Abstract
Key notes
The relationship between ankyloglossia and breastfeeding difficulties is highly controversial, leading to inconsistent referrals for surgical treatment.
This systematic review and meta-analysis showed that paediatric ankyloglossia is typically associated with suboptimal breastfeeding, infant gastroesophageal reflux, low maternal breastfeeding self-efficacy, and moderately intense nipple pain; approximately half of mother-infant dyads in this population experienced breastfeeding difficulties.
Ankyloglossia is a significant condition, and associated symptoms may deter mothers from practicing exclusive breastfeeding.
Abstract
Aim
To evaluate breastfeeding symptoms associated with ankyloglossia/tongue-tie.
Methods
Databases included PubMed, Embase, CINAHL, PsycINFO, Web of Science, and Google Scholar. Eligible studies reported baseline breastfeeding symptoms/severity from tongue-tied infants. Two reviewers independently screened studies, extracted data, and assessed quality. Low-quality studies were excluded. Main outcomes were weighted mean severity scores for dyads with ankyloglossia relative to reference values for successful breastfeeding. Meta-analyses used inverse-variance-weighted random-effects models.
Results
Of 1328 screened studies, 39 were included (5730 infants with ankyloglossia). The mean LATCH score for patients with untreated ankyloglossia, 7.1 (95% CI: 6.7–7.4), was significantly below the good-breastfeeding threshold. The mean Infant Breastfeeding Assessment Tool score, 10.0 (8.2–11.7), was not significantly below the good-breastfeeding threshold. The mean Infant-Gastroesophageal Reflux Questionnaire-Revised score, 18.2 (10.5–26.0), was consistent with gastroesophageal reflux disease. The mean Breastfeeding Self-Efficacy Scale-Short Form score, 43.7 (39.3–48.1), indicated significant risk of cessation of exclusive breastfeeding within 1–3 months. Mean nipple pain was 4.9 (4.1–5.7) on a 0–10 scale, greater than typical scores for breastfeeding mothers without nipple damage. Total prevalence of breastfeeding difficulties was 49.3% (95% CI: 47.3–51.4%). Early, undesired weaning occurred in 20.3% (18.5–22.2%) of cases before intervention.
Conclusion
Ankyloglossia is adversely associated with breastfeeding success and maternal well-being.
The relationship between ankyloglossia and breastfeeding difficulties is highly controversial, leading to inconsistent referrals for surgical treatment.
This systematic review and meta-analysis showed that paediatric ankyloglossia is typically associated with suboptimal breastfeeding, infant gastroesophageal reflux, low maternal breastfeeding self-efficacy, and moderately intense nipple pain; approximately half of mother-infant dyads in this population experienced breastfeeding difficulties.
Ankyloglossia is a significant condition, and associated symptoms may deter mothers from practicing exclusive breastfeeding.
Abstract
Aim
To evaluate breastfeeding symptoms associated with ankyloglossia/tongue-tie.
Methods
Databases included PubMed, Embase, CINAHL, PsycINFO, Web of Science, and Google Scholar. Eligible studies reported baseline breastfeeding symptoms/severity from tongue-tied infants. Two reviewers independently screened studies, extracted data, and assessed quality. Low-quality studies were excluded. Main outcomes were weighted mean severity scores for dyads with ankyloglossia relative to reference values for successful breastfeeding. Meta-analyses used inverse-variance-weighted random-effects models.
Results
Of 1328 screened studies, 39 were included (5730 infants with ankyloglossia). The mean LATCH score for patients with untreated ankyloglossia, 7.1 (95% CI: 6.7–7.4), was significantly below the good-breastfeeding threshold. The mean Infant Breastfeeding Assessment Tool score, 10.0 (8.2–11.7), was not significantly below the good-breastfeeding threshold. The mean Infant-Gastroesophageal Reflux Questionnaire-Revised score, 18.2 (10.5–26.0), was consistent with gastroesophageal reflux disease. The mean Breastfeeding Self-Efficacy Scale-Short Form score, 43.7 (39.3–48.1), indicated significant risk of cessation of exclusive breastfeeding within 1–3 months. Mean nipple pain was 4.9 (4.1–5.7) on a 0–10 scale, greater than typical scores for breastfeeding mothers without nipple damage. Total prevalence of breastfeeding difficulties was 49.3% (95% CI: 47.3–51.4%). Early, undesired weaning occurred in 20.3% (18.5–22.2%) of cases before intervention.
Conclusion
Ankyloglossia is adversely associated with breastfeeding success and maternal well-being.
| Original language | English |
|---|---|
| Number of pages | 11 |
| Journal | Acta Paediatrica, International Journal of Paediatrics |
| DOIs | |
| Publication status | Published - 27 Nov 2022 |
Bibliographical note
Funding Information:This work benefitted from a science infrastructure grant provided by the Marcus Foundation. The authors have no conflicts of interest to disclose.
Publisher Copyright:
© 2022 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.