A comparison between an early- and a late frenulotomy for neonates with problematic tongue-tie.

PURPOSE: To compare breastfeeding outcomes between early and late frenulotomy in infants with problematic tongue-tie to determine optimal intervention timing.

METHODS

Conducted over two years at Thammasat University Hospital, this prospective cohort study divided mother-infant pairs into an early group (n = 103; <72 h postpartum) and a late group (n = 123; 7-14 days postpartum). Primary outcomes focused on exclusive breastfeeding (EBF) success at three months of age, while secondary outcomes measured LATCH scores improvement, pain reduction, and weight regain.

RESULTS

Both groups showed significant postoperative improvements. Median LATCH scores increased from 5 to 6 to 9, and latching pain decreased significantly within one week. However, the early group demonstrated a significantly higher EBF rate at three months (78.64% vs. 66.67%). Using inverse probability of treatment weighting (IPTW), early frenulotomy was associated with a higher likelihood of EBF success (RR = 1.60; p < 0.001) and superior pain reduction (RR = 1.33). No significant differences were observed in weight regain or LATCH score between groups.

CONCLUSION

For infants with symptomatic tongue-tie, performing a frenulotomy within 72 h of birth provides greater benefits in terms of EBF success and latching pain reduction compared to delayed intervention, suggesting early correction is the preferred clinical approach.