Is frenotomy effective in improving breastfeeding in newborn babies with tongue-tie? A literature review
This literature review explores whether frenotomy can result in more successful breastfeeding of newborn infants with ankyloglossia.
A systematic literature search was carried out. Nine pieces of research were chosen and appraised using two critical appraisal tools.
Three main themes emerged: the mother's experiences of breastfeeding; duration of breastfeeding; and latch. The majority of studies found that frenotomy could improve latch and alleviate nipple pain. However, there is little information available about outcomes for babies with ankyloglossia who do not undergo the frenotomy procedure.
Frenotomy is a procedure that can benefit breastfeeding mothers and babies, but the cultural and social background of families is not addressed in much of the research, nor is the risk of distress to the infant and parents.
With the increasingly persuasive evidence that breastfeeding provides infants and mothers with significant health benefits (Oddy et al, 1999; Kull et al, 2002; UNICEF, 2010), midwives and other health professionals should be doing everything possible to support women to initiate and continue breastfeeding. In some cases, ankyloglossia (or tongue-tie) is considered to inhibit breastfeeding, and current National Institute for Health and Care Excellence (NICE, 2005) guidelines support frenotomy—division of the tongue-tie—as an intervention to rectify this. However, the guidelines recognise that there is limited evidence to justify this; in addition, the guidelines are now dated, which makes the subject of this literature review highly topical. The literature available on frenotomy for tongue-tie is controversial (McBride, 2005; Edmunds et al, 2012) and lacks reliable, objective primary research studies (Hall and Renfrew, 2005).
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