CoDAS
https://www.codas.org.br/article/doi/10.1590/2317-1782/20202019026
CoDAS
Artigo Original

Influência da frenotomia na amamentação em recém-nascidos com anquiloglossia

Influence of frenotomy on breastfeeding in newborns with ankyloglossia

Anna Letícia Xavier de Lima, Monique Ramos Paschoal Dutra

Downloads: 4
Views: 444

Resumo

Objetivo: avaliar a influência da frenotomia sobre a amamentação de recém-nascidos com diagnóstico de anquiloglossia. Método: trata-se de um estudo de intervenção realizado com 50 recém-nascidos com diagnóstico de anquiloglossia. Foi realizado em três etapas: diagnóstico, intervenção e reavaliação. Na fase diagnóstica, foram aplicados o Protocolo de Avaliação do Frênulo da Língua com Escores para Bebês para o diagnóstico de anquiloglossia e um questionário de avaliação dos sintomas e coordenação de sucção, deglutição e respiração durante a amamentação. Na intervenção, foi realizada a frenotomia e, na reavaliação, foram reaplicados o protocolo de diagnóstico e o questionário para comparação dos efeitos pós-cirúrgicos. Resultados: dos 50 bebês participantes do estudo, 35 (70%) eram do gênero masculino e 15 (30%) do gênero feminino. Foram relatados 68% dos casos de anquiloglossia na família, sendo primo (a) o grau de parentesco na maioria desses casos (38%). Houve redução estatisticamente significativa na média de pontuação no protocolo de 8,38 (7-12 pontos) para 0,86 (0-5 pontos), na etapa de reavaliação, assim como melhora estatisticamente significante em todas as variáveis relacionadas aos sintomas da amamentação. Conclusão: a intervenção cirúrgica, denominada frenotomia, possibilitou a melhora dos sintomas negativos da amamentação em neonatos com diagnóstico de anquiloglossia.

Palavras-chave

Freio lingual; Aleitamento materno; Recém-nascido; Anquiloglossia; Protocolos Clínicos

Abstract

Purpose: evaluate the influence of frenotomy on the breastfeeding of newborns diagnosed with ankyloglossia. Methods: this is an intervention study performed with 50 newborns diagnosed with ankyloglossia. It was conducted in three stages: diagnosis, intervention and reassessment. In the diagnostic phase, the Protocol for the Assessment of Speech Language with Scores for Babies was applied to diagnose ankyloglossia and a questionnaire assessing the symptoms and coordination of sucking, swallowing and breathing during breastfeeding. In the intervention, frenotomy was performed, and at reassessment, the diagnostic protocol and questionnaire in order to compare the post-surgical effects. Results: of the 50 babies participating in the study, 35 (70%) were boys and 15 (30%) girls. A total of 68% of ankyloglossia cases were reported in the family, a majority (38%) involving cousins. There was a statistically significant reduction in the average protocol score in the reassessment stage, from 8.38 (7-12 points) to 0.86 (0-5 points), as well as a statistically significant improvement in all variables related to the symptoms of breastfeeding. Conclusion: surgical intervention, known as frenotomy, made it possible to improve the negative symptoms of breastfeeding in newborns diagnosed with ankyloglossia.

Keywords

Lingual frenulum; Breastfeeding; Infant; Newborn; Ankyloglossia; Clinical Protocols

Referências

1. Singh S, Kent RD. Dictionary of speech-language pathology. San Diego, California: Singular’s; 2000

2. Kupietzky A, Botzer E. Ankyloglossia in the infant and young child: clinical suggestions for diagnosis and management. Pediatr Dent. 2005; 27(1):40-6. PMid: 15839394.

3. Jamilian A, Fattahi F, Kootanayi N. Ankyloglossia and tongue mobility. Eur Arch Paediatr Dent. 2014;(15):33-5. PMid: 23860620. http://dx.doi. org/ 10.1007/s40368-013-0049-0.

4. Hogan M, Westcott C, Griffiths M. Randomized, controlled trial of division of tongue-tie in infants with feeding problems. J Paediatr Child Health. 2005; 41(5-6):246-50. PMid: 15953322. DOI: 10.1111/j.1440-1754.2005.00604.x.

5. Buryk M., Bloom D., Shope T. Efficacy of Neonatal Release of Ankyloglossia: A Randomized Trial. Pediatrics. 2011;128(2):280-8. PMid: 21768318. http://dx.doi.org/10.1542/peds.2011-0077.

6. Berry J, Griffiths M, Westcott C. A double-blind, randomized, controlled trial of tongue-tie division and its immediate effect on breastfeeding. Breast Med. 2012.7(3):189-93. PMid: 21999476. http://dx.doi.org/10.1089/ bfm.2011.0030.

7. WHO (World Health Organization). The optimal duration of exclusive breastfeeding: Results of a WHO systematic review. Indian Pediatrics. 2001.[cited 2019 Jan 26]. Avaliable from: https://www.who.int/nutrition/ publications/optimal_duration_of_exc_bfeeding_review_eng.pdf.

8. Sarafana S, Abecasis F, Tavares A, Soares I, Gomes A. Aleitamento Materno: evolução na última década. Acta Pediatr Port. 2006;1(37):9-15. https://dx.doi.org/10.25754/pjp.2006.4737.

9. Segal LM, Stephenson R, Dawes M, Feldman P. Prevalence, diagnosis, and treatment of ankyloglossia. Can Fam Physician. 2007;53 (6):1027-33. PMid: 17872781.

10. Martinelli RL, Marchesan IQ, Berretin-felix G. Lingual frenulum evaluation protocol for infants: relationship between anatomic and functional aspects. Rev CEFAC. 2013;15(3):599-610. http://dx.doi.org/10.1590/S1516- 18462013005000032.

11. Ngerncham S, Laohapensang M, Wongvisutdhi T, Ritjaroen Y, Painpichan N, Hakularb P et al. Lingual frenulum and effect on breastfeeding in Thai newborn infants. Paediatr Int Child Health. 2013; 33(2):86-90. PMid: 23925281. https://dx.doi.org/10.1179/2046905512Y.0000000023.

12. Brasil, Lei 13.002, de 20 de junho de 2014. Obriga a realização do Protocolo de Avaliação do Frênulo da Língua em Bebês. 2014.

13. Geddes D, Langton D, Gollow I, Jacobs L., Hartmann P, Simmer K. Frenulotomy for Breastfeeding Infants With Ankyloglossia: Effect on Milk Removal and Sucking Mechanism as Imaged by Ultrasound. Pediatrics. 2008; 122(1):188-94. PMid: 18573859. https://dx.doi.org/10.1542/peds.2007-2553.

14. Schulz KF, Altman DG, Moher D; CONSORT Group. CONSORT 2010 statement: updated guidelines for reporting parallel group randomised trials. BMJ. 2010;340. https://dx.doi.org/10.1136/bmj.c332.

15. Martinelli RL, Marchesan IQ, Gusmão RJ, Honório HM, Berretin-Felix G. The effects of frenotomy on breastfeeding. J Appl Oral Sci. 2015; 23(2):153-7. https://dx.doi.org/10.1590/1678-775720140339.

16. Muldoon K, Gallagher L, McGuinness D, Smith V. Effect of frenotomy on breastfeeding variables in infants with ankyloglossia (tongue-tie): a prospective before and after cohort study. BMC Pregnancy and Childbirth. 2017; 17(1): 1-9. PMid: 29132414. https://dx.doi.org/10.1186/s12884- 017-1561-8.

17. Almeida KR, Leal TP, Kubo H, Castro TES, Ortolani CLF. Lingual frenotomy in a newborn, from diagnosis to surgery: a case report. Rev. CEFAC. 2018;20(2):258-262. https://dx.doi.org/10.1590/1982-0216201820212917.

18. Brasil. Ministério da Saúde. Secretaria de atenção à saúde. Departamento de ações programáticas estratégicas. Nota técnica nº 25/2018.

19. Messner AH, Lalakea ML, Aby J, MacMahon j, Bair E. Ankyloglossia Incidence and associated feeding difficulties. Arch Otolaryngol Head Neck Surg. 2000;126(1):36-39. PMid: 10628708. https://dx.doi.org/10.1001/ archotol.126.1.36.

20. Berg, K. Tongue-Tie (Ankyloglossia) and Breastfeeding: A Review. J Hum Lact 1990; 6 (3):109-12. http://dx.doi.org/10.1177/089033449000600315.

21. Han S, Kim Y, Choi Y, Lim J, Han K. A Study on the Genetic Inheritance of Ankyloglossia Based on Pedigree Analysis. Arch Plast Surg. 2012; 39(4): 329-32. PMid: 22872835. http://dx.doi.org/10.5999/aps.2012.39.4.329.

22. Marchesan IQ. Frênulo lingual: proposta de avaliação quantitativa. Rev. CEFAC. 2004;6(3):288-93.

23. Ricke LA, Baker NJ, Madlon-Kay DJ. Newborn tongue tie: prevalence and effect on breast-feeding. J Am Board Fam Pract. 2005;18:1-7. PMid: 15709057. http://dx.doi.org/10.3122/jabfm.18.1.1.

24. Vargas BC, Monnerat LHP, Favilla EE, Pinto LAPF, Gandelmann ÍHA, Cavalcante MAA; Anquiloglossia: quando indicar a frenectomia lingual? Rev.Uningá. 2008;(18):161-170.

25. Ingram J, Johnson D, Copeland M, Churchill C, Taylor H, Emond A. The development of a tongue assessment tool to assist with tongue-tie identification. Arch Dis Child Fetal Neonatal. 2015;100(4):344-8. PMid: 25877288. http://dx.doi.org/10.1136/archdischild-2014-307503.

26. Hazelbaker AK. The assessment tool for lingual frenulum function (ATLFF): Use in a lactation consultant private practice [thesis]. Pasadena (CA): Pacific Oaks College; 1993. https://dx.doi.org/10.1177/089033449401000135.

27. Martinelli RLC, Marchesan IQ, Lauris JR, Honório HM, Gusmão RJ, Felix GB. Validade e confiabilidade da triagem: “teste da linguinha”. Rev. CEFAC. 2016;18(6):1323-31. http://dx.doi.org/10.1590/1982-021620161868716.

28. Francis DO, Krishnaswami S, McPheeters M. Treatment of Ankyloglossia and Breastfeeding Outcomes: A Systematic Review. Pediatrics. 2015, 135 (6):1458-66. http://dx.doi.org/10.1542/peds.2015-0658.

29. Srinivasan A, Dobrich C, Mitnick H, Feldman P. Ankyloglossia in Breastfeeding Infants: The Effect of Frenotomy on Maternal Nipple Pain and Latch. Breastfeeding Medicine. 2006;1(4):216-24. PMid: 17661602. http://dx.doi.org/10.1089/bfm.2006.1.216.

30. Sethi N, Smith D, Kortequee S, Ward V, Clarke S. Benefits of frenulotomy in infants with ankyloglossia. Int J Pediatr Otorhinolaryngol. PMid: 23453795. 2013;77(5):762-5. http://dx.doi.org/10.1016/j.ijporl.2013.02.005.


Submetido em:
11/02/2019

Aceito em:
22/01/2020

60c50583a9539539382b7324 codas Articles

CoDAS

Share this page
Page Sections