Newborns with feeding difficulty may not need frenotomy

Reference

Caloway C, Hersh CJ, Baars R, et al. Association of feeding evaluation with frenotomy rates in infants with breastfeeding difficulties. JAMA Otolaryngol Head Neck Surg 2019;145(9):817-822.

Synopsis

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.