Feeding and swallowing are among the most important functions in the early period of child development. In addition to ensuring adequate nutritional intake, they enable growth, development, and the establishment of early interactions between the child and parents. Although feeding develops without major difficulties in most full-term newborns, some children present with various disorders and deviations that may affect feeding efficiency, weight gain, and quality of life. Their causes can be numerous and include anatomical, physiological, and environmental factors. Among the frequently discussed anatomical factors is ankyloglossia, or a short lingual frenulum, which may limit tongue mobility and affect the efficiency of sucking, swallowing, and breastfeeding.
The empirical part is based on a study conducted on a sample of 333 full-term newborns. Data were collected using a questionnaire immediately after birth, as well as at two and three months after birth. The questionnaires were developed based on literature and in collaboration with professionals from clinical practice and were used for the purposes of this study.
In recent years, interest in ankyloglossia has been increasing, along with ongoing debates regarding its impact on feeding and the need for surgical intervention. Despite numerous studies, many questions remain unresolved. There is a lack of uniform diagnostic criteria in the literature, and various classification systems and assessment protocols are used; moreover, research findings on the impact of ankyloglossia on feeding are not always consistent. Therefore, further research in this area remains necessary, particularly in full-term newborns.
The aim of the study was to investigate the prevalence of feeding and swallowing difficulties in full-term newborns and the factors associated with their occurrence. Particular attention was given to the role of ankyloglossia, its impact on feeding and swallowing, and the potential effect of surgical intervention on the lingual frenulum. Feeding was monitored during the early neonatal period and two and three months after birth, providing insight into the course and resolution of feeding difficulties over time. In the first days after birth, a paediatrician at the maternity hospital assessed the infant’s lingual frenulum using the Tongue-tie and Breastfed Babies (TABBY) assessment tool and determined whether surgical intervention on the lingual frenulum was indicated. Questionnaire results were compared between children with and without ankyloglossia at the maternity hospital and two months after discharge, and the potential positive effect of surgery on feeding was assessed.
In the maternity hospital, 13,8% of the 333 term newborns experienced feeding difficulties. The occurrence of feeding difficulties was associated with mode of delivery (feeding difficulties were more common among children born by caesarean section, p = 0,037), being a first-born child (p = 0,021), the presence of ankyloglossia (p = 0,024), and maternal experience of stress during feeding (p < 0,001). Thus, in term newborns, ankyloglossia was identified as a factor associated with a higher occurrence of feeding and swallowing difficulties in the univariate analysis; however, this association was not statistically significant in the binary logistic regression analysis. Only 308 children were assessed using the TABBY tool, and ankyloglossia was diagnosed based on the TABBY score in 39 children. Frenulotomy was performed in 33 newborns. Among children with ankyloglossia, 25,6 % experienced feeding difficulties, compared with 13,0 % of children without ankyloglossia. Following surgery, feeding improved in only 25,8 % of children with ankyloglossia.
Two months after discharge, only 240 mothers completed the questionnaire. Of these, 11,4 % reported that their children still experienced feeding difficulties. These mothers were sent the same questionnaire three months after discharge. At that time, 17 of the 37 parents who responded reported feeding difficulties. This represented 5,1 % of the children in the initial sample. Among these children, 10,3 % had ankyloglossia, including 7 (17,9 %) children who had undergone frenulotomy.
The results suggest that feeding difficulties occur in 13,8 % of healthy term newborns; however, in most children, these difficulties resolve within three months after discharge from the maternity hospital. Ankyloglossia is a factor associated with an increased likelihood of feeding difficulties in healthy newborns; however, surgical treatment improves feeding in only one quarter of these children. Further research may help determine which children with ankyloglossia are most likely to experience improved feeding following surgical intervention on the lingual frenulum.
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