103 - Association of Newborn Lingual Frenum and Maxillary Labial Frenum Characteristics with Breastfeeding Difficulties

ABSTRACT

Objective: To determine the incidence of ankyloglossia, examine anatomical and functional characteristics of lingual frenum and maxillary labial frenum attachments, and determine whether an association exists between these characteristics and breastfeeding problems. MATERIALS AND

Methods: Lingual frenum and maxillary labial frenums of healthy infants born to mothers who intended to breastfeed were examined and classified using modified HATLFF (LF) and Stanford Classification Systems (MF), respectively. Demographic data, experience feeding previous children, and family history of ankyloglossia were obtained. A 3-8 month follow-up questionnaire gathered information regarding feeding experience with examined infant, evaluations for ankyloglossia and frenotomy procedures.

Results: 64 mother-newborn dyads and 4 additional newborns were evaluated in this study, with 34 available for follow-up. Prolonged breastfeeding time per session was observed significantly with infants who had limited tongue lift and/or protrusion, attachment of the tongue tip to the inner alveolar ridge, and/or an overall low LF score (P <0.05). Mothers of infants with a notched tongue tip were significantly more likely to report an ankyloglossia diagnosis at follow up (P=0.047). Infants with a “present” murphy score were more likely to have borderline or low LF scores (P=0.0014). Majority of newborns (77.2%) presented with Type 2 MF.

Conclusions: Lingual frenum classification systems may help predict breastfeeding problems due to tongue-ties in newborns, but breastfeeding assessments should additionally be used to determine the need for frenotomies. Substantial maxillary labial frenum attachments are common in newborns and not significantly correlated with breastfeeding difficulties.