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A comparison between an early- and a late frenulotomy for neonates with problematic tongue-tie
Junsujee Wakhanrittee1, Jiraporn Khorana2,3,4, Siriphut Kiatipunsodsai5
1Division of Pediatric Surgery, Department of Surgery, Faculty of Medicine, Thammasat University, Pathumthani, Bangkok, 12120, Thailand.
Purpose:
To compare breastfeeding outcomes between early and late frenulotomy in infants with problematic tongue-tie to determine optimal intervention timing.
Methods:
Conducted over two years at Thammasat University Hospital, this prospective cohort study divided mother-infant pairs into an early group (n = 103; <72 h postpartum) and a late group (n = 123; 7-14 days postpartum). Primary outcomes focused on exclusive breastfeeding (EBF) success at three months of age, while secondary outcomes measured LATCH scores improvement, pain reduction, and weight regain.
Results:
Both groups showed significant postoperative improvements. Median LATCH scores increased from 5 to 6 to 9, and latching pain decreased significantly within one week. However, the early group demonstrated a significantly higher EBF rate at three months (78.64% vs. 66.67%). Using inverse probability of treatment weighting (IPTW), early frenulotomy was associated with a higher likelihood of EBF success (RR = 1.60; p < 0.001) and superior pain reduction (RR = 1.33). No significant differences were observed in weight regain or LATCH score between groups.
Conclusion:
For infants with symptomatic tongue-tie, performing a frenulotomy within 72 h of birth provides greater benefits in terms of EBF success and latching pain reduction compared to delayed intervention, suggesting early correction is the preferred clinical approach.
