Ankyloglossia, Breastfeeding, and Infant Weight Gain: A Mixed-Methods Study

Area of Science:

• Pediatrics
• Lactation Science
• Neonatal Care

Background:

• Ankyloglossia, or tongue-tie, is often cited as a cause of breastfeeding difficulties and early cessation of exclusive breastfeeding (EBF).
• Despite increased frenotomy rates, EBF rates have not risen, questioning ankyloglossia's primary role in breastfeeding challenges.
• This study investigates the specific contribution of untreated ankyloglossia to the early cessation of EBF.

Purpose of the Study:

• To determine the impact of untreated ankyloglossia on exclusive breastfeeding (EBF) duration.
• To assess the effect of ankyloglossia on infant weight gain velocity.
• To identify factors contributing to early breastfeeding cessation in mother-infant dyads.

Main Methods:

• A sequential explanatory mixed-methods study was conducted with 476 mother-infant dyads within 48 hours of birth.
• Infants were assessed for ankyloglossia (tongue-tie), and breastfeeding difficulties were evaluated.
• Exclusive breastfeeding (EBF) rates and infant weight gain were compared between infants with and without ankyloglossia, supplemented by qualitative interviews.

Main Results:

• No significant difference was observed in EBF rates at 6 months (81.4% No-TT vs. 78.6% TT) or infant weight gain velocity.
• Maternal concern regarding inadequate milk supply was linked to lower EBF odds (OR 0.22).
• Early breastfeeding cessation was rarely attributed to infant sucking skills or nipple pain in either group.

Conclusions:

• Ankyloglossia alone does not appear to significantly affect breastfeeding maintenance or infant weight gain.
• Breastfeeding outcomes can be improved by addressing all potential contributing factors through multidisciplinary management, rather than focusing exclusively on ankyloglossia.
• Maternal perception of insufficient milk supply is a critical factor influencing breastfeeding cessation.