title: Immediate nipple pain relief after frenotomy in breast-fed infants with ankyloglossia: a randomized, prospective study.
abstract: OBJECTIVE
  Ankyloglossia ("tongue-tie") occurs in nearly 5% of neonates, but its clinical significance relating to breast-feeding difficulties is controversial. We tested the hypothesis that in infants with ankyloglossia referred because of breast-feeding difficulties, frenotomy alleviates the symptoms.
  
  
  METHODS
  Twenty-five mothers of healthy infants with ankyloglossia were recruited because of sore nipples. Infants were randomized to either of 2 sequences: (1) frenotomy, breast-feeding, sham, breast-feeding (n = 14) or (2) sham, breast-feeding, frenotomy, breast-feeding (n = 11). The mothers as well as all personnel taking care of the child after each sham or frenotomy procedure were masked as to the study sequence. In every sequence, and after each sham or frenotomy procedure, a standardized latch score and pain score were obtained from the mother.
  
  
  RESULTS
  There was a significant decrease in pain score after frenotomy than after sham (P = .001). There was also a nearly significant improvement in latch after the frenotomy in these mothers (P = .06).
  
  
  CONCLUSIONS
  Frenotomy appears to alleviate nipple pain immediately after frenotomy. We speculate that ankyloglossia plays a significant role in early breast-feeding difficulties, and that frenotomy is an effective therapy for these difficulties.
authors.affiliation: Department of Neonatology, Lis Maternity Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv 64239, Israel. dolberg@post.tau.ac.il
authors.forename: Shaul
authors.initials: S
authors.lastname: Dollberg
authors.forename: Eyal
authors.initials: E
authors.lastname: Botzer
authors.forename: Esther
authors.initials: E
authors.lastname: Grunis
authors.forename: Francis B
authors.initials: FB
authors.lastname: Mimouni
mesh_terms: D001942:Breast Feeding / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008035:Lingual Frenum / Q000601:surgery; D009056:Mouth Abnormalities / Q000150:complications*; D009558:Nipples; D010146:Pain / Q000209:etiology*; D011446:Prospective Studies; D013391:Sucking Behavior; D014060:Tongue Diseases / Q000150:complications* / Q000601:surgery*