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      • Record: found
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      Breastfeeding improvement following tongue‐tie and lip‐tie release: A prospective cohort study

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          Abstract

          Objectives/Hypothesis

          Numerous symptoms may arise that prevent mother‐infant dyads from maintaining desired breastfeeding intervals. Investigations into treatments that positively influence breastfeeding outcomes allow for improved patient counseling for treatment decisions to optimize breastfeeding quality. This investigation aimed to determine the impact of surgical tongue‐tie/lip‐tie release on breastfeeding impairment.

          Study Design

          Prospective, cohort study from June 2014 to April 2015 in a private practice setting.

          Methods

          Study participants consisted of breastfeeding mother–infant (0–12 weeks of age) dyads with untreated ankyloglossia and/or tethered maxillary labial frenula who completed preoperative, 1 week, and 1 month postoperative surveys consisting of the Breastfeeding Self‐Efficacy Scale‐Short Form (BSES‐SF), visual analog scale (VAS) for nipple pain severity, and the revised Infant Gastroesophageal Reflux Questionnaire (I‐GERQ‐R). Breastmilk intake was measured preoperatively and 1 week postoperatively.

          Results

          A total of 237 dyads were enrolled after self‐electing laser lingual frenotomy and/or maxillary labial frenectomy. Isolated posterior tongue‐tie was identified in 78% of infants. Significant postoperative improvements were reported between mean preoperative scores compared to 1 week and 1 month scores of the BSES‐SF ( F (2) = 212.3; P < .001), the I‐GERQ‐R ( F (2) = 85.3; P < .001), and VAS pain scale ( F (2) = 259.8; P < .001). Average breastmilk intake improved 155% from 3.0 (2.9) to 4.9 (4.5) mL/min ( P < .001).

          Conclusions

          Surgical release of tongue‐tie/lip‐tie results in significant improvement in breastfeeding outcomes. Improvements occur early (1 week postoperatively) and continue to improve through 1 month postoperatively. Improvements were demonstrated in both infants with classic anterior tongue‐tie and less obvious posterior tongue‐tie. This study identifies a previously under‐recognized patient population that may benefit from surgical intervention if abnormal breastfeeding symptoms exist.

          Level of Evidence

          2c Laryngoscope, 127:1217–1223, 2017

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          Most cited references21

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          Why mothers stop breastfeeding: mothers' self-reported reasons for stopping during the first year.

          Jeremy B. Fein, Ruowei Li, L Grummer-Strawn … (2008)
          Our goal was to determine why women stop breastfeeding at various times during their infant's first year. We analyzed self-reported data from 1323 mothers who participated in the Infant Feeding Practice Study II. Mail questionnaires were sent to mothers approximately 2, 3, 4, 5, 6, 7, 9, 10 1/2, and 12 months after their child's birth, in which they were asked to rate the importance of 32 reasons for their decision to stop breastfeeding. We applied exploratory factorial analysis to extract meaningful constructs of mothers' responses to the 32 reasons. We then compared the percentages of mothers who indicated that each reason was important in their decision to stop breastfeeding among various weaning ages and used multiple logistic regression models to examine sociodemographic differences in the most frequently cited reasons for stopping breastfeeding. The perception that their infant was not satisfied by breast milk alone was cited consistently as 1 of the top 3 reasons in the mothers' decision to stop breastfeeding regardless of weaning age (43.5%-55.6%) and was even more frequent among Hispanic mothers and mothers with annual household incomes of or = 9 months of age. Our findings about the major reasons why mothers stop breastfeeding at various times during their child's first year should be useful to health professionals when attempting to help mothers overcome breastfeeding barriers and to health officials attempting to devise targeted breastfeeding interventions on those issues prominent for each infant age.
          Article 0 comments Cited 150 times – based on 0 reviews     Review now
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            The burden of suboptimal breastfeeding in the United States: a pediatric cost analysis.

            Melissa Bartick, A. K. Reinhold (2010)
            A 2001 study revealed that $3.6 billion could be saved if breastfeeding rates were increased to levels of the Healthy People objectives. It studied 3 diseases and totaled direct and indirect costs and cost of premature death. The 2001 study can be updated by using current breastfeeding rates and adding additional diseases analyzed in the 2007 breastfeeding report from the Agency for Healthcare Research and Quality. Using methods similar to those in the 2001 study, we computed current costs and compared them to the projected costs if 80% and 90% of US families could comply with the recommendation to exclusively breastfeed for 6 months. Excluding type 2 diabetes (because of insufficient data), we conducted a cost analysis for all pediatric diseases for which the Agency for Healthcare Research and Quality reported risk ratios that favored breastfeeding: necrotizing enterocolitis, otitis media, gastroenteritis, hospitalization for lower respiratory tract infections, atopic dermatitis, sudden infant death syndrome, childhood asthma, childhood leukemia, type 1 diabetes mellitus, and childhood obesity. We used 2005 Centers for Disease Control and Prevention breastfeeding rates and 2007 dollars. If 90% of US families could comply with medical recommendations to breastfeed exclusively for 6 months, the United States would save $13 billion per year and prevent an excess 911 deaths, nearly all of which would be in infants ($10.5 billion and 741 deaths at 80% compliance). Current US breastfeeding rates are suboptimal and result in significant excess costs and preventable infant deaths. Investment in strategies to promote longer breastfeeding duration and exclusivity may be cost-effective.
            Article 0 comments Cited 141 times – based on 0 reviews     Review now
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              The Breastfeeding Self‐Efficacy Scale: Psychometric Assessment of the Short Form

              Cindy-Lee Dennis (2003)
              Article 0 comments Cited 133 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                Bobak A. Ghaheri: drghaheri@gmail.com
                Journal
                Journal ID (nlm-ta): Laryngoscope
                Journal ID (iso-abbrev): Laryngoscope
                Journal ID (doi): 10.1002/(ISSN)1531-4995
                Journal ID (publisher-id): LARY
                Title: The Laryngoscope
                Publisher: John Wiley and Sons Inc. (Hoboken )
                ISSN (Print): 0023-852X
                ISSN (Electronic): 1531-4995
                Publication date (Electronic): 19 September 2016
                Publication date (Print): May 2017
                Volume: 127
                Issue: 5 ( doiID: 10.1002/lary.v127.5 )
                Pages: 1217-1223
                Affiliations
                [ 1 ] Division of Otolaryngology–Head and Neck Surgery The Oregon Clinic Portland Oregon U.S.A.
                [ 2 ] Luna Lactation Portland Oregon U.S.A.
                [ 3 ] School of Medicine Oregon Health and Science University Portland, Oregon U.S.A.
                [ 4 ] Department of Otolaryngology–Head and Neck Surgery, Division of Rhinology and Skull Base Surgery Oregon Health and Science University Portland Oregon U.S.A.
                Author notes
                [*] [* ]Send correspondence to Bobak A. Ghaheri, MD, The Oregon Clinic, Division of Otolaryngology, 1111 NE 99th Avenue, Suite 101, Portland, OR 97220. E‐mail: drghaheri@ 123456gmail.com
                Article
                Publisher ID: LARY26306
                DOI: 10.1002/lary.26306
                PMC ID: 5516187
                PubMed ID: 27641715
                SO-VID: 4f808736-4706-4b1e-8814-3594c3453dda
                Copyright © Laryngoscope published by Wiley on behalf of the American Laryngological, Rhinological and Otological Society, Inc, “The Triological Society” and American Laryngological Association (the “Owner”).
                License:

                This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

                History
                Date received : 29 March 2016
                Date revision received : 18 July 2016
                Date accepted : 04 August 2016
                Page count
                Figures: 0, Tables: 6, Pages: 7, Words: 4443
                Categories
                Subject: Pediatrics
                Subject: Pediatrics
                Subject: Original Reports
                Custom metadata
                source-schema-version-number 2.0
                component-id lary26306
                cover-date May 2017
                details-of-publishers-convertor Converter:WILEY_ML3GV2_TO_NLMPMC version:5.1.4 mode:remove_FC converted:19.07.2017

                ScienceOpen disciplines: Otolaryngology
                Keywords: breastfeeding,ankyloglossia,patient outcome assessment,outcome assessment (healthcare),visual analog scale,gastroesophageal reflux
                Data availability:
                ScienceOpen disciplines: Otolaryngology
                Keywords: breastfeeding, ankyloglossia, patient outcome assessment, outcome assessment (healthcare), visual analog scale, gastroesophageal reflux

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