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. 2025 Jan 14;25(1):64.
doi: 10.1186/s12903-025-05444-1.

Ankyloglossia and breastfeeding self-efficacy in newborns: a birth cohort study

Carlos Alberto Feldens  1 , Moréniké Oluwátóyìn Foláyan  2   3 , Lívia Mund de Amorim  4 , Elisa Maria Rosa de Barros Coelho  5 , Gabriela Fernandes Kern Dos Santos  6 , Paulo Floriani Kramer  5
Affiliations

Ankyloglossia and breastfeeding self-efficacy in newborns: a birth cohort study

Carlos Alberto Feldens et al. BMC Oral Health. .

Abstract

Background: The impact of ankyloglossia (tongue-tie) on breastfeeding outcomes may be overestimated and surgical treatment in newborns remains a controversial topic. The aim of the present study was to assess and quantify the impact of ankyloglossia in newborns on breastfeeding self-efficacy at 14 days of life.

Methods: A birth cohort study was conducted involving mothers and newborns soon after childbirth at a public hospital in the city of Canoas, southern Brazil. At the hospital, the lingual frenum of newborns were clinically examined and classified using the Bristol Tongue Assessment Tool. For every newborn with defined or suspected ankyloglossia, two newborns without ankyloglossia were co-enrolled for the study. At 14 days of the children's lives, the mothers were interviewed at home to collect data on breastfeeding self-efficacy using the Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF). Poisson regression with robust variance was conducted to quantify differences in the Breastfeeding Self-Efficacy scores between exposed and nonexposed newborns after adjusting for maternal sociodemographic variables (mother's completed years of schooling, mother's age, family structure, progenitor status of child, mother's smoking status), the gestational variables (number of prenatal appointments, gestational age, comorbidities, type of childbirth), and child related variables (sex, birth weight, birth length) as confounders.

Results: The final sample was composed of 31 children with ankyloglossia (exposed) and 57 without ankyloglossia (nonexposed). No significant differences were found in the BSEF-SF scores between the 31 children with ankyloglossia (mean BSEF-SF scores: 56.0; median BSEF-SF scores: 60; 95% CI: 51.9-60.1) and the 57 children without ankyloglossia (mean BSEF-SF scores: 59.6; median BSEF-SF scores: 60; 95% CI: 57.5-61.7). The Poisson regression analysis showed no significant difference in the BSEF-SF scores between newborns with ankyloglossia and those without ankyloglossia (Ratio = 0.95; 95% CI: 0.88-1.02; p = 0.139).

Conclusion: Ankyloglossia at birth exerted no clinically relevant impact on breastfeeding self-efficacy in children at 14 days of life.

Keywords: Ankyloglossia; Breastfeeding; Lingual frenum; Newborn.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: This study was performed in line with the principles of the Declaration of Helsinki and approved by the Human Research Ethics Committee of the Lutheran University of Brazil (certificate number: 5.378.250). All parents signed a statement of informed consent after receiving clarifications regarding the intervention and all phases of the data collection process. Consent for publication: Not applicable. Competing interests: Morẹ́nikẹ́ Oluwátóyìn Foláyan is a Senior Editor Board member with BMC Oral Health. All other authors declare no conflict of interest.

Figures

Fig. 1
Fig. 1
Flowchart of cohort participants
See this image and copyright information in PMC

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