A Narrative Review and Case Report: Frenotomy Procedure in Neonate with Tongue-Tie
Special thanks to the Journal of Clinical Chiropractic Pediatrics, Dr. Valerie Lavigne and Dr. Sharon Vallone for allowing us to share this article
Objective: The objective of this report is to present the case of a neonate who presented to a chiropractor with a tongue-tie causing breastfeeding difficulties as well as evaluate the evidence for the frenotomy procedure.
Design: Case report
Clinical Features: A mother presented to the clinic for breastfeeding difficulties. Upon examination, the three-week -old neonate had clear signs of tongue-tie. The mother also had cracked and bleeding nipples associated with a poor latch caused by tongue-tie.
Intervention and outcome: After evaluation of the case, a frenotomy procedure was suggested to improve tongue function and reduce the breastfeeeding difficulties and nipple injury. Following the frenotomy, the pain decreased substantially on latch-on and during the feed. The nipples began to heal as well.
Conclusions: It is becoming more common for neonates with biomechanical dysfunctions affecting breastfeeding to present to a chiropractor. This biomechanical dysfunction along with congenital limitations should be explored to solve breastfeeding issues. This case suggests that the frenotomy procedure can help breastfeeding difficulties linked to tongue-tie. Considering the evidence published in the literature on the effectiveness of frenotomy with very few complications, it is the author’s view that patients experiencing breastfeeding difficulties caused by tongue-tie should consider the procedure.
Keywords: neonate, breastfeeding, tongue-tie, frenotomy, chiropractic