Avaliação clínica e instrumental da sucção não nutritiva em recém-nascidos antes e após frenotomia: relato de casos
Clinical and instrumental evaluation of nonnutritive sucking in newborns before and after frenotomy: a case report
Danielle Cristine Marques; Renata Maria Moreira Moraes Furlan; Narciso Sena Fracaroli; Andréa Rodrigues Motta; Estevam Barbosa de Las Casas; Sandra Raquel de Melo Gomes
Resumo
Palavras-chave
Abstract
Changes in the lingual frenulum can impair breastfeeding, leading to poor weight gain and/or early weaning. This study aimed to investigate the influence of frenotomy on the clinical and instrumental parameters of nonnutritive sucking in newborns. It is a case series study with six full-term newborns, three males and three females, diagnosed with ankyloglossia through the Lingual Frenulum Evaluation Protocol for Infants and the Bristol Tongue Assessment Tool. Clinical assessment of non-nutritive sucking was conducted using the Non-Nutritive Sucking Assessment Protocol, and instrumental assessment was performed using an instrument that records sucking pressure. Both assessments were conducted before frenotomy and up to 48 hours after the procedure, respectively, comparing the parameters between these moments. The number of suctions, suction groups, and the mean pressure increased significantly. The evaluation scores also changed significantly after surgery, with a decrease in the lingual frenulum assessment protocol score and an increase in the Bristol Tool score. Instrumental parameters (number of suction groups, total suctions, and mean pressure) and clinical parameters (lip sealing, tongue cupping, tongue dorsum elevation and lowering, mandible elevation and lowering, sucking strength, sucking rhythm, bites, exaggerated mandible excursions, and signs of stress) improved after frenotomy.
Keywords
Referencias
1 Sohn M, Ahn Y, Lee S. Assessment of primitive reflexes in high-risk newborns. J Clin Med Res. 2011;3(6):285-90.
2 Eishima K. The analysis of sucking behaviour in newborn infants. Early Hum Dev. 1991;27(3):163-73.
3 Medoff-Cooper B, Bilker W, Kaplan JM. Sucking patterns and behavioral state in 1- and 2-day-old full-term infants. J Obstet Gynecol Neonatal Nurs. 2010;39(5):519-24.
4 Guido-Campuzano MA, Ibarra-Reyes MP, Mateos-Ortiz C, Mendoza-Vásquez N. Effectiveness of non-nutritive sucking in preterm infants. Perinatol Reprod Hum. 2012;26:198-207.
5 Rendón Macías ME, Serrano Meneses GJ. Physiology of nutritive sucking in newborns and infants. Bol Méd Hosp Infant México. 2011;68:319-27.
6 McCain GC. An evidence-based guideline for introducing oral feeding to healthy preterm infants. Neonatal Netw. 2003;22(5):45-50.
7 Saigal S, Doyle LW. An overview of mortality and sequelae of preterm birth from infancy to adulthood. Lancet. 2008;371(9608):261-9.
8 Gewolb IH, Vice FL. Maturational changes in the rhythms, patterning, and coordination of respiration and swallow during feeding in preterm and term infants. Dev Med Child Neurol. 2006;48(7):589-94.
9 Salas AA, Meads C, Ganus S, Bhatia A, Taylor C, Chandler-Laney P, et al. Quantitative assessment of nutritive sucking patterns in preterm infants. Early Hum Dev. 2020;146:105044.
10 Sales BGSM, Furlan RMMM, Ramos CAV, Fracaroli NS, Casas EBL, Motta AR. Characterization of parameters for the analysis of objective measures of non-nutritive sucking of newborns. CoDAS. 2024;36(4):e20230149.
11 Martinelli RCL, Marchesan IQ, Berretin-Felix G. Lingual frenulum evaluation protocol for infants: relationship between anatomic and functional aspects. Rev CEFAC. 2013;15(3):599-609.
12 Jackson R. Improving breastfeeding outcomes: the impact of tongue-tie. Community Pract. 2012;85(6):42-4. PMid:22779397.
13 SBFA: Sociedade Brasileira de Fonoaudiologia. Comitê de Motricidade Orofacial. Vocabulário técnico-científico em Motricidade Orofacial. São Paulo: SBFA; 2007. 28 p.
14 Fraga MRBA, Barreto KA, Lira TCB, Celerino PRRP, Tavares ITS, Menezes VA. Ankyloglossia and breastfeeding: what is the evidence of association between them?. Rev CEFAC. 2020;22(3):e12219.
15 Ngerncham S, Laohapensang M, Wongvisutdhi T, Ritjaroen Y, Painpichan N, Hakularb P, et al. Lingual frenulum and effect on breastfeeding in Thai newborn infants. Paediatr Int Child Health. 2013;33(2):86-90.
16 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.
17 Martinelli RLC, Marchesan IQ, Lauris JR, Honório HM, Gusmão RJ, Berretin-Felix G. Validade e confiabilidade da triagem: “teste da linguinha. Rev CEFAC. 2016;18(6):1323-31.
18 Martinelli RLC, Marchesan IQ, Lauris JR, Honório HM, Gusmão RJ, Berretin-Felix G. Validation of the lingual frenulum protocol for infants. Int J Orofacial Myology. 2016;42:5-13.
19 Ingram J, Johnson D, Copeland M, Churchill C, Taylor H, Emond A. The development of a tongue assessment tool to assist with tongue-tie identification. Arch Dis Child Fetal Neonatal Ed. 2015;100(4):F344-8.
20 Neiva FCB, Leone C, Leone CR. Non-nutritive sucking scoring system for preterm newborns. Acta Paediatr. 2008;97(10):1370-5.
21 Pineda R, Dewey K, Jacobsen A, Smith J. Non-nutritive sucking in the preterm infant. Am J Perinatol. 2019;36(3):268-76.
22 Nishi E, Wakamatsu Y, Nagamatsu Y, Kuroyanagi Y, Niikawa T. Measurement of tongue-artificial nipple contact force in infants with sucking difficulties. In: 35th Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC); 2013; Osaka, Japan. Proceedings. New York: IEEE; 2013. p. 616-9.
23 França ECL, Albuquerque LCA, Martinelli RLC, Gonçalves IMF, Souza CB, Barbosa MA. Surface electromyographic analysis of the suprahyoid muscles in infants based on lingual frenulum attachment during breastfeeding. Int J Environ Res Public Health. 2020;17(3):859.
24 O’Shea JE, Foster JP, O’Donnell CPF, Breathnach D, Jacobs SE, Todd DA, et al. Frenotomy for tongue-tie in newborn infants. Cochrane Database Syst Rev. 2017;3(3):CD011065.
25 Srinivasan A, Al Khoury A, Puzhko S, Dobrich C, Stern M, Mitnick H, et al. Frenotomy in infants with tongue-tie and breastfeeding problems. J Hum Lact. 2019;35(4):706-12.
26 Martinelli RL, Marchesan IQ, Gusmão RJ, Honório HM, Berretin-Felix G. The effects of frenotomy on breastfeeding. J Appl Oral Sci. 2015;23(2):153-7.
Submitted date:
19/09/2024
Accepted date:
22/11/2024


