Research ArticleOriginal Article

Newborn Tongue-tie: Prevalence and Effect on Breast-Feeding

Lori A. Ricke, Nancy J. Baker, Diane J. Madlon-Kay and Terese A. DeFor
The Journal of the American Board of Family Practice January 2005, 18 (1) 1-7; DOI: https://doi.org/10.3122/jabfm.18.1.1

Article Figures & Data

Figures

  • Figure 1.
    Figure 1.

    Study outline. ATLFF, Assessment Tool for Lingual Frenulum Function; IBFAT, Infant Breast-feeding Assessment Tool.

Tables

  • Table 1.

    Characteristics of Study Mothers

    Case Subjects (n = 49)Control Subjects (n = 98)P value
    Mean age, years (standard deviation)25.9 (6.2)26.5 (5.9).193
    Race
        White28 (57.1%)56 (57.1%).974
        Hispanic15 (30.6%)30 (30.6%)
        Black4 (8.1%)8 (8.1%)
        Asian2 (4.0%)4 (4.0%)
    Male newborn32 (65.3%)63 (64.2%).480
    Nulliparous22 (44.8%)44 (44.8%).999
    Decided to breast-feed.149
        Before pregnancy29 (59.2%)69 (70.4%)
        During pregnancy18 (36.7%)26 (26.5%)
        After delivery2 (4.1%)3 (3.1%)
    Prepared for breast-feeding by.367
        Classes11 (22.9%)15 (15.8%)
        Reading15 (31.3%)31 (32.6%)
    Were breast-fed themselves25 (51.0%)52 (53.1%).811
    The baby’s father was breast-fed22 (44.9%)48 (49.5%).655
    Number of previous babies breast-fed.394
        None25 (53.2%)45 (48.9%)
        ≥122 (46.8%)47 (51.1%)
    Has household/family member who feels should NOT breast-feed1 (2.0%)2 (2.0%).999
  • Table 2.

    Feeding Status of Infants at 1 Week and 1 Month of Age

    1 Week*1 Month†
    Case Subjects (n = 38)Control Subjects (n = 71)Case Subjects (n = 33)Control Subjects (n = 65)
    Bottle-feeding only8 (21.05%)4 (5.63%)10 (30.3%)15 (23.08%)
    Breast-feeding and bottle-feeding15 (39.47%)32 (45.07%)20 (60.61%)40 (61.54%)
    Breast-feeding only15 (39.47%)35 (49.3%)3 (9.09%)10 (15.38%)

    • * P = .035.

    • † P = .46.

  • Table 3.

    Survey of Mothers Breast-Feeding at 1 Week and 1 Month of Age

    1 Week1 Month
    Case Subjects (n = 30)Control Subjects (n = 67)P ValueCase Subjects (n = 23)Control Subjects (n = 50)P Value
    Breast-feeding going well:.398
        Yes29 (96.7%)63 (94%)
        No1 (3.3%)1 (1.5%)
        Don’t know3 (4.5%)
    Extremely sore nipples7 (23.3%)19 (28.4%).2165 (21.7%)5 (10%).439
    Nipples cracked or bleeding4 (13.3%)13 (19.4%).2162 (8.6%)6 (12%).398
    Mother worried baby not growing well1 (3.3%)6 (9.0%).3553 (13%)7 (14%).999
    Baby’s doctor worried baby not growing well1 (3.3%)2 (3.0%).6951 (4.3%)2 (4%).617
    Baby always hungry9 (39.1%)19 (38%).522
    Breast pain8 (34.7%)8 (16%).425
    Breast infection3 (13%)4 (8%).674
    Not enough milk1 (4.3%)4 (8%).808
  • Table 4.

    Survey of Bottle Feeding Mothers at 1 Week and 1 Month Combined

    Problems when breast-feedingCase Subjects (n = 10)Control Subjects (n = 15)P Value
    Baby always hungry5 (50.0%)9 (60.0%).225
    Nipples extremely sore8 (80.0%)10 (66.7%)NA*
    Cracked or bleeding nipples6 (60.0%)8 (53.3%).317
    Breast pain8 (80.0%)11 (73.3%).617
    Breast infection1 (10.0%)4 (26.7%).072
    Not enough milk2 (20.0%)7 (46.7%).086
    When breast-feeding, mother worried baby not growing well4 (40.0%)2 (13.3%).808
    When breast-feeding, baby’s doctor worried baby not growing well2 (20.0%)1 (6.7%)NA

    • * NA, not able to be calculated.

  • Table 5.

    Outcomes at 1 Week of Age Based on Initial Newborn Assessment Tool for Lingual Frenulum Function Score

    Function Impaired (n = 5)Perfect (n = 8)
    Bottle-feeding only2 (40%)1 (12.5%)
    Breast-feeding and bottle-feeding1 (20%)3 (37.5%)
    Breast-feeding only04 (50%)
    Frenotomy followed by breast-feeding only2 (40%)0
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