Frenotomy for tongue-tie in newborn infants

Frenotomy for infants with tongue-tie and feeding difficulties may cause a short-term reduction in nipple pain among breastfeeding mothers but may not consistently improve infant feeding compared to no frenotomy or sham procedure.

The quality of evidence is downgraded by study limitations (lack of blinding), and by imprecise results (few patients and outcome events).

Summary

A Cochrane review included 5 studies with a total of 302 healthy term infants with moderate or severe tongue-tie and feeding difficulties and/or whose mothers were experiencing nipple pain. The studies compared frenotomy versus no frenotomy or frenotomy versus sham procedure. Three studies objectively measured infant breastfeeding. Pooled analysis showed no change on a 10-point feeding scale following frenotomy (MD -0.1, 95% CI -0.6 to 0.5 units; 2 studies, n=155). A third study (n = 58) showed objective improvement on a 12-point feeding scale (MD 3.5, 95% CI 3.1 to 4.0 units of a 12-point feeding scale). Four studies objectively assessed maternal pain. Pooled analysis based on a 10-point pain scale showed a reduction in maternal pain scores following frenotomy (MD -0.7, 95% CI -1.4 to -0.1 units; 3 studies, n=212). A fourth study (n = 58) also showed a reduction in pain scores on a 50-point pain scale (MD -8.6, 95% CI -9.4 to -7.8 units). All studies reported no adverse effects following frenotomy.

Clinical comments

Date of latest search:

Ədəbiyyat

1. O'Shea JE, Foster JP, O'Donnell CP et al. Frenotomy for tongue-tie in newborn infants. Cochrane Database Syst Rev 2017;(3):CD011065.