*Tongue tie division in infants with breast feeding difficulties.*

*Wallace H*<http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&itool=PubMed_Abstract&term=%22Wallace+H%22%5BAuthor%5D>,
*Clarke S*<http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&itool=PubMed_Abstract&term=%22Clarke+S%22%5BAuthor%5D>
.   Int J Pediatr Otorhinolaryngol. Mar. 6 2006

Department of Otolaryngology, Pinderfields Hospital, Aberford Rd.,
Wakefield, West Yorkshire WF1 4DG, United Kingdom.

OBJECTIVE: Tongue tie is a congenital oral abnormality characterised by an
abnormally short lingual frenulum. The majority of current medical and
surgical opinion is that tongue tie rarely, if ever, causes feeding
difficulties and therefore, should not be divided. With increased popularity
of breast feeding in the last decade there has been renewed interest in
tongue tie and its effect on breast feeding. We present a case series of
infants who underwent tongue tie division for feeding difficulties and
assess the indications for and outcomes of the procedure. METHODS: Eleven
infants with breast feeding difficulties associated with tongue tie
underwent tongue tie division using a standard technique in the outpatient
clinic. No anaesthetic or analgesia was used and there was little or no
bleeding or infant distress. Parents were subsequently contacted by phone at
least 4 months after the procedure to enquire about the effect of the
procedure on feeding and any complications encountered. RESULTS: The age at
tongue tie division ranged from 2 to 31 days (median=10 days). 10/11 of
these infants were followed up. The age at follow up was 4-20 months
(median=10 months). Prior to division, all mothers had attempted breast
feeding and were keen to continue. 9/10 had experienced difficulties due to
poor latch (8/10), sore nipples (6/10) and continual feeding cycle (5/10).
Only 3/10 mothers were breast feeding exclusively. Following tongue tie
division, an improvement in breast feeding was noticed immediately by 4/10
mothers. Three mothers did not notice any improvement. 6/10 mothers
successfully breast fed for at least 4 months. There were no reported
complications of the procedure. CONCLUSIONS: The benefits of breast feeding
are well known and lactation consultants are becoming more aware of tongue
tie as a treatable cause of breast feeding difficulty. The procedure is
quick and simple, not requiring any analgesia or anaesthesia and can be
performed in the outpatient clinic. Although not conclusive, this case
series suggests a possible benefit of tongue tie division in symptomatic
infants.

PMID: 16527363 [PubMed - as supplied by publisher]

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