A new study in Pediatrics should help settle the question of whether clipping a tight frenulum improves breastfeeding outcomes.
I've written about tongue tie a number of times, assisted by some wonderful moms who agreed to share their stories. Here are Danielle, Lisa, William's mom, and Allyson's stories. In a number of those stories mothers were told that clipping a frenulum wouldn't make a difference.
That's why I was so pleased to see that this new study was a randomized, blinded, controlled trial - the gold standard for research. The researchers wanted to know if clipping frenula would have an effect on mothers' nipple pain, and also if it affected breastfeeding duration. Check out the method they used:
Over a 12-month period, neonates who had difficulty breastfeeding and significant ankyloglossia were enrolled in this randomized, single-blinded, controlled trial and assigned to either a frenotomy (30 infants) or a sham procedure (28 infants). Breastfeeding was assessed by a preintervention and postintervention nipple-pain scale and the Infant Breastfeeding Assessment Tool. The same tools were used at the 2-week follow-up and regularly scheduled follow-ups over a 1-year period. The infants in the sham group were given a frenotomy before or at the 2-week follow-up if it was desired.
Clever design, huh? Here are the results:
The frenotomy group improved significantly more than the sham group (P < .001). Breastfeeding scores significantly improved in the frenotomy group (P = .029) without a significant change in the control group. All but 1 parent in the sham group elected to have the procedure performed when their infant reached 2 weeks of age, which prevented additional comparisons between the 2 groups.
Interestingly, the "sham" group also had improved pain scores, suggesting a placebo effect. But overall, the fretonomy group improved more, and were breastfeeding better, too. And did you catch why they couldn't measure breastfeeding duration? Because all but one mom in the "sham" group said, "Clip that sucker!"
I'm hoping that this study might result in moms getting better care when their babies have tongue ties. If you're struggling with this, please print out the study and bring it in to your providers!
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