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Published on: February 5, 2019
Randomized, controlled trial of division of tongue-tie in infants with feeding problems
Monica Hogan1, Carolyn Westcott, Mervyn Griffiths
1Princess Anne Hospital and General Hospital, Southampton, UK.
Insights
Immediate division of tongue-tie significantly improved infant feeding compared to lactation consultant support. This safe and successful intervention addresses feeding difficulties in infants with tongue-tie, benefiting both mother and baby.
Area of Science:
- Pediatric Medicine
- Surgical Interventions
- Lactation Support
Background:
- Tongue-tie (ankyloglossia) can cause feeding problems in infants.
- Current management often involves lactation consultant support.
- The efficacy of immediate surgical division versus conservative management is debated.
Purpose of the Study:
- To compare the effectiveness of immediate tongue-tie division versus lactation consultant support for infant feeding problems.
- To determine which intervention leads to normal feeding in infants with tongue-tie.
Main Methods:
- A randomized controlled trial was conducted with infants diagnosed with tongue-tie and feeding problems.
- Infants were randomized to either 48 hours of intensive lactation consultant support or immediate surgical division.
- Feeding outcomes were assessed post-intervention.
Main Results:
- Immediate division resulted in significant improvement in feeding for 96% of infants, with 95% feeding normally overall.
- Only 3% of infants receiving lactation consultant support improved without subsequent division.
- Division was found to be safe and significantly improved feeding outcomes.
Conclusions:
- Surgical division of tongue-tie is a safe and highly effective treatment for infant feeding problems.
- Division significantly outperforms intensive lactation consultant support in resolving feeding issues.
- This intervention offers substantial benefits for both infants and mothers experiencing feeding difficulties due to tongue-tie.
Objective:
To determine whether, in infants with a tongue-tie and a feeding problem, the current medical treatment (referral to a lactation consultant) or immediate division works best and enables the infants to feed normally.
Methods:
Between March and July 2002, all the babies in the district of Southampton with tongue-ties were followed in order to see if they had any feeding problems. If they developed problems, the mothers gave written consent and were enrolled in an ethics committee approved, randomized, controlled trial, comparing 48 h of intensive lactation consultant support (control) with immediate division.
Results:
A total of 201 babies had tongue-tie, of whom 88 had breast-feeding or bottle-feeding problems. Thirty-one were not enrolled, so 57 were randomized. Of the 29 controls, one improved (3%) and breast-fed for 8 months, but 28 did not. At 48 h, these 28 were offered division, which all accepted, and 27 improved (96%) and fed normally. Of the 28 babies who had immediate division, 27 improved and fed normally but one remained on a nipple shield (P < 0.001). Twenty-four mothers breast-fed for 4 months (24/40, 60%). Overall, division of the tongue-tie babies resulted in improved feeding in 54/57 (95%) babies.
Conclusions:
This randomized, controlled trial has clearly shown that tongue-ties can affect feeding and that division is safe, successful and improved feeding for mother and baby significantly better than the intensive skilled support of a lactation consultant.
