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Published on: February 5, 2019
Ankyloglossia and Breastfeeding Duration: A Multicenter Birth Cohort Study
Carlos Alberto Feldens1, Amanda Baptista da Silva Heck2, Priscila Humbert Rodrigues1,2
1Department of Pediatric Dentistry, School of Dentistry, Universidade Luterana do Brasil, Porto Alegre, Brazil.
Insights
Ankyloglossia (tongue-tie) prevalence in infants is low, with defined cases at 1%. This condition showed no significant association with breastfeeding duration in a Brazilian study, questioning routine interventions.
Area of Science:
- Pediatrics
- Lactation Studies
- Oral Health
Background:
- Ankyloglossia, commonly known as tongue-tie, is a condition that may affect infant feeding.
- Concerns exist regarding the potential overdiagnosis and overtreatment of ankyloglossia, particularly in newborns.
- The actual prevalence and impact on breastfeeding require further investigation.
Purpose of the Study:
- To determine the prevalence of ankyloglossia in Brazilian infants during their first year of life.
- To examine the relationship between ankyloglossia and the duration of exclusive and total breastfeeding.
- To provide evidence regarding the necessity of interventions for ankyloglossia.
Main Methods:
- A multicenter prospective cohort study involving 293 mother-infant pairs in Brazil.
- Data collected via maternal interviews (sociodemographics, breastfeeding duration) and infant dental examinations at 12 months using the Bristol Tongue Assessment Tool.
- Statistical analysis employed Poisson regression to calculate relative risks.
Main Results:
- The prevalence of defined ankyloglossia was 1%, and defined/suspected ankyloglossia was 5.8%.
- No statistically significant differences were observed in exclusive or total breastfeeding duration at 1, 4, or 6 months between infants with and without ankyloglossia.
- Multivariable analysis indicated no difference in the likelihood of achieving 6 months of breastfeeding (RR=0.98).
Conclusions:
- The prevalence of defined ankyloglossia in this cohort was notably low.
- Defined or suspected ankyloglossia was not found to be associated with shorter exclusive or total breastfeeding durations.
- Findings suggest that the impact of ankyloglossia on breastfeeding may be overestimated, potentially reducing unnecessary interventions.
Abstract:
The prevalence of ankyloglossia and its impact on breastfeeding practices may be overestimated, leading to surgical overtreatment in newborns. The study was conducted to estimate the prevalence of ankyloglossia in the first year of life and investigate the association with exclusive and total breastfeeding duration in different regions of Brazil. This multicenter prospective cohort study involved the recruitment of mother-infant pairs soon after childbirth in public hospitals in three state capitals in Brazil. Interviews were held with the mothers after birth, at 6 and 12 months to collect sociodemographic variables and data on exclusive and total breastfeeding duration. At 12 months of age, the children were submitted to a dental examination for classification of the lingual frenulum using the Bristol Tongue Assessment Tool. Data analysis involved Poisson regression with robust variance, with the calculation of unadjusted and adjusted relative risk (RR). The final sample was composed of 293 children. The prevalence of defined and suspected ankyloglossia was 1% and 4.8%, respectively, totaling 5.8% (confidence interval [95% CI]: 3.1-8.5). No significant difference was found in the prevalence of exclusive and total breastfeeding at 1, 4, and 6 months between children with defined/suspected ankyloglossia and those without ankyloglossia. The multivariable analysis showed that the probability of the child achieving 6 months of breastfeeding did not differ between groups (RR = 0.98; 95% CI: 0.79-1.23; p = 0.907). The prevalence of defined ankyloglossia was very low and defined/suspected ankyloglossia was not associated with exclusive or total breastfeeding duration. Registered with clinicaltrials.gov (n° NCT03841123).
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