A Holistic Supplementation Regimen for Tongue-Tied Babies With Slow Weight Gain and Failure to Thrive

Abstract

Breastfeeding is the best way to feed infants, but optimal milk transfer and weight gain depend on good latching. Tongue- and lip-tie can prevent successful latching and prevent adequate nutrition. Tongue- and lip-tied babies can either have slow weight gain (SWG) or failure to thrive (FTT). We examine the effect of a holistic supplementation regimen on tongue-tied babies with SWG and FTT. This was a descriptive, cross-sectional study of 55 tongue- and lip-tied babies with SWG and FTT at KMC Hospital, Jakarta, Indonesia. All babies underwent frenotomy and received supplementation with formula (64%) or pasteurized donor breast milk, using either a modified lactation aid (78%) or the Medela Supplemental Nursing System (22%). All mothers received domperidone and acupuncture to improve milk supply. A majority of babies had type 3 tongue-tie (46%) and class 3 upper lip-tie. Twenty-five subjects (45%) had SWG, and 30 subjects (55%) had FTT. All mothers had low milk supply. At-the-breast supplementation improved the nutritional status of 44/55 subjects (80%,p< .001), whereas 11 subjects received early complementary feeding at 4 months of age. By the end of the study, all subjects were solely breastfed without at-the-breast supplementation. The holistic management of tongue- and lip-tied babies with SWG or FTT consisting of frenotomy, at-the-breast supplementation, domperidone, and acupuncture improved infant nutritional status and the mother’s milk supply. Babies could breastfeed without supplementation after treatment and gained weight.