CoDAS
https://codas.org.br/article/doi/10.1590/2317-1782/20232023054
CoDAS
Artigo Original

Dysfunctional suction dynamics in newborns with ankyloglossia

Dinâmica de sucção disfuncional em recém-nascidos com anquiloglossia

Bruna Mendes Lourenço Cunha; Erika Baptista Luiz Badarane; Paulo Vitor Melo Sousa Filho; Kauê Machado Costa; Manoel da Silva Filho

Downloads: 0
Views: 339

Abstract

ABSTRACT: Purpose: Compare infant suction in babies with and without ankyloglossia using a microprocessor-controlled pressure sensor coupled to a pacifier.

Methods: Fifty-five infants from 0 to 2 months of age underwent clinical examination for ankyloglossia, after which they were offered a silicone pacifier connected to the pressure acquisition

device and suction activity was recorded. Thus, we extracted the frequency of sucks within a burst, the average suck duration, the burst duration, the number of sucks per burst, the maximum amplitude of sucks per burst and the inter-burst interval.


Results: The key difference in newborns with ankyloglossia in relation to control was that they perform longer bursts of suction activity.

Conclusion: The longer burst durations are likely a compensatory strategy and may underlie the pain reported by mothers during breastfeeding. We therefore propose a method for objectively quantifying some parameters of infant suction capacity and demonstrate its use in assisting the evaluation of ankyloglossia.

Keywords

Ankyloglossia, Sucking Behavior, Newborn, Breast Feeding, Lingual Frenum

Resumo

RESUMO: Objetivo: Comparar a sucção infantil em bebês com e sem anquiloglossia usando um sensor de pressão controlado por microprocessador acoplado a uma chupeta.

Método: Cinquenta e cinco lactentes de 0 a 2 meses de idade foram submetidos ao exame clínico de anquiloglossia, em seguida foi oferecido uma chupeta de silicone conectada ao dispositivo de aquisição de pressão e a atividade de sucção foi registrada. Assim, obtivemos dados sobre a frequência de sucções dentro de um período de sucções, a duração média da sucção, a duração da rajada, o número de sucções por rajada, a amplitude máxima das sucções por rajada e o intervalo entre rajadas. O teste t não pareado foi utilizado para comparações entre os grupos.

Resultados: A principal diferença dos recém-nascidos com anquiloglossia em relação aos do grupo controle é que eles realizam rajadas mais longas durante a atividade de sucção.

Conclusão: A duração mais longa das rajadas é provavelmente uma estratégia compensatória e pode estar por trás da dor relatada pelas mães durante a amamentação. Portanto, propomos um método para quantificar objetivamente alguns parâmetros da sucção infantil e demonstramos seu uso para auxiliar na avaliação da anquiloglossia.
 

Palavras-chave

Anquiloglossia, Comportamento de Sucção, Recém-Nascido, Aleitamento Materno, Freio Lingual

Referências

1 World Health Organization. United Nations Children’s Fund. Global strategy for infant and young child feeding [Internet]. Geneva: WHO; 2003 [cited 2023 Feb 10]. Available from: http://apps.who.int/iris/bitstream/10665/42590/1/9241562218.pdf

2 Neu AP, Silva AMT, Mezzom CL, Busanello-Stella AR, Moraes AB. Relationship between time and type of breastfeeding and stomatognathic system functions. CEFAC. 2013;15(2):420-6. http://dx.doi.org/10.1590/S1516-18462012005000020.

3 Campanha SM, Martinelli RL, Palhares DB. Association between ankyloglossia and breastfeeding. CoDAS. 2019;31(1):e20170264. http://dx.doi.org/10.1590/2317-1782/20182018264. PMid:30810632.

4 Knox I. Tongue tie and frenotomy in the breastfeeding newborn. Neoreviews. 2010;11(9):513-9. http://dx.doi.org/10.1542/neo.11-9-e513.

5 Schwartz J. Identifying ankyloglossia in newborns at Paoli Hospital : a quality improvement project [dissertation]. Filadélfia: Drexel University; 2018. 72 p. http://dx.doi.org/10.17918/etd-7849.

6 Greener M. Tongue tie and breastfeeding [Internet]. Mum and Baby Academy; 2017 [cited 2023 Feb 10]. Available from: https://www.healthprofessionalacademy.co.uk/mum-and-baby/resource/tongue-tie

7 Bruney TL, Scime NV, Madubueze A, Chaput KH. Systematic review of the evidence for resolution of common breastfeeding problems-Ankyloglossia (Tongue Tie). Acta Paediatr. 2022;111(5):940-7. http://dx.doi.org/10.1111/apa.16289. PMid:35150472.

8 Zaghi S, Shamtoob S, Peterson C, Christianson L, Valcu-Pinkerton S, Peeran Z, et al. Assessment of posterior tongue mobility using lingual-palatal suction: progress towards a functional definition of ankyloglossia. J Oral Rehabil. 2021;48(6):692-700. http://dx.doi.org/10.1111/joor.13144. PMid:33386612.

9 Lau C. Development of infant oral feeding skills : what do we know? Am J Clin Nutr. 2016;103(2, Suppl Suppl):616S-21S. http://dx.doi.org/10.3945/ajcn.115.109603. PMid:26791183.

10 Genna CW. Supporting sucking skills in breastfeeding infants. 4th ed. Burlington: Jones & Bartlett Publishers; 2022.

11 Francis DO, Krishnaswami S, Mcpheeters M. Treatment of ankyloglossia and breastfeeding outcomes: a systematic review. Pediatrics. 2015;135(6):e1458-66. http://dx.doi.org/10.1542/peds.2015-0658. PMid:25941303.

12 Muldoon K, Gallagher L, McGuinness D, Smith V. Effect of frenotomy on breastfeeding variables in infants with ankyloglossia (tongue-tie): a prospective before and after cohort study. BMC Pregnancy Childbirth. 2017;17(1):373. http://dx.doi.org/10.1186/s12884-017-1561-8. PMid:29132414.

13 Geddes DT, Langton DB, Gollow I, Jacobs LA, Hartmann PE, Simmer K. Frenulotomy for breastfeeding infants with ankyloglossia: effect on milk removal and sucking mechanism as imaged by ultrasound. Pediatrics. 2008;122(1):e188-94. http://dx.doi.org/10.1542/peds.2007-2553. PMid:18573859.

14 Jin RR, Sutcliffe A, Vento M, Miles C, Travadi J, Kishore K, et al. What does the world think of ankyloglossia? Acta Paediatr. 2018;107(10):1733-8. http://dx.doi.org/10.1111/apa.14242. PMid:29385272.

15 Martinelli RLC, Marchesan IQ, Rodrigues AC, Berretin-Felix G. Protocol for infants: relationship between anatomic and functional aspects. CEFAC. 2013;15(3):599-609. http://dx.doi.org/10.1590/S1516-18462013005000032.

16 Cunha M, Barreiros J, Pereira JM, Viegas V, Banha C, Diniz A, et al. A promising and low-cost prototype to evaluate the motor pattern of nutritive and non-nutritive suction in newborns. JPNIM. 2019;8(2):e080220. http://dx.doi.org/10.7363/080220.

17 Coryllos E, Genna C, Salloum A. Congenital tongue- tie and its impact on breastfeeding [Internet]. Am Acad Pediatr; 2004 [cited 2023 Feb 10]. Available from: https://www.researchgate.net/publication/301346077_Congenital_tongue-tie_and_its_impact_on_breastfeeding.

18 Hogan M, Westcott C, Griffiths M. Randomized, controlled trial of division of tongue-tie in infants with feeding problems. J Paediatr Child Health. 2005;41(5-6):246-50. http://dx.doi.org/10.1111/j.1440-1754.2005.00604.x. PMid:15953322.

19 Foster JP, Psaila K, Patterson T. Non-nutritive sucking for increasing physiologic stability and nutrition in preterm infants. Cochrane Database Syst Rev. 2016;10(10):CD001071. http://dx.doi.org/10.1002/14651858.CD001071.pub3. PMid:27699765.

20 Sakalidis VS, Williams TM, Garbin CP, Hepworth AR, Hartmann PE, Paech MJ, et al. Ultrasound imaging of infant sucking dynamics during the establishment of lactation. J Hum Lact. 2013;29(2):205-13. http://dx.doi.org/10.1177/0890334412452933. PMid:22965645.

21 Walker M. Functional assessment of infant breastfeeding patterns. Birth. 1989;16(3):140-7. http://dx.doi.org/10.1111/j.1523-536X.1989.tb00883.x. PMid:2789563.

22 Alves YV, Santos JC, Barreto ID, Fujinaga CI, Medeiros AM. Full term newborns in non-nutritive suction evaluation and their relation on feeding performance. Ver Bras Saúde Mater Infant. 2019;19(3):621-30. http://dx.doi.org/10.1590/1806-93042019000300008.

23 O’Shea JE, Foster JP, O’Donnell CP, Breathnach D, Jacobs SE, Todd DA, et al. Frenotomy for tongue-tie in newborn infants. Cochrane Database Syst Rev. 2017;3(3):CD011065.

24 World Health Organization. Complementary feeding. Geneva: WHO; 2001.
 


Submetido em:
16/03/2023

Aceito em:
26/06/2023

66578528a9539566b7027e93 codas Articles

CoDAS

Share this page
Page Sections