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Effect of Frenotomy on Breastfeeding in Infants with Ankyloglossia: A Rapid Review
Introduction: Ankyloglossia or tongue-tie is a congenital disorder characterized
by a short lingual frenulum resulting in limited tongue movement, therefore
causing difficulty in breastfeeding. Frenotomy is indicated if there is interference
in breastfeeding. The objective of this study is to determine the effect of frenotomy
on breastfeeding in infants with ankyloglossia. Methods: Rapid review was
conducted using PRISMA guidelines through Pubmed, Scopus, and Embase using
keywords according to research questions based on PICO and used boolean
operators to combine keywords. Risk of bias was assessed using JBI Critical
Appraisal Tools. Result: Five articles consisting of four randomized controlled
trials and one quasi-experimental were included for review. Two studies reported
nipple pain reduction after frenotomy, while the other two studies did not.
Effectiveness of breastfeeding was found to increase in two studies, whereas one
study found no increase. Two studies using different instrument to assess the
effectiveness of breastfeeding did not show an increase after frenotomy. Maternal
self-efficacy was found to be elevated in one study. Maternal subjective
assessment reported improvement in breastfeeding in three studies. All studies
reported no serious complications after frenotomy. Conclusion: Frenotomy was
found to be inconsistent in improving breastfeeding ability in infants with
ankyloglossia. Practitioners should do case selection carefully by taking into
account the assessment of tongue-tie and breastfeeding, as well as conservative
approach (lactation support) before performing frenotomy.
Keywords: ankyloglossia, frenotomy, breastfeeding
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