方差加权随机效应模型。
在筛选出的 1328 项研究中，有 39 项研究符合纳入标准（5730 例患有舌系带过紧的婴儿）。未经治疗的舌系带过紧患者的 LATCH 评分平均值为 7.1（95%CI：6.7-7.4），明显低于良好母乳喂养的阈值。婴儿母乳喂养评估工具评分的平均值为 10.0（8.2-11.7），并不显著低于良好母乳喂养的阈值。婴儿胃食管反流问卷修订版评分的平均值为 18.2（10.5-26.0），与胃食管反流病一致。母乳喂养自我效能量表-短式评分的平均值为 43.7（39.3-48.1），表明在 1-3 个月内停止纯母乳喂养的风险显著增加。0-10 分制的乳头疼痛平均值为 4.9（4.1-5.7），高于无乳头损伤的母乳喂养母亲的典型得分。母乳喂养困难的总发生率为 49.3%（95%CI：47.3-51.4%）。在干预前，20.3%（18.5-22.2%）的病例出现过早、非意愿性断奶。
舌系带过紧与母乳喂养的成功和母亲的健康状况呈负相关。
