Authors (including presenting author) :
Leung YN(1), Lam YY(2), Ng F(3), Kwong S(4), Siu MK(2), Leung SK(1), Chan KM(2), Chung SF(1), So H Y(2), Lau S Y(2), Leung WC(1)
Affiliation :
(1) Department of Obstetrics and Gynaecology, Kwong Wah Hospital (KWH) (2) Department of Pediatrics, KWH (3) Department of Surgery, KWH (4) Department of Occupational Therapy, KWH
Introduction :
Ankyloglossia, or tongue-tie, is a congenital oral anomaly, which may lead to breastfeeding challenges and contribute to early cessation of breastfeeding. In June 2017, a group of workers (lactation consultants (LCs), neonatal doctors and nurses, plastic surgeons, occupational therapists (OTs), and physiotherapists) formed an infant feeding management committee in Kwong Wah Hospital (KWH). One of the aims is to support breastfed infants affected by ankyloglossia. Tongue exercises and breast attachment adjustment were initiated by LCs after ankyloglossia was identified during breastfeeding coaching. If breastfeeding problem(s) were unresolved, affected infants would be referred to plastic surgeons and neonatal unit for frenotomy to improve breastfeeding outcomes. The mother-infant dyads were re-assessed and followed up by LCs and OTs for post-frenotomy care.
Objectives :
To investigate the effectiveness of ankyloglossia management in breastfed infants and evaluate the experience of breastfeeding mothers whose infants received pre- and post-frenotomy care in KWH.
Methodology :
A retrospective cohort survey was conducted in January 2020. Telephone survey was administered by using a structured Likert scale questions to evaluate mothers’ experience on lactation support, pre- and post-frenotomy management, and their satisfaction of multidisciplinary care.
Result & Outcome :
Between June 2017 and November 2019, a total of 8337 breastfed infants were assessed by LCs for unresolved breastfeeding problem such as weight loss in infants on postnatal discharge and maternal nipple pain. 562 infants (6.08%) were diagnosed with breastfeeding problem associated with ankyloglossia. Eighteen infants received frenotomy by plastic surgeons at KWH. Follow-up telephone survey response rate was 72.2%. There was a statistically significant reduction in nipple pain post-frenotomy (p=0.008). Attachment at the breast and breast milk intake were improved in all infants (p=0.002). Improvement in breast milk removal and transfer were also statistically significant after the procedure (p=0.011). All mothers were satisfied with the multidisciplinary care and would recommend the service to others in need. In conclusion, infant feeding management team with multidisciplinary collaboration is an innovative service supporting breastfed infants with ankyloglossia. It offers an effective lactation management for unresolved breastfeed challenges.
