Evaluation of the Effects of Tongue-Tie and Upper Lip-Tie on Breastfeeding With Ultrasound Measurements and the LATCH Breastfeeding Assessment Tool.

BACKGROUND

Tongue-tie and upper lip-tie have been linked to breastfeeding difficulties; however, traditional evaluation tools rely on subjective assessments. Ultrasound imaging enables objective assessment of infant sucking dynamics.

RESEARCH AIM: This study aimed to assess the impact of tongue-tie and upper lip-tie on sucking function in newborns, using ultrasound imaging and other evaluation tools.

METHODS

This comparative observational study with short-term follow-up included 67 newborns (25 with tongue-tie, 21 with upper lip-tie, and 21 controls) and their mothers. Oral examinations were conducted during the hospital stay, prior to discharge. The maxillary labial frenulum was evaluated using the Kotlow classification, and the lingual frenulum was assessed with the Tongue Tie and Breastfed Infants (TABBY) tool. Sucking function was examined using ultrasound imaging between postnatal Days 5 and 15. Breastfeeding was evaluated via the LATCH tool, and maternal nipple pain was rated using a numeric scale. A 1-month follow-up call gathered data on feeding status, nipple pain, and surgical interventions.

RESULTS

No significant differences in LATCH or nipple pain scores were found across groups. Ultrasound measurements in the tongue-up position showed significantly lower anterior tongue height in the tongue-tie group. In the same position, intraoral space depth was reduced significantly in the upper lip-tie group. Anterior tongue height correlated negatively with maternal nipple pain in the tongue-tie group (r = -0.49, p = 0.014).

CONCLUSION

Tongue-tie and upper lip-tie do not always lead to observable breastfeeding problems. Ultrasound imaging offers valuable insights into subtle sucking dysfunctions not captured by clinical assessment.