Impact of Neonatal Frenotomy on Breastfeeding in the Medium Term: A Cross-Sectional Study

Excerpt

To the Editor: Ankyloglossia may cause breastfeeding difficulties and early weaning. There is controversy on the usefulness of performing a frenotomy to improve breastfeeding [1‐4]. We conducted a cross-sectional study of the neonates born in our hospital in 2018 to determine whether performing a neonatal frenotomy increased breastfeeding rates. We offered a frenotomy to all tongue-tied patients and performed 422 frenotomies; 396 improved: 93.1% of tongue-tied neonates were breastfed at discharge, 81.7% at 3.5 mo (vs. 70.4%, p = 0.02) and 64.6% 6 mo (vs. 55.6%, p = 0.525). Full-term neonates, neonates born via a normal vaginal delivery, frenotomized infants and infants whose mothers improved after a frenotomy were more likely to be breastfed at 3.5 mo. However, being the first baby and previous breastfeeding experience did not increase breastfeeding. Almost the same variables affected breastfeeding at 6 mo, although mothers with previous breastfeeding experience breastfed more at 6 mo (65.9 vs. 59.6%). We do not have a “control group” because we offered the frenotomy to all symptomatic patients and most parents accepted the procedure. Motivation for breastfeeding may be relevant among mothers who refused frenotomy, for which comparisons must be interpreted cautiously. We preferred to relate the success of a frenotomy to the breastfeeding rate at 3.5 mo rather than at 6, because at that time point, other factors such as the mother’s return to work could have influenced weaning (maternity leave in Spain lasts 16 wk). …