CoDAS
https://codas.org.br/article/doi/10.1590/2317-1782/e20240297pt
CoDAS
Case Report

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

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Resumo

RESUMO: Alterações do frênulo lingual podem comprometer a amamentação, causando baixo ganho de peso e/ou desmame precoce. O objetivo deste estudo foi verificar a influência da frenotomia nos parâmetros da avaliação clínica e instrumental da sucção não-nutritiva em recém-nascidos. Trata-se de um estudo de série de casos, com seis recém-nascidos a termo, três do sexo masculino e três do sexo feminino, com anquiloglossia, diagnosticada utilizando-se o Protocolo de Avaliação do Frênulo da Língua em Bebês e Protocolo Bristol de Avaliação da Língua. A avaliação clínica foi realizada por meio do Protocolo da Avaliação da Sucção Não-Nutritiva, e a avaliação instrumental utilizando um equipamento que registra a pressão de sucção. Ambas foram realizadas antes da frenotomia e até 48h após o procedimento, respectivamente, sendo realizada a comparação dos parâmetros entre esses momentos. Foi possível verificar aumento significativo da quantidade de sucções, de grupos de sucções e da pressão média. Houve mudança significativa na pontuação das avaliações após realização do procedimento cirúrgico, com diminuição do escore no protocolo de avaliação do frênulo lingual e aumento no protocolo Bristol. Os parâmetros instrumentais (número de grupos de sucções, número de sucções totais, pressão média) e clínicos (vedamento labial, canolamento, elevação e abaixamento de dorso de língua, elevação e abaixamento de mandíbula, força de sucção, ritmo de sucção, mordidas, excursões exageradas de mandíbula, sinais de estresse) de sucção melhoraram após frenotomia.

Palavras-chave

Comportamento de Sucção, Recém-nascido, Anquiloglossia, Aleitamento Materno, Fonoaudiologia

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

Sucking Behavior; Infant, Newborn; Ankyloglossia; Breast Feeding; Speech, Language and Hearing Sciences

Referencias

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Submitted date:
19/09/2024

Accepted date:
22/11/2024

689a44aca9539524c53ff286 codas Articles

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