All Tied Up! Influences of Oral Frenulae on Breastfeeding and their Recommended Management Strategies

Abstract

Background: Recently, there has been an increased awareness of the role of the labial and lingual frenulae on a neonate's ability to latch and breastfeed efficiently. This critical review explores the (i) oral physiology of a baby nursing (ii) factors that can decrease a baby's ability to nurse efficiently, the problems these cause and their management and the (iii) relation between poor nursing efficacy and the risk of early childhood caries (ECC) Study design: An expansive search of the literature was performed using four electronic databases. Results and conclusions: Most studies assessing the role of labial and lingual frenulae on breastfeeding were of a low quality. The relation between ECC and poor nursing efficacy was found to be largely speculative. Hence, the results of these studies should be interpreted with caution. Despite the limited quality and external validity of the current evidence, in cases where breastfeeding difficulties are identified, surgical management of labial or lingual frenulae may provide some subjective improvements in breastfeeding outcome.