One thing that struck me regarding this article summary is that "50% of breastfeeding infants with ankyloglossia will not encounter any problems and therefore do not require surgical intervention." That indicates that 50% do. With Type I and Type II error, I am flummoxed as to why a HCP would make that risk instead of the potential benefit from something so simple as this revision. sigh.


Tue, 15 Sep 2015 07:45:13 -0500
From:    Pat Young
<[log in to unmask]>
Subject: another interesting article

See what
happens when you go away for over a month and the journals pile up!

"An
Infant's Glossal Anomaly: A Diagnosis on the Tip of the Tongue". Leung, Leung,
Hon. Consultant for Pediatricians, Aug. 2015, pg 357,360
"Ankyloglossia is
usually a harmless condition.  The frenulum usually lengthens as the chld gets
older and with progressive stretching and thinning of the frenulum.  Treatment 
usuallymis unnecessary apart from parental education and reassurance.

The
absolute indication for surgical intervention (frenotomy and less commonly,
frenuloplasty) is breastfeeding difficulties as a result of the ankyloglossia. 
Frenuloplasty usually is reserved for ankyloglossia that is not relieved by
frenotomy or patients with a very thick frenulum.  The optimal timing of
surgical intervention is controversial.  Some authors suggest that ankyloglossia
shuld be treated as early as possible to minimize breastfeeding problems.  Other
authors recommend 2 to 3 weeks as reasonable timing for intervention, since 50%
of breastfeeding infants with ankyloglossia will not encounter any problems and
there fore do not require surgical intervention.  "  Goes on to explain
procedure and  talks about articulation problems. Ends with a paragraph about
how systematic review of 20 studies didn't show improvement in articulation
[maybe if it had been done younger there wouldn't even be articulation
problems!} 23 ref given.

Oh well I'll have to think about answering this one!
Pat in SNJ


Constance Pond, MS in OT, IBCLC, LLLI BoD, LLLL
Board Certified Lactation Consultant
917.940.8699
New York, NY

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