Lingual frenulum and effect on breastfeeding in Thai newborn infants.
BACKGROUND
Breastfeeding has abundant biological and psychological benefits. Effective breastfeeding requires good latching on, which is possible when the infant is able to cup around the maternal areola with his tongue. One of the most common conditions resulting in poor latching on is tongue-tie.


OBJECTIVE
To determine the prevalence of tongue-tie with subsequent breastfeeding difficulties and other factors affecting the success of breastfeeding in newborn infants.


METHODS
This was a prospective, cross-sectional study of healthy Thai infants without contraindications for breastfeeding. Physical examination of the infants and mothers and their breastfeeding practices were assessed between 24 and 48 hours of life.


RESULTS
2679 mother-infant dyads were recruited. The study detected a prevalence of 16% for severe tongue-tie, 37.9% of which was associated with breastfeeding difficulties. Using multiple logistic regression analysis, moderate (adjusted OR 13.3, 95% CI 7.2-24.5) and severe (adjusted OR 62, 95% CI 34.1-112.8) tongue-tie, short nipples (adjusted OR 1.5, 95% CI 1.1-2.2), mothers feeling the infant's tongue on the nipple area (adjusted OR 3.4, 95% CI 2.2-5.2) and mothers' inability to feel the infant's tongue (adjusted OR 11.8, 95% CI 4.3-32.4) independently increased the risk of breastfeeding difficulties.


CONCLUSIONS
Tongue-tie is not uncommon and is associated with breastfeeding difficulty in newborn infants. Mothers of infants with severe tongue-tie should be closely and individually coached during breastfeeding and followed up, especially during the first critical weeks of the infant's life.
Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Sopapan
S
Ngerncham
Mongkol
M
Laohapensang
Thidaratana
T
Wongvisutdhi
Yupin
Y
Ritjaroen
Nipa
N
Painpichan
Pussara
P
Hakularb
Panidaporn
P
Gunnaleka
Penpaween
P
Chaturapitphothong
D000328:Adult; D000072676:Ankyloglossia; D001942:Breast Feeding; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008035:Lingual Frenum / Q000473:pathology*; D008297:Male; D009056:Mouth Abnormalities / Q000453:epidemiology*; D015995:Prevalence; D011446:Prospective Studies; D013785:Thailand