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Revision Lingual Frenotomy Improves Patient-Reported Breastfeeding Outcomes: A Prospective Cohort Study.
Bobak A Ghaheri1, Melissa Cole2, Jess C Mace3
11 Division of Otolaryngology/Head and Neck Surgery, The Oregon Clinic, Portland, OR, USA.
Summary
Incomplete lingual frenotomy can cause ongoing breastfeeding issues. Full release of the tethered lingual frenulum significantly improves infant reflux, nipple pain, and maternal breastfeeding self-efficacy.
Area of Science:
- Lactation and infant feeding
- Pediatric surgery
- Speech and language pathology
Background:
- Lingual frenotomy is a procedure to release a restrictive lingual frenulum.
- While often successful, some infants continue to experience breastfeeding difficulties post-procedure.
- Persistent issues may stem from incomplete release of the tethered lingual frenulum.
Purpose of the Study:
- To investigate the impact of incomplete lingual frenulum release on breastfeeding.
- To determine if further intervention improves breastfeeding outcomes.
- To identify patient populations that may benefit from re-evaluation of tongue function.
Main Methods:
- A prospective cohort study involving 54 mother-infant dyads.
- Participants underwent repeat lingual frenotomy and/or maxillary labial frenectomy.
- Surveys assessing breastfeeding self-efficacy (BSES-SF), nipple pain (VAS), and infant reflux (I-GERQ-R) were administered preoperatively and at 1 week and 1 month postoperatively.
Main Results:
- Significant improvements were observed in BSES-SF, I-GERQ-R, and VAS pain scores at 1 week and 1 month postoperatively compared to preoperative scores.
- Statistical significance was achieved for all measured outcomes (p < .001).
- These findings indicate a positive response to the repeat frenotomy procedure.
Conclusions:
- Full release of the lingual frenulum can improve infant reflux, nipple pain, and maternal breastfeeding confidence.
- Repeat frenotomy is beneficial for dyads experiencing persistent breastfeeding difficulties after initial procedures.
- Increased scrutiny of infant tongue function is recommended when initial frenotomy is unsuccessful.
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