Acta Paediatr. 2022 Feb 12. doi: 10.1111/apa.16289. Online ahead of print.
ABSTRACT
AIM: Tongue tie is a common problem affecting breastfeeding due to poor infant latch and/or maternal pain. Evidence of whether treatment improves breastfeeding outcomes is conflicting. We conducted a systematic review and meta-analysis to examine the effectiveness of tongue tie treatment on breastfeeding difficulties.
METHODS: We searched peer-reviewed and grey literature in MEDLINE (OVID), PubMed, CINAHL Plus, EMBASE and PsycINFO, from 01/1970 to 09/2019. Inclusion: randomized and non-randomized clinical trials, and quasi-experimental study designs, involving breastfeeding interventions for full-term singleton infants, using standardized measure of breastfeeding difficulty. Exclusion: qualitative and purely observational studies, lacked operational definition of breastfeeding difficulty, lacked control/comparison group. We assessed risk of bias, summarized study quality and results, and conducted meta-analysis using random effects modelling.
RESULTS: Six studies on tongue tie division were included (4 randomized, 2 non-randomized). Meta-analysis of standardized mean differences in breastfeeding difficulty scores in four studies showed statistically significant differences in favour of frenotomy (Pooled SMD +2.12, CI:(0.17-4.08)p=0.03). Similarly, a statistically significant difference in favour of frenotomy was observed for pain (Pooled SMD -1.68, 95% CI:(-2.87- -0.48).
CONCLUSION: Results support that infant frenotomy is effective for improving standardized scores on breastfeeding difficulty and maternal pain scales and could improve breastfeeding outcomes.
PMID:35150472 | DOI:10.1111/apa.16289
