Ankyloglossia and Breastfeeding

Overview

Ankyloglossia is a congenital condition characterized by a restrictive lingual frenulum that may limit normal tongue mobility and be associated with breastfeeding difficulties. Reported problems include ineffective latch, maternal nipple pain and nipple trauma, mastitis, reduced milk transfer, poor infant weight gain, and early breastfeeding cessation. However, the available evidence regarding the impact of ankyloglossia on breastfeeding outcomes remains limited and controversial. The primary objective of this prospective cohort study is to evaluate the association between neonatal ankyloglossia, assessed using the TABBY assessment tool during the first 72 hours of life, and breastfeeding effectiveness measured using the LATCH scale during the same period. Mother-infant dyads will be recruited during the newborn's first 72 hours of life, during the hospital admission for childbirth, at the University Hospital of Guadalajara, Spain. Newborns will be classified according to the presence or absence of ankyloglossia using the TABBY assessment tool and will be followed for the first 6 months of life. Information will be collected during routine clinical follow-up and through telephone interviews. The secondary objectives are to evaluate the association between ankyloglossia and breastfeeding duration, exclusive breastfeeding duration, maternal pain during breastfeeding, and maternal breastfeeding satisfaction.

A prospective observational cohort study will be conducted. Mother-infant dyads will be recruited during the newborn's first 72 hours of life, during the hospital admission for childbirth at the University Hospital of Guadalajara. The presence of ankyloglossia will be assessed using the TABBY tool during the first 72 hours of life. Newborns will be classified into two cohorts according to the presence or absence of ankyloglossia. The planned sample size is 146 mother-infant dyads: 73 newborns with ankyloglossia and 73 newborns without ankyloglossia. Non-probability consecutive sampling will be used. For each newborn with ankyloglossia included in the study, one newborn without ankyloglossia will be selected from among the next newborns assessed who meet the inclusion criteria and whose parents provide informed consent. The study will not assign interventions or modify routine clinical care. The performance of frenotomy and the provision of individual breastfeeding counselling will depend on the clinical assessment and the decisions made by the healthcare professionals responsible for the participants' care. These procedures will be recorded to analyse their possible association with breastfeeding outcomes. The initial assessment of ankyloglossia using TABBY and breastfeeding effectiveness using LATCH will be performed during the first 72 hours of life. The dyads will be followed up between 5 and 15 days, between 30 and 40 days, and at 4 and 6 months of life. Information will be obtained from clinical assessments, electronic health records and, when necessary, telephone interviews.