Quantitative impact of frenotomy on breastfeeding: a systematic review and meta-analysis.
Pediatr Res
; 95(1): 34-42, 2024 Jan.
Article
em En
| MEDLINE
| ID: mdl-37608056
ABSTRACT
BACKGROUND:
Symptoms related to infant ankyloglossia/tongue-tie may deter mothers from breastfeeding, yet frenotomy is controversial.METHODS:
Databases included PubMed, Embase, CINAHL, PsycINFO, Web of Science, and Google Scholar from 1961-2023. Controlled trials and cohort studies with validated measures of surgical efficacy for breastfeeding outcomes were eligible. Meta-analyses synthesized data with inverse-variance weighting to determine standardized mean differences (SMD) between pre-/postoperative scores.RESULTS:
Twenty-one of 1568 screened studies were included. Breastfeeding self-efficacy improved significantly post-frenotomy medium effect after 5-10 days (SMD 0.60 [95% CI 0.48, 0.71; P < 0.001]), large effect after 1 month (SMD 0.91 [CI 0.79, 1.04; P < 0.001]). Nipple pain decreased significantly post-frenotomy large effect after 5-15 days (SMD -1.10 [CI -1.49, -0.70; P < 0.001]) and 1 month (SMD -1.23 [CI -1.79, -0.67; P = 0.002]). Frenotomy had a medium effect on infant gastroesophageal reflux severity at 1-week follow-up (SMD -0.63 [CI -0.95, -0.31; P = 0.008]), with continued improvement at 1 month (SMD -0.41 [CI -0.78, -0.05; P = 0.04]). From LATCH scores, breastfeeding quality improved after 5-7 days by a large SMD of 1.28 (CI 0.56, 2.00; P = 0.01).CONCLUSIONS:
Providers should offer frenotomy to improve outcomes in dyads with ankyloglossia-associated breastfeeding difficulties. PROTOCOL REGISTRATION PROSPERO identifier CRD42022303838 . IMPACT This systematic review and meta-analysis showed that breastfeeding self-efficacy, maternal pain, infant latch, and infant gastroesophageal reflux significantly improve after frenotomy in mother-infant dyads with breastfeeding difficulties and ankyloglossia. Providers should offer frenotomy to improve breastfeeding outcomes in symptomatic mother-infant dyads who face challenges associated with ankyloglossia.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Refluxo Gastroesofágico
/
Anquiloglossia
Tipo de estudo:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
/
Systematic_reviews
Limite:
Female
/
Humans
/
Infant
Idioma:
En
Revista:
Pediatr Res
Ano de publicação:
2024
Tipo de documento:
Article
País de afiliação:
Estados Unidos