A retrospective review of frenotomy in neonates and infants with feeding difficulties

Objectives: To measure maternal breast feeding benefit after infant frenotomy. To investigate if timing of neonatal/infant frenotomy affects outcome.

Study design: Cohort survey and retrospective review.

Methods: Medical records of neonates and infants suspected to have ankyloglossia between April 2006 and February 2011 were reviewed. Patient demographic data was compiled. A telephone survey was conducted to gather data on this cohort of patients.

Results: Neonatal and infant consultations (N=367) were performed for feeding difficulties due to suspected ankyloglossia, 302 of these infants underwent frenotomy for ankyloglossia. A total of 91 mothers agreed to participate in a follow-up telephone survey regarding the intervention. Results showed that 80.4% of mothers strongly believed the procedure benefited their child's ability to breastfeed, and 82.9% of mothers were able to initiate/resume breastfeeding after the procedure was performed. The belief that frenotomy significantly benefitted an infant's ability to feed significantly differed in patients that had the procedure performed in the first week of life (86%) as compared to infants that had the procedure performed after the first week of life (74%) (p<0.003).

Conclusions: Based on maternal observations, when frenotomy is performed on neonates with ankyloglossia and feeding difficulties in the first week of life, there is more benefit than when it is performed after the first week of life. The population of patients with ankyloglossia is predominantly male with a high familial/genetic correlation associated with the phenotypic trait. Frenotomy for ankyloglossia demonstrates a high degree of maternal satisfaction, is well tolerated and has been shown to improve breastfeeding and decrease pain and difficulty associated with breastfeeding.