Asia Pacific Journal of Pediatric and Child Health

Abstract Ref Number = APCP1257

Poster Presentation

ULTRASOUND FOR SUBMENTAL IMAGING OF BREASTFEEDING INFANT WITH TONGUE-TIE IN NEED FOR FRENOTOMY

Muhammad Reza,Risa Etika,Agus Harianto,Martono Tri Utomo,Dina Angelika,Kartika D H,Mahendra TAS Child Health Dept Dr Soetomo Hospital Airlangga Univ Surabaya Indonesia Child Health Dept, DrSoetomo HospitalAirlangga Univ, Surabaya, Indonesia

Background : Breastfeeding and human milk are the standard for infant's nutrition feeding. The effect of tongue-tie on breastfeeding has been controversy. Tongue-tie is a congenital oral condition, an abnormally short thick lingual frenulum, which restricts tongue movement. The diagnosis is primarily based on the appearance of the tongue and its functional disturbances caused by restricted tongue movement. There is no agreement on the clinical criteria for diagnosis, the justification for frenotomy in need to improving breastfeeding. Ultrasound imaging has been employed as a non-invasive technique can be chosen to explore the sucking dynamics disturbed of the breastfeeding infant by tongue-tie. Case Presentation Summary : Healthy male term infant, 12 days old, 2600g, vaginal birth came to the lactation clinic. He was start not feeding well after delivery with birth weight 2800g. The mother experienced with a discomfort and pain nipples. The infant's oral cavity appeared normal, attached well to the breast, the majority of the feeding sucking non-nutritively. Ultrasound examination revealed a weak suck with inability to either nipple or elevate the tongue to the palate, a tight band extending from the proximal insertion of the frenulum to the tip of the tongue was confirmed. A typical presentation of tongue-tie was queried. He was referred to a pediatric surgeon for further assessment of tongue mobility and agreed, frenotomy was performed. Ultrasound imaging of tongue movement and measurement have done. Now he was fully breastfeeding with better weight gain. Learning Points/Discussion : Ultrasound have potential to provide useful information. This case demonstrate that submental ultrasound imaging successfully identify sucking anomalies in infant with tongue-tie. In the assessment of breastfeeding difficulties, tongue-tie should be considered as a contributing factor.

Keywords: infant tongue-tie frenotomy ultrasound