RESUMO
ABSTRACT Purpose To analyze the effects of lingual frenotomy on the breastfeeding of infants, based on the electrical activity of the masseter and suprahyoid muscles and assessment of the breastfeeding. Methods Observational study developed between October 2017 and June 2018 with a sample of 20 newborns and infants who attended a dental clinic and were diagnosed with ankyloglossia. Another 20 were excluded for meeting some of the following exclusion criteria: babies more than 6 months old, who were not on exclusive or mixed breastfeeding, who had other clinical impairments that interfered with breastfeeding, who had other foods introduced into their diet, who had neurological changes and/or craniofacial deformities, and/or who did not finish all the stages of the study. Breastfeeding was assessed with the UNICEF Breastfeeding Assessment and Observation Protocol, while the muscle electrical activity was assessed with the Electrical Activity Assessment Protocol for the Masseter and Suprahyoid Muscles in Newborns During Breastfeeding. The same speech-language-hearing therapist conducted the two assessments both before the conventional frenotomy and 7 days after it. Results The signs suggestive of breastfeeding difficulties changed 7 days after the surgery, with a p-value ≤ 0.002 for general observation of the mother, position of the infant, latch, and sucking. The maximum voluntary contraction of the masseter was the only integral parameter with a difference, as the electrical activity had decreased. Conclusion Behaviors favorable to breastfeeding increased 7 days after the frenotomy in all the breastfeeding assessment categories, whereas the electrical activity of the masseter decreased.
RESUMO Objetivo Analisar os efeitos da frenotomia lingual na amamentação de recém-nascidos, com base na atividade elétrica dos músculos masseter e supra-hióideos e avaliação da mamada. Método Estudo observacional, desenvolvido entre outubro de 2017 e junho de 2018. Amostra de 20 recém-nascidos e lactentes de uma clínica odontológica, diagnosticados com anquiloglossia; 20 foram excluídos por se encaixarem em algum dos critérios de exclusão: ter mais de seis meses de vida, não fazer aleitamento materno exclusivo ou misto, apresentar outro comprometimento clínico que interfira na amamentação, ter iniciado a ingestão de outros alimentos, alterações neurológicas e/ou deformidades craniofaciais e não ter finalizado todas as etapas do estudo. A avaliação da amamentação seguiu o Protocolo de Observação e Avaliação da Mamada da UNICEF, e a avaliação da atividade elétrica muscular o Protocolo de Avaliação da Atividade Elétrica dos Músculos Masseter e Supra-hióideos em Recém-Nascidos Durante a Alimentação, ambas realizadas pela mesma fonoaudióloga antes da frenotomia convencional e sete dias após. Resultados Os sinais sugestivos de dificuldade na amamentação mudaram sete dias após a cirurgia, com valor de p≤0,002 para a observação geral da mãe, posição do bebê, pega e sucção. Houve diferença apenas no parâmetro integral da Contração Voluntária Máxima do masseter, com diminuição da atividade elétrica. Conclusão Sete dias após a frenotomia observou-se aumento de comportamentos favoráveis à amamentação em todas as categorias de avaliação da mamada e diminuição da atividade elétrica do masseter.
RESUMO
ABSTRACT Purpose: to investigate what effects lingual frenotomy has on breastfeeding. Methods: based on the research question - "Is there a relationship between the improvement in breastfeeding and the lingual frenotomy?" -, a bibliographical survey was carried out in three databases, using the following descriptors: ankyloglossia, lingual frenum, breastfeeding and frenotomy. Frenotomy is a free term. Original articles with babies up to 6 months old who had difficulties breastfeeding due to ankyloglossia and who had been submitted to lingual frenotomy were chosen. An instrument was developed, containing the following information: name of the authors, year of publication, country of origin, the objective of the study, type of study, sample, main results, and conclusion. Literature Review: of the 243 articles screened, four met the inclusion criteria for this study. It was observed that, after lingual frenotomy, some changes may take place in breastfeeding patterns, such as an increase in the number of suctions and a decrease in the time of pause in between series of suctions. Conclusion: the lingual frenotomy can be an important procedure in the treatment of babies with ankyloglossia, possibly helping improve the latch and breastfeeding.