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Using the electronic baby bottle to support tongue-tie diagnosis in infants: a prospective study
Lene Dahl Siggard1, Dorte Rytter2, Torben Lildholdt3
1Department of Otorhinolaryngology, Head & Neck Surgery, and Audiology, Aalborg University Hospital, Aalborg, Denmark.
Insights
The electronic baby bottle (EBB) shows promise for assessing infant feeding issues like tongue-tie. While subjective utility was high, objective signal analysis is needed for accurate diagnosis and clinical use.
Area of Science:
- Pediatric Otolaryngology
- Infant Feeding Dynamics
- Biomedical Engineering
Background:
- Diagnosing tongue-tie (ankyloglossia) in infants is challenging due to a lack of objective diagnostic criteria.
- Tongue-tie can significantly interfere with successful infant breastfeeding and bottle-feeding.
- Novel technologies are needed to objectively assess infant suckling mechanics.
Purpose of the Study:
- To evaluate the clinical utility and diagnostic value of the electronic baby bottle (EBB) in infants.
- To assess the EBB's ability to record intraoral forces during suckling.
- To compare EBB findings with clinical assessments and outcomes after frenotomy.
Main Methods:
- A prospective cohort study involving 106 infants under 3 months across four ENT clinics.
- Infants were assessed using the EBB and the Tonguewise Assessment of Buccal-Tongue tie in Infants (TABBY) scoring system.
- Eighty-five infants underwent frenotomy, with 21 serving as controls.
Main Results:
- The EBB demonstrated high diagnostic value scores, with no significant change observed post-frenotomy.
- TABBY scores significantly improved after frenotomy, confirming anatomical changes.
- Frenotomy led to significant improvements in caregiver-reported feeding symptoms.
Conclusions:
- The EBB is rated subjectively useful by clinicians but requires automated signal analysis for objective diagnostic potential.
- Current subjective interpretation of EBB data is insufficient for standalone diagnosis.
- Further validation is necessary before recommending the EBB for routine clinical adoption.
Background:
Tongue-tie may interfere with infant feeding, but diagnosis remains challenging due to lack of objective criteria.
Aims/Objectives:
To evaluate the clinical utility of the electronic baby bottle (EBB), a novel device recording intraoral forces during suckling.
Material And Methods:
A prospective cohort study across four ENT clinics included 106 infants under 3 months, assessed at baseline and 1-week follow-up. ENT specialists rated the EBB's diagnostic value; tongue anatomy and mobility were screened using the TABBY scoring system. Eighty-five infants underwent frenotomy; 21 not meeting diagnostic criteria served as controls.
Results:
The EBB received high diagnostic value scores in both groups, with no significant change following frenotomy. TABBY scores improved significantly post-operatively (mean difference 3.87 (95% CI 3.4-4.3), p < 0.001), consistent with expected anatomical changes. Infant cooperation was positively associated with device utility (p < 0.001). Frenotomy was associated with significant improvements in caregiver-reported symptoms, including latch quality, breast pain, and feeding duration.
Conclusions And Significance:
ENT specialists rated the EBB as subjectively useful, but no signal-level change was detected following frenotomy using clinician-based rating. Subjective interpretation of EBB readouts is insufficient as a standalone diagnostic approach; automated signal analysis on biomechanical responsiveness is required to realise the device's diagnostic potential. Further prospective validation is needed before clinical adoption can be recommended.
