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Date: | Wed, 27 Oct 2010 16:38:21 -0400 |
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I wonder if the second frenotomy has healed/scarred back down? If so,
and it's only a few weeks, moms might be able to lift the tongue with
clean fingers and break the attachment. The very experienced docs are
starting to recommend lifting the tongue after posterior frenotomy for 3
seconds 5-8 times a day for a week or more to prevent re-adhesion, which
seems to be more likely with a posterior than an anterior frenotomy
according to a recent study, see abstract below:
Defining ankyloglossia: A case series of anterior and posterior tongue
ties.
Paul Hong, Denise Lago, Judi Seargeant, Lauren Pellman, Anthony E Magit
and Seth M Pransky
Abstract
INTRODUCTION: Ankyloglossia is a congenital condition in which tongue
mobility is limited due to an abnormality of the lingual frenulum. The
impact of ankyloglossia on breastfeeding is poorly understood but there
is a recent trend toward more recognition of this condition and early
intervention when needed. Currently, there lacks clear definition of
ankyloglossia and different subtypes have been proposed with no clinical
correlation. OBJECTIVE: To determine the prevalence of anterior versus
posterior ankyloglossia in a large series of consecutive patients and to
assess clinical outcomes after frenotomy. METHODS: Retrospective chart
review of patients from July 2007 to July 2009 who were diagnosed with
ankyloglossia and underwent office frenotomy. Baseline characteristics,
specific feeding issues, type of ankyloglossia, and clinical outcomes
after frenotomy were reviewed. RESULTS: Of the 341 total patients, 322
(94%) had anterior ankyloglossia and 19 (6%) had posterior
ankyloglossia. Median age at presentation was 2.7 weeks (range 1 day of
life to 24 weeks); 227 were males and 114 were females. Revision
frenotomy rates were significantly higher for the posterior
ankyloglossia group (3.7% anterior and 21.1% posterior, p=0.008).
CONCLUSION: Anterior ankyloglossia is much more common and readily
managed when compared to posterior ankyloglossia. Posterior
ankyloglossia is a poorly recognized condition that may contribute to
breastfeeding difficulties. The diagnosis is difficult due to the subtle
clinical findings but relevant health care providers should be aware of
this condition. Frenotomy is a simple, safe, and effective intervention
for ankyloglossia which improves breastfeeding. Copyright © 2010
Elsevier Ireland Ltd. All rights reserved. | PMID: 20557951
Catherine Watson Genna, BS, IBCLC NYC
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