Tongue-tie: incidence and outcomes in breastfeeding after lingual frenotomy in 2333 newborns.

AIM: To determine the prevalence of ankyloglossia in newborns with breastfeeding problems and to assess the effectiveness of frenotomy in the maintenance of exclusive breastfeeding at 1 month, 3 months and 6 months in newborns at an Andorran Hospital. STUDY DESIGN: A descriptive, cross-sectional, population-based, retrospective study of newborns over a 5-year period (2016-2020) was performed. Nine medical history variables (presence or absence of ankyloglossia and type of frenulum, surgical intervention or not, first degree hereditary component, gender, Rh and blood group, type of breastfeeding, causes of cessation and duration of breastfeeding) related to perinatal and feeding history were collected confidentially and anonymously. The Coryllos classification was used for the diagnosis of ankyloglossia. Descriptive analysis of the data, Chi-square test and prevalence ratios were calculated. RESULTS: A total of 2333 newborns were included in the study (50.02% males and 49.98% females). The prevalence of ankyloglossia was 7.84% (n = 183). Of the infants examined, 136 underwent lingual frenotomy. The number of infants who maintained exclusive breastfeeding, both surgically and non-surgically treated, was no statistically significant differences at 1 month (p = 0.65), 3 months (p = 0.61) and 6 months (p = 0.49). CONCLUSIONS: Lingual frenotomy was only performed on patients with ankyloglossia associated with ineffective suction that causes BF difficulties. The realization or not of frenotomy was not a determining factor for the maintenance of breastfeeding at 1 month, 3 months and 6 months. On the contrary, it was a determining factor for the prolongation of mixed feeding. Ankyloglossia related to breastfeeding difficulties should be treated by a multidisciplinary team.

Testing Species Assignments in Extant Terebratulide Brachiopods: A Three-dimensional Geometric Morphometric Analysis of Long-Looped Brachidia.

Species of terebratulide brachiopods have been largely characterized qualitatively on the basis of morphology. Furthermore, species-level morphological variability has rarely been analyzed within a quantitative framework. The objective of our research is to quantify morphological variation to test the validity of extant named species of terebratulide brachiopods, focusing on the lophophore-supporting structures-the "long loops." Long loops are the most distinctive and complex morphological feature in terebratellidine brachiopods and are considered to be phylogenetically and taxonomically informative. We studied eight species with problematic species identities in three genera distributed in the North Pacific: Laqueus, Terebratalia, and Dallinella. Given how geometrically complex long loops are, we generated 3D models from computed tomography (CT) scans of specimens of these eight species and analyzed them using 3D geometric morphometrics. Our goal was to determine ranges of variation and to test whether species are clearly distinguishable from one another in morphospace and statistically. Previous studies have suggested that some species might be overly split and are indistinguishable. Our results show that these extant species of terebratellidines can be reliably distinguished on the basis of quantitative loop morphometrics. Using 3D geometric morphometric methods, we demonstrate the utility of CT beyond purely descriptive imaging purposes in testing the morphometric validity of named species. It is crucial to treat species described and named from qualitative morphology as working hypotheses to be tested; many macroevolutionary studies depend upon the accurate assessment of species in order to identify and seek to explain macroevolutionary patterns. Our results provide quantitative documentation of the distinction of these species and thus engender greater confidence in their use to characterize macroevolutionary patterns among extant terebratellidine brachiopods. These methods, however, require further testing in extinct terebratellidines, which only rarely preserve the delicate long loop in three dimensions. In addition, molecular analyses of extant terebratellidines will test the species delimitations supported by the morphometric analyses presented in this study. [Species determination; morphological variability; 3D geometric morphometrics; terebratulide brachiopods; long loops.].