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Eur J Pediatr Surg. 2009 Dec;19(6):370-3. doi: 10.1055/s-0029-1234041.

Nipple pain at presentation predicts success of tongue-tie division for breastfeeding problems.

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1
Department of Paediatric Surgery, King's College Hospital, Denmark Hill, London, United Kingdom.

Abstract

INTRODUCTION:

In mother-infant pairs experiencing breastfeeding difficulties, frenulotomy for tongue-tie may improve breastfeeding. We tested the hypothesis that those experiencing nipple pain are most likely to benefit from the procedure in a prospective cohort study.

MATERIALS AND METHODS:

Mother-infant pairs attending a dedicated clinic for the assessment and treatment of tongue-tie completed a standardised, structured symptom questionnaire. Three months later outcome was assessed by questionnaire. Multivariate logistic regression analysis was used to determine preoperative predictors of successful outcome.

RESULTS:

Sixty-two infants <90 days old underwent frenulotomy and completed follow-up. At presentation, 52 mothers (84%) reported nipple pain, and 32 mothers (52%) nipple trauma. Three months after frenulotomy, 78% of respondents were still breastfeeding. Feed lengths (mean reduction: 17 mins; p<0.001) and time between feeds (mean increase: 38 mins; p<0.001) had significantly improved, as had difficulty of feeding (mean improvement in self-rated difficulty score: 42%; p<0.001). Those having difficulty breastfeeding due to nipple pain showed a significant long-term benefit from frenulotomy; pre-frenulotomy nipple pain was associated with an increased likelihood of breastfeeding at 3 months in adjusted multivariate analysis (OR 5.8 [95% CI 1.1-31.6]).

CONCLUSION:

Mother-infant pairs with tongue-tie and breastfeeding difficulties due to nipple pain are most likely to benefit from frenulotomy.

PMID:
19750457
DOI:
10.1055/s-0029-1234041
[Indexed for MEDLINE]

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