Evidence of improved milk intake after frenotomy: a case report

Ankyloglossia (tongue tie) is a well-recognized cause of breastfeeding difficulties and, if untreated, can cause maternal nipple pain and trauma, ineffective feeding, and poor infant weight gain. In some cases, this condition will result in a downregulation of the maternal milk supply. Milk-producti...

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Bibliographic Details
Published in:Pediatrics (Evanston) 2013-11, Vol.132 (5), p.e1413-e1417
Main Authors: Garbin, Catherine Peta, Sakalidis, Vanessa Susanna, Chadwick, Lynda Maree, Whan, Elizabeth, Hartmann, Peter Edwin, Geddes, Donna Tracy
Format: Article
Language:English
Subjects:
Ankyloglossia
Babies
Breast feeding
Breast Feeding - methods
Breastfeeding & lactation
Care and treatment
Case studies
Female
Frenectomy
Health aspects
Humans
Infant, Newborn
Lingual Frenum - pathology
Lingual Frenum - surgery
Male
Maternal & child health
Milk, Human
Mouth Abnormalities - diagnosis
Mouth Abnormalities - surgery
Pain
Pediatrics
Sucking Behavior - physiology
Surgery
Tongue
Treatment Outcome
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Summary:Ankyloglossia (tongue tie) is a well-recognized cause of breastfeeding difficulties and, if untreated, can cause maternal nipple pain and trauma, ineffective feeding, and poor infant weight gain. In some cases, this condition will result in a downregulation of the maternal milk supply. Milk-production measurements (24-hour) for a breastfeeding infant with ankyloglossia revealed the ineffective feeding of the infant (78 mL/24 hours), and a low milk supply (350 mL/24 hours) was diagnosed. Appropriate management increased milk supply (1254 mL/24 hours) but not infant milk intake (190 mL/24 hours). Test weighing convincingly revealed the efficacy of frenotomy, increasing breastfeeding milk transfer from 190 to 810 mL/24 hours. Postfrenotomy, breastfeeding almost completely replaced bottle-feeding of expressed breast milk. This case study confirms that ankyloglossia may reduce maternal milk supply and that frenotomy can improve milk removal by the infant. Milk-production measurements (24-hour) provided the evidence to confirm these findings.
ISSN:0031-4005
1098-4275
DOI:10.1542/peds.2012-2651