title: Breastfeeding difficulties and oral cavity anomalies: The influence of posterior ankyloglossia and upper-lip ties.
abstract: OBJECTIVE
  Oral cavity anomalies may contribute to breastfeeding problems. The objective of this study was to describe our experience in a high-volume breastfeeding difficulty clinic with a focus on posterior ankyloglossia and upper-lip ties.
  
  
  METHODS
  A retrospective review of patients from a dedicated breastfeeding difficulty clinic from January 2014 to December 2014 was performed. Those identified to have ankyloglossia and/or upper-lip ties underwent release procedures. Subjective breastfeeding changes were documented afterwards.
  
  
  RESULTS
  Of the 618 total patients, 290 (47%) had anterior ankyloglossia, 120 (19%) had posterior ankyloglossia, and 14 (2%) had upper-lip tie. Some patients had both anterior ankyloglossia and upper lip-tie (6%), or posterior ankyloglossia and upper-lip tie (5%). For those with anterior ankyloglossia, 78% reported some degree of improvement in breastfeeding after frenotomy. For those with posterior ankyloglossia, 91% reported some degree of improvement in breastfeeding after frenotomy. Upper lip-tie release also led to improved breastfeeding (100%).
  
  
  CONCLUSIONS
  Anterior and posterior ankyloglossia and upper-lip tie, or combinations thereof, were commonly recognized in our study population. Many newborns, however, also had no oral cavity anomalies. Although causation cannot be implied, these oral cavity anomalies may contribute to breastfeeding difficulties in some cases.
authors.affiliation: Rady Children's Hospital, San Diego, CA, United States; Division of Otolaryngology-Head and Neck Surgery, University of California, San Diego, CA, United States. Electronic address: spranky@rchsd.org.
authors.forename: Seth M
authors.initials: SM
authors.lastname: Pransky
authors.affiliation: Rady Children's Hospital, San Diego, CA, United States.
authors.forename: Denise
authors.initials: D
authors.lastname: Lago
authors.affiliation: Division of Otolaryngology-Head and Neck Surgery, Dalhousie University, Halifax, NS, Canada. Electronic address: Paul.Hong@iwk.nshealth.ca.
authors.forename: Paul
authors.initials: P
authors.lastname: Hong
mesh_terms: D000072676:Ankyloglossia; D001942:Breast Feeding; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007742:Labial Frenum / Q000002:abnormalities / Q000601:surgery*; D008035:Lingual Frenum / Q000002:abnormalities / Q000601:surgery*; D008297:Male; D009056:Mouth Abnormalities / Q000150:complications / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: Ankyloglossia; Breastfeeding difficulty; Frenotomy; Frenulotomy; Upper-lip tie