IMPROVING SCREENING FOR BREASTFEEDING DIFFICULTY AND ASSESSMENT OF LABIAL AND LINGUAL FRENULUM-TIES IN BREASTFEEDING INFANTS DURING THE PEDIATRIC VISIT

Abstract

The correlation between breastfeeding difficulty and labial (lip) and lingual (tongue)-tie has recently been a controversial topic with focus on treatment concerns. The focus should be redirected to standardized identification of breastfeeding difficulty and assessment for frenulum tethers as a cause for infants during pediatric office visits. In order to meet American Academy of Pediatrics and U.S. Preventative Task Force recommendations to exclusively breastfeed infants up to at least 6 months of age, a project was designed to encourage standardized inquiry and education about breastfeeding and potential tongue/lip-tie during the highly influential outpatient pediatric visit (AAP, 2015; U.S. Preventative Task Force, 2016). This project introduces clinical guidelines comprised of breastfeeding difficulty screening questions, lingual/labial frenulum assessment tools, and treatment recommendations for use by providers in a private pediatric clinic. Methods for educating and implementing new guidelines with practitioners included educational sessions with visual and descriptive tools, and interdisciplinary instruction with Lactation Consultants and Otorhinolaryngologists (ENT). Participants included private and government-funded paying families with breastfed infants in an urban pediatric clinic over the course of 3 months. Data analysis was collected during weekly medical record audits. There were a total of 109 breastfeeding infants screened or examined for frenulum tie. There was an increase in breastfeeding difficulty screening. In conclusion, after evaluation it was determined that dissemination of current literature regarding how best to screen for breastfeeding difficulty and, in response, recognize, assess, and repair tongue and lip-tie in infants experiencing breastfeeding difficulties increases standardization and consistency of screening as well as awareness of tongue/lip-tie as a contributor to breastfeeding difficulty.