Unraveling the Tongue-Tie Phenomenon
The prevalence of ankyloglossia, commonly known as tongue-tie, has been a topic of increasing interest in the pediatric and breastfeeding communities. This systematic review and meta-analysis dives deep into the associated breastfeeding symptoms and their challenges to both mother and infant.
The Source Article Details
Severity and prevalence of ankyloglossia-associated breastfeeding symptoms: A systematic review and meta-analysis. by Holly Cordray et al. in 2023.
Cited By: 3 (Updated: September 6, 2023)
The Source Article's Abstract
To evaluate breastfeeding symptoms associated with ankyloglossia/tongue-tie.
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.
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.
Ankyloglossia is adversely associated with breastfeeding success and maternal well-being.
The Source Article References
- Trends of ankyloglossia and lingual frenotomy in hospital settings among children in Denmark by Ellehauge E, 2020 in Dan Med J
- Frenotomy for tongue-tie in newborn infants by O'Shea JE, 2017 in Cochrane Database Syst Rev
- Prevalence, diagnosis, and treatment of ankyloglossia: methodologic review by Segal LM, 2007 in Can Fam Physician
- Meta: an R package for meta-analysis by Schwarzer G, 2007 in R News
- The prevalence of ankyloglossia in 302 newborns with breastfeeding problems and sucking difficulties in Barcelona: a descriptive study by Ferrés-Amat E, 2017 in Eur J Paediatr Dent
- Short lingual frenum in infants, children and adolescents. Part 1: breastfeeding and gastroesophageal reflux disease improvement after tethered oral tissues release by Hand P, 2020 in Eur J Paediatr Dent
- Does ankyloglossia interfere with breastfeeding in newborns? A cross-sectional study by Souza-Oliveira AC, 2021 in J Clin Transl Res
- Ankyloglossia (tongue-tie): a diagnostic and treatment quandary by Kotlow LA, 1999 in Quintessence Int
Citing the Source Article (APA)
Cordray, H., Mahendran, G.N., Tey, C.S., Nemeth, J., Sutcliffe, A., Ingram, J., Raol, N. (2023). Severity and prevalence of ankyloglossia-associated breastfeeding symptoms: A systematic review and meta-analysis.. Acta Paediatr, 112(3), 347-357. 10.1111/apa.16609
The Methodical Approach
With a comprehensive search strategy encompassing databases like PubMed, Embase, and Google Scholar, the study aimed to understand the baseline breastfeeding symptoms of tongue-tied infants. The rigorous methodology ensured that only high-quality studies were considered, providing a robust foundation for the conclusions drawn.
- The mean LATCH score for patients with untreated ankyloglossia was significantly below the threshold for good breastfeeding.
- Notable symptoms included gastroesophageal reflux disease, significant risk of cessation of exclusive breastfeeding within the first few months, and heightened nipple pain.
- A staggering 49.3% prevalence of breastfeeding difficulties was observed, with early, undesired weaning occurring in 20.3% of cases before any intervention.
Implications for the Medical Community
These findings underscore the critical need for early detection and intervention in cases of ankyloglossia. The adverse effects on breastfeeding success and maternal well-being cannot be understated. It calls for a multi-disciplinary approach involving pediatricians, lactation consultants, and otolaryngologists to ensure optimal outcomes for both mother and child.
What are the broader implications of these findings for breastfeeding mothers worldwide? How can the medical community better support them? Share your insights and experiences below.