À compter du 1er décembre 2023, l’accès à POEMs et à Essential Evidence Plus ne fera plus partie des avantages offerts aux membres de l’AMC.
Question clinique
Do all infants with feeding difficulty referred for frenotomy actually need it?
L’Essentiel
More than 60% of infants referred to a tertiary care center for frenotomy because of feeding difficulty were satisfactorily treated with nonsurgical approaches. Consider evaluation by a pediatric speech and language pathologist to investigate the full range of addressable causes of feeding difficulty before referring infants for frenotomy. 4
Référence
Plan de l'etude: Cohort (prospective)
Financement: Self-funded or unfunded
Cadre: Outpatient (specialty)
Sommaire
This observational study describes the results of a quality improvement project at a tertiary care center, The project involved 115 infants (average age = 1 month) referred for frenotomy because of feeding difficulty. Prior to the start of the project, 95% of infants referred over the prior 6 months had undergone either a tongue-tie release or a tongue-tie/lip-tie release. During the project, instead of going directly to surgery, the infants and mothers were evaluated by a pediatric speech and language pathologist to determine other possible causes of feeding difficulty rather than lip-tie or tongue-tie. Other primary causes of feeding difficulty were investigated and addressed if present, such as positioning, latch, and milk supply, but also feeding and swallowing problems. As a result of this investigation, only 37.4% of the infants completed surgical intervention. One patient initially treated with alternative strategies evenually underwent surgical treatment.
Reviewer
Allen F. Shaughnessy, PharmD, MMedEd
Professor of Family Medicine
Tufts University
Boston, MA