Qualité de l'allaitement chez le nourrisson diagnostiqué avec une ankyloglossie suite à une frénotomie linguale
Objectives. To assess breastfeeding efficacy and mother’s nipple pain over time after lingual frenotomy in infants diagnosed with ankyloglossia. The secondary objective is to assess the impact of timing of the procedure and type of frenum on the outcomes. Methods. Healthy infants under 3 months of age diagnosed with ankyloglossia and difficult breastfeeding were recruited for this cohort study at the Montreal Children’s Hospital. Age of infant and type of ankyloglossia according to Coryllos classification were noted and frenotomy was done if indicated. Breasfeeding efficacy using the Infant Breastfeeding Assessment Tool (IBAT) and nipple pain using Numerical Pain Rating Scale (NRS) were recorded at baseline, 7 days and 1 month post-frenotomy. A 6-month telephone follow-up was used to assess length of breastfeeding.  Results. Seventy infants diagnosed with ankyloglossia were included in this study and received a frenotomy. Sixty-one percent were males and the average age at time of the frenotomy was 17 days.  Ankyloglossia of type 2 (41%) was the most common, followed by type 3 (38%), type 1 (17%) and type 4 (4%). In all types, IBAT and NRS scores improved significantly between baseline and 7 days (p<.001) and between 7 days and 1 month (p<.001). Fifty-five percent of infants were 14 days or less. Infant age at the time of frenotomy and frenum type were not significantly correlated to breastfeeding scores or pain rating. Conclusions. A significant improvement of IBAT and mothers's NRS in infants presenting with ankyloglossia and breastfeeding difficulties were observed after frenotomy, regardless of the timing of the procedure and type of frenum. Ankyloglossia should always be examined in infants with breastfeeding difficulties, and frenotomy may be considered by healthcare providers.  Keywords : Tongue-tie, ankyloglossia, frenotomy, frenuloplasty, breastfeeding problem
Tongue-tie Ankyloglossia Frenotomy Frenuloplasty Breastfeeding problem