Acta PaediatricaVolume 99, Issue 2 p. 301-303 Sucking characteristics of successfully breastfeeding infants with ankyloglossia: a case series DT Geddes, DT Geddes School of Biomolecular, Biomedical and Chemical Sciences, Faculty of Life and Physical Sciences, The University of Western Australia, Crawley, WA, AustraliaSearch for more papers by this authorJC Kent, JC Kent School of Biomolecular, Biomedical and Chemical Sciences, Faculty of Life and Physical Sciences, The University of Western Australia, Crawley, WA, AustraliaSearch for more papers by this authorHL McClellan, HL McClellan School of Biomolecular, Biomedical and Chemical Sciences, Faculty of Life and Physical Sciences, The University of Western Australia, Crawley, WA, AustraliaSearch for more papers by this authorCP Garbin, CP Garbin School of Biomolecular, Biomedical and Chemical Sciences, Faculty of Life and Physical Sciences, The University of Western Australia, Crawley, WA, AustraliaSearch for more papers by this authorLM Chadwick, LM Chadwick School of Biomolecular, Biomedical and Chemical Sciences, Faculty of Life and Physical Sciences, The University of Western Australia, Crawley, WA, AustraliaSearch for more papers by this authorPE Hartmann, PE Hartmann School of Biomolecular, Biomedical and Chemical Sciences, Faculty of Life and Physical Sciences, The University of Western Australia, Crawley, WA, AustraliaSearch for more papers by this author DT Geddes, DT Geddes School of Biomolecular, Biomedical and Chemical Sciences, Faculty of Life and Physical Sciences, The University of Western Australia, Crawley, WA, AustraliaSearch for more papers by this authorJC Kent, JC Kent School of Biomolecular, Biomedical and Chemical Sciences, Faculty of Life and Physical Sciences, The University of Western Australia, Crawley, WA, AustraliaSearch for more papers by this authorHL McClellan, HL McClellan School of Biomolecular, Biomedical and Chemical Sciences, Faculty of Life and Physical Sciences, The University of Western Australia, Crawley, WA, AustraliaSearch for more papers by this authorCP Garbin, CP Garbin School of Biomolecular, Biomedical and Chemical Sciences, Faculty of Life and Physical Sciences, The University of Western Australia, Crawley, WA, AustraliaSearch for more papers by this authorLM Chadwick, LM Chadwick School of Biomolecular, Biomedical and Chemical Sciences, Faculty of Life and Physical Sciences, The University of Western Australia, Crawley, WA, AustraliaSearch for more papers by this authorPE Hartmann, PE Hartmann School of Biomolecular, Biomedical and Chemical Sciences, Faculty of Life and Physical Sciences, The University of Western Australia, Crawley, WA, AustraliaSearch for more papers by this author First published: 08 January 2010 https://doi.org/10.1111/j.1651-2227.2009.01577.xCitations: 6 DT Geddes, M310, School of Biomolecular, Biomedical and Chemical Sciences, Faculty of Life and Physical Sciences, The University of Western Australia, 35 Stirling Highway, Crawley 6009, WA, Australia.Tel: +61 8 6488 1208 |Fax: +61 8 6488 1148 |Email: [email protected] Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onEmailFacebookTwitterLinkedInRedditWechat References 1 Ballard JCC, Howard CR. ABM Clinical Protocol #11: guidelines for the evaluation and management of neonatal ankyloglossia and its complications in the breastfeeding dyad. Available at: http://www.bfmed.org/Resources/Protocols.aspx (accessed October 24, 2009). 2 Segal LM, Stephenson R, Dawes M, Feldman P. Prevalence, diagnosis, and treatment of ankyloglossia: methodologic review. Can Fam Physician 2007; 53: 1027–33. 3 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: 246–50. 4 Messner AH, Lalakea ML, Aby J, Macmahon J, Bair E. Ankyloglossia: incidence and associated feeding difficulties. Arch Otolaryngol Head Neck Surg 2000; 126: 36–9. 5 Dollberg S, Botzer E, Grunis E, Mimouni FB. Immediate nipple pain relief after frenotomy in breast-fed infants with ankyloglossia: a randomized, prospective study. J Pediatr Surg 2006; 41: 1598–600. 6 Ballard JL, Auer CE, Khoury JC. Ankyloglossia: assessment, incidence, and effect of frenuloplasty on the breastfeeding dyad. Pediatrics 2002; 110: e63. 7 Livingstone VH, Willis CE, Abdel-Wareth LO, Thiessen P, Lockitch G. Neonatal hypernatremic dehydration associated with breast-feeding malnutrition: a retrospective survey. Can Med Assoc J 2000; 162: 647–52. 8 Messner AH, Lalakea ML. Ankyloglossia: controversies in management. Int J Pediatr Otorhinolaryngol 2000; 54: 123–31. 9 Srinivasan A, Dobrich C, Mitnick H, Feldman P. Ankyloglossia in breastfeeding infants: the effect of frenotomy on maternal nipple pain and latch. Breastfeed Med 2006; 1: 216–24. 10 Geddes DT, Langton DB, Gollow I, Jacobs LA, Hartmann PE, Simmer K. Frenulotomy for breastfeeding infants with ankyloglossia: effect on milk removal and sucking mechanism as imaged by ultrasound. Pediatrics 2008; 122: e188–94. 11 Geddes DT, Kent JC, Mitoulas LR, Hartmann PE. Tongue movement and intra-oral vacuum in breastfeeding infants. Early Hum Dev 2008; 84: 471–7. 12 Kent JC, Mitoulas LR, Cregan MD, Ramsay DT, Doherty DA, Hartmann PE. Volume and frequency of breastfeedings and fat content of breast milk throughout the day. Pediatrics 2006; 117: e387–95. 13 Prieto C, Cardenas H, Salvatierra AM, Boza C, Montes CG, Croxatto HB. Sucking pressure and it s relationship to milk transfer during breastfeeding in humans. J Reprod Fertil 1996; 108: 69–74. 14 McClellan HL, Geddes DT, Kent JC, Garbin CP, Mitoulas LR, Hartmann PE. Infants of mothers with persistent nipple pain exert strong sucking vacuums. Acta Paediatr 2008; 9: 1205–9. 15 Kent JC, Mitoulas LR, Cregan MD, Geddes DT, Larsson M, Doherty DA, et al. Importance of vacuum for breastmilk expression. Breastfeed Med 2008; 3: 11–9. 16 Mizuno K, Ueda A, Kani K, Kawamura H. Feeding behaviour of infants with cleft lip and palate. Acta Paediatr 2002; 91: 1227–32. Citing Literature Volume99, Issue2February 2010Pages 301-303 ReferencesRelatedInformation

Aim: The objective of this study was to determine whether infants of mothers experiencing persistent nipple pain exerted very strong intraoral vacuums during a breastfeed.Methods: Thirty mothers experiencing persistent pain during breastfeeding (Pain group; infants aged 49.4 +/- 35.5 days) were compared to 30 successfully breastfeeding mothers (Control group; infants aged 55.0 +/- 22.7 days). Infant intraoral vacuums were measured via a small milk-filled tube taped alongside the nipple and connected to a pressure transducer. Milk intake was measured using the test weigh method.Results: Infants in the Pain group applied significantly stronger baseline (-90.8 +/- 54.5 vs. -56.4 +/- 31.4 mmHg, p = 0.004), peak (-214.3 +/- 60.5 vs. 163.2 +/- 62.4 mmHg, p = 0.002) and pause vacuums (-104.8 +/- 67.9 vs. -45.8 +/- 30.3 mmHg, p < 0.001). Despite similar active sucking times (377.5 +/- 175.2 vs. 349.4 +/- 184.0 sec, p = 0.554) the mean milk intake was significantly lower for infants of mothers with nipple pain (41.6 +/- 31.3 vs. 70.7 +/- 30.7 g, p = 0.001).Conclusion: Infants of breastfeeding mothers experiencing persistent nipple pain applied significantly higher vacuum to the breast during breastfeeding despite assistance with positioning and attachment from a lactation consultant. Further investigation into the cause of the abnormally high vacuums is essential to develop successful interventions for these mother-infant dyads.