Frenotomy Revision Rate in Breastfeeding Infants: The Impact of Early Versus Late Follow-Up

The protocol for postoperative follow-up time after lingual frenotomy in breastfeeding infants with ankyloglossia was changed from 2 weeks to 1 week at our institution. This study examined the impact of this change in practice on frenotomy revision rate. A retrospective chart review of breastfeeding infants who underwent lingual frenotomy for ankyloglossia from January 2016 to December 2017 was performed. Subjects were divided into 1-week (1-9 days) and 2-week (10-20 days) follow-up groups. Statistical analyses were performed to investigate the relationship between revision rate and postoperative follow-up time, as well as additional patient characteristics. Of the 369 patients included in the study, 34 (9.2%) underwent frenotomy revision. The individual revision rates of the 1- and 2-week follow-up cohorts were 5.2% and 12.7%, respectively. The difference in revision rate was statistically significant (p = 0.022), and logistic regression revealed the odds of revision for the 2-week cohort to be 2.67 times (95% confidence interval: 1.207-5.918) greater than the 1-week cohort (p = 0.015). This study demonstrates a significant association between a shorter postoperative follow-up time and decreased frenotomy revision rate. With earlier follow-up, manual adjustment can be performed sooner in the postoperative period as needed, which may prevent scarring or healing complications that usually necessitate full revision. Our findings support a shift to a shorter postoperative follow-up time as a means of improving frenotomy outcomes.