Breastfeeding and the Lingual Frenulum: Diagnostic Tests

Objectives: To assess the lingual frenulum of newborns through the application of the Bristol Tongue Assessment Tool (BTAT) and verify its association with breastfeeding.
Methods: Transversal study developed at the Integral Institute of Medicine Professor Fernando Figueira (IMIP), Pernambuco, Brazil from March to May, 2016. The sample had 449 newborns evaluated through a protocol, known as "the lingual test" and by BTAT, proposed by Brazil Ministry of Health. Breastfeeding was evaluated by the protocol proposed by UNICEF. Scores were created to evaluate every aspect of feeding to be observed. The study was approved by the ethics on Research Committee of the IMIP under the number 1.066.444. Descriptive statistical analysis and Chi-squared tests were performed. For all the analysis was considered the significance level of 5%.
Results: According to the two protocols used, 3.11% of the babies showed change in lingual frenulum, most prevalent in male babies (64.28%), and 21.5% had functional limitations during suction. As for the evaluation of feeding, 91.3% presented the binomial mothers/ baby score well, 8% regular and 0.07% bad. The biggest cause of difficulties while breastfeeding was the anatomy of the breast of the mother (51.3%), followed by the reply of the binomial (18.9%), the item "no milk ejection signal" was responsible for all cases, followed by difficulty in sucking (10.8%). There was statistically significant association between the Protocol "the lingual test" and breastfeeding (p = 0.028) and between the BTAT protocol and breastfeeding (p = 0.028).
Conclusions: The compatibility of the lingual frenulum characterization between the two protocols used demonstrated that both can be used as a diagnostic tool. The feature of the lingual frenulum interfere with movements of the tongue and consequently the effectiveness of breastfeeding in the first days of life, therefore the frenotomia must be considered an important tool for tongue mobility and babies functional development.