title: Efficacy of neonatal release of ankyloglossia: a randomized trial.
abstract: BACKGROUND
  Ankyloglossia has been associated with a variety of infant-feeding problems. Frenotomy commonly is performed for relief of ankyloglossia, but there has been a lack of convincing data to support this practice.
  
  
  OBJECTIVE
  Our primary objective was to determine whether frenotomy for infants with ankyloglossia improved maternal nipple pain and ability to breastfeed. A secondary objective was to determine whether frenotomy improved the length of breastfeeding.
  
  
  METHODS
  Over a 12-month period, neonates who had difficulty breastfeeding and significant ankyloglossia were enrolled in this randomized, single-blinded, controlled trial and assigned to either a frenotomy (30 infants) or a sham procedure (28 infants). Breastfeeding was assessed by a preintervention and postintervention nipple-pain scale and the Infant Breastfeeding Assessment Tool. The same tools were used at the 2-week follow-up and regularly scheduled follow-ups over a 1-year period. The infants in the sham group were given a frenotomy before or at the 2-week follow-up if it was desired.
  
  
  RESULTS
  Both groups demonstrated statistically significantly decreased pain scores after the intervention. The frenotomy group improved significantly more than the sham group (P < .001). Breastfeeding scores significantly improved in the frenotomy group (P = .029) without a significant change in the control group. All but 1 parent in the sham group elected to have the procedure performed when their infant reached 2 weeks of age, which prevented additional comparisons between the 2 groups.
  
  
  CONCLUSIONS
  We demonstrated immediate improvement in nipple-pain and breastfeeding scores, despite a placebo effect on nipple pain. This should provide convincing evidence for those seeking a frenotomy for infants with signficant ankyloglossia.
authors.affiliation: Naval Medical Center Portsmouth, Portsmouth, VA 23708, USA. melissa.buryk@gmail.com
authors.forename: Melissa
authors.initials: M
authors.lastname: Buryk
authors.forename: David
authors.initials: D
authors.lastname: Bloom
authors.forename: Timothy
authors.initials: T
authors.lastname: Shope
mesh_terms: D001942:Breast Feeding / Q000009:adverse effects; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008035:Lingual Frenum / Q000002:abnormalities* / Q000601:surgery*; D008297:Male; D009056:Mouth Abnormalities / Q000150:complications / Q000601:surgery; D009558:Nipples / Q000473:pathology; D010146:Pain / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control; D010147:Pain Measurement / Q000379:methods; D016037:Single-Blind Method; D016896:Treatment Outcome