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Ankyloglossia and Frenulotomy by neos in the newborn nursery


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1000-dollar-question!

We do it sometimes (I'd estimate 1 procedure/week among our 7500 inborn babies/year) and almost always after request from the midwife or parents when the return for the maternity care follow-up (typically around 5-7th postnatal day), if breastfeeding is not on track as expected.

However, science tells that there is not much effect on a group level in terms of breastfeeding rate/length, but some proxy outcomes (such as maternal satisfaction and tongue movement measured with ultrasound) improve.

 

We do this procedure ourselves (no ENT referral). Baby head towards the doctor, 30% glucose as "pre-med", left index finger in the baby mouth that pulls the tounge towards the palate exposing the tongue tie, and then, open scissors down to the tongue base, and one cut. My experience is that the babies react little to the cut, if anything.

 

Here is a thorough post on a (very nice!) web site for pediatric residents:

http://dontforgetthebubbles.com/tongue-tie-cut/

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@selvanr4 - laser surgery?! Frenotomy seems closer to rocket science than I had thought :)

 

Related to your case: a speech therapist I met said we (in neonatal care) should also consider that a cut tongue tie lead to pronounciation difficulties later in childhood.

 

Found some good parents info about this condition here:

http://www.entnet.org/content/tongue-tie-ankyloglossia

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  • 2 weeks later...

Have a look here:

 

http://www.ncbi.nlm.nih.gov/pubmed/23537928

 

Looks encouraging for breast feeding  but speech benefits are still to be proved

 

Also http://www.ncbi.nlm.nih.gov/pubmed/24937906 shows office frenotomy to be satisfying to the parents...(isn't that the new motto...CUSTOMER SATISFACTION !!!!....but is it all about the parents...how does the baby feel ????)

 

Nice opinion: http://fn.bmj.com/content/99/3/F178.extract

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