Effectiveness of Tongue-Tie and Lip-Tie Release in Infants With Feeding Problems: A Prospective Study of 343 Cases

Abstract

Purpose: This study was aimed to determine the impact of frenotomy in tongue-tie and/or lip-tie on breastfeeding problems.

Methods: A total of 343 infants with tongue-tie and/or lip-tie operated owing to their breastfeeding problems at Musashino Tokushukai Hospital from July 2015 to June 2019 were studied prospectively. Operation was indicated using the “Tongue-tie Score for Infants,” which the author developed. One month after surgery, improvement of symptoms and mothers’ satisfaction was evaluated on the basis of the mothers’ responses to a questionnaire.

Results: The male-to-female ratio was 1.5:1. Heredity of tongue-tie was observed in 48% of patients. The average age was 3.1 months. Poor latch was seen in 312 infants, nipple pain in 148 mothers, breast problems in 110 mothers, and poor weight gain in 23 infants. Two hundred seventy-one infants underwent both tongue-tie and lip-tie release. Tongue-tie release alone was conducted in 41 infants, and lip-tie release alone was performed in 31 infants. The percentages of tongue-tie types were as follows: 14% for the tongue tip type, 48% for the anterior membranous type, 20% for the tenting type, and 18% for the posterior type. The mean tongue-tie score was 4.5. Poor latch improved in 93% of the infants, nipple pain in 81% of the mothers, and poor weight gain in 62% of the infants one month after surgery. Poor latch and nipple pain improved in 85% of the infants and 81% of the mothers, respectively, even in infants with only lip-tie release. Ninety-seven percent of the mothers answered “satisfied” or “very satisfied” with the results.

Conclusions: Surgical release of tongue tie and/or lip tie resulted in improvement in the majority of the infants with poor latch and mothers with nipple pain at one month after surgery. Feeding problems was also improved by lip-tie release alone in those for whom tongue-tie release was not indicated.