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Κυριακή 13 Δεκεμβρίου 2020

Effect of frenotomy on breastfeeding and reflux: results from the BRIEF prospective longitudinal cohort study

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Abstract

Objectives

To assess the Efficacy of Frenotomy with regard to Breastfeeding and Reflux Improvement (BRIEF) in infants with breastfeeding problems.

Materials and methods

A cohort of 175 consecutive breastfeeding women with breastfeeding and reflux problems related to a tongue-tie or lip-tie fulfilling the inclusion criteria was longitudinally followed for 6 months. The effect of frenotomy on these problems was studied by a standardized oral assessment and completing the validated Breastfeeding Self-Efficacy Short Form (BSES-SF), nipple pain score (Visual Analogue Scale, VAS), and Infant Gastroesophageal Reflux Questionnaire Revised (I-GERQ-R) questionnaires pre-frenotomy and at 1 week, 1 month, and 6 months' post frenotomy.

Results

All 175 women completed the 1-month follow-up and 146 women the 6 months' follow-up. Frenotomy resulted in a significant improvement of BSES-SF, nipple pain score, and I-GERQ-R after 1 week, which improvement maintained to be significant after 1 month for BSES-SF and I-GERQ-R, and after 6 months for I-GERQ-R. The improvements were irrespective of the type lip-tie or tongue-tie underlying the breast feeding and reflux problems. No post-operative complications were observed. About 60.7% of infants still was breastfed 6 months after treatment.

Conclusions

Frenotomy is a safe procedure with no post-operative complications and resulting in significant improvement of breastfeeding self-efficacy, nipple pain, and gastro-oesophageal reflux problems.

Clinical relevance

Frenotomy of a tongue-tie and or lip-tie can lead to improvement of breastfeeding and reflux problems irrespective of the type of tongue-tie or lip-tie and should be considered by clinicians as a proper tool to resolve these problems if non-interventional support did not help.

International trial register

ISRCTN64428423

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