Incidence of “tight –frenulum” and effect on Breastfeeding Experience
K Dockrill MD*, D Crosby, D. Gvozdic MD
Introduction: Incidence of newborn ankyloglossia is defined as 5% to 10% in current
literature. Incidence data is complicated by variable criteria for definition of
ankyloglossia/tongue-tie. Breastfeeding pain occurs in about 25% of affected motherinfant dyads. Frenotomy can enhance their breastfeeding experience. With more
awareness of the association a trend to see “preventative” frenotomy within the first days
of birth has emerged.
Objective: To audit incidence of ankyloglossia and to look at breastfeeding experience
for women receiving unrestricted IBCLC care in a pediatric collaborative care practice.
Methods: Retrospective chart audit of all newborns admitted between 01/2006 and
06/2009. Results: 135 AGA newborns, greater than 35 weeks gestation, were admitted
for primary care. 114 infants were exclusively breastfed for greater than 2 months. 3/135
infants had tongue-tie. All 3 were labeled by birthing staff to have “tight frenulum”. All
were advised to discuss tongue-tie clipping with their MD. None of the infants had
frenotomy. All achieved minimum 2 months exclusive breastfeeding. 1 of 3 mothers had
protracted nipple discomfort in the 1st month. Option for frenotomy was offered and
declined.
Conclusions: Our data shows a much lower incidence of ankyloglossia than the
published literature. Our data also raises question about potential overuse of frenotomy in
preventing breastfeeding pain and the implication of labeling infants with “tongue-tie” in
affecting a women’s breastfeeding experience. Further study is warranted to evaluate
benefit of universal LC support for breastfeeding mothers.
Self-funded office based research / Clinical Practice Abstract
Submitted by:
Dr. Karen Dockrill FRCPC
Paediatrics, Perinatal-Neonatal Medicine
207 Dundas St. West, Whitby
Ontario, Canada
L1N 2M4
905 666-2229 phone
905 666-2115 fax
Karen@momandbabydepot.ca
www.momandbabydepot.ca