Objective: This study explored clinical implications of tongue-tie (TT) on breastfeeding from the mothers' perspective and evaluated the assistance provided.
Materials and methods: This was a single-center observational study using a structured survey. All newborns with TT born in 2005-2010 were identified; two controls without TT were assigned for each. Mothers were interviewed using a uniform structured questionnaire regarding breastfeeding experience, challenges, lactation consultation, and frenotomy, if performed.
Results: One hundred eighty-three TT mothers and 314 controls were interviewed. Although the overall rates of breastfeeding problems in the first month were similar (59% vs. 52%, respectively), TT mothers reported significantly more problems with latching, prolonged breastfeeding, and infant's exhaustion during feedings, but not pain or sore nipples. Breastfeeding rates at 6 months were similar. TT mothers more frequently used pumped breastmilk to supplement breastfeeding. Significantly more TT mothers sought consultation after discharge, and a significantly greater proportion of them felt that lactation consultation helped. Eighty-seven percent of the mothers were aware of their children's TT, yet only 50% associated it with breastfeeding problems. Of the TT infants at 2 years of age or older, 11.9% were reported to have speech problems. The possibility of frenotomy was mentioned to 69% of mothers, and it was performed in 35% of cases. Procedure satisfaction was generally poor, except for when done to solve breastfeeding problems.
Conclusions: TT infants had significantly more breastfeeding problems in the first month, but similar rates and durations of breastfeeding. Early diagnosis and lactation consultation may assist mother-infant dyads substantially. Mothers whose infants underwent frenotomies for breastfeeding more frequently found the procedure alleviated breastfeeding problems.