{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T22:35:37Z","timestamp":1784673337596,"version":"3.55.0"},"reference-count":30,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2019,7,2]],"date-time":"2019-07-02T00:00:00Z","timestamp":1562025600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Paediatrica"],"published-print":{"date-parts":[[2019,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>We evaluated what determined breastfeeding problems in a non\u2010selected mother\u2010infant cohort, with special reference to tongue\u2010tie and improvements in breastfeeding following frenulotomy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This 2014\u20102015 prospective, observational study was carried out in a tertiary level maternity unit affiliated to the University of Freiburg, Germany, using a breastfeeding questionnaire, standardised breastfeeding scores and the Assessment Tool For Lingual Frenulum Function (ATLFF). The standard intervention was breastfeeding support, a frenulotomy for tongue\u2010tie was performed if necessary. All cases of breastfeeding problems and, or tongue\u2010tie, were followed up by telephone 2.5\u00a0weeks after birth.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We enrolled 776 newborn\u2010mother dyads: 345 had breastfeeding problems, 116 had a tongue\u2010tie and 30 underwent a frenulotomy. In the multivariate analysis, severe breastfeeding problems were more frequent in newborn infants with tongue\u2010tie, with an odds ratio (OR) of 2.6 (<jats:italic>P<\/jats:italic>=\u00a00.014). Other risk factors were: no breastfeeding experience (OR 4.4, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.001), low birth weight (OR 2.9, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.001), prematurity (OR 3.6, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.000) and Caesarean section (OR 1.6, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.023). There was a significant reduction in breastfeeding problems after frenulotomy (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.01).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Tongue\u2010tie had a significant impact on breastfeeding and so did low birth weights and prematurity. Frenulotomy proved helpful when breastfeeding problems were reported.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apa.14924","type":"journal-article","created":{"date-parts":[[2019,7,2]],"date-time":"2019-07-02T14:28:51Z","timestamp":1562077731000},"page":"2214-2221","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":36,"title":["The role of tongue\u2010tie in breastfeeding problems\u2014A prospective observational study"],"prefix":"10.1111","volume":"108","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7766-8207","authenticated-orcid":false,"given":"Sara\u2010Maria","family":"Schlatter","sequence":"first","affiliation":[{"name":"Division of Neonatology\/Intensive Care Medicine, Department of General Pediatrics, Medical Center University of Freiburg Freiburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wiebke","family":"Schupp","sequence":"additional","affiliation":[{"name":"Center for Dental Medicine, Division of Oral and Maxillofacial Surgery, Medical Center University of Freiburg Freiburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00f6rg\u2010Elard","family":"Otten","sequence":"additional","affiliation":[{"name":"Center for Dental Medicine, Division of Oral and Maxillofacial Surgery, Medical Center University of Freiburg Freiburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabine","family":"Harnisch","sequence":"additional","affiliation":[{"name":"Division of Neonatology\/Intensive Care Medicine, Department of General Pediatrics, Medical Center University of Freiburg Freiburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mirjam","family":"Kunze","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Medical Center University of Freiburg Freiburg 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