{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T01:06:06Z","timestamp":1785546366166,"version":"3.56.0"},"reference-count":44,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2022,2,21]],"date-time":"2022-02-21T00:00:00Z","timestamp":1645401600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100003206","name":"Alberta Children's Hospital Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003206","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Paediatrica"],"published-print":{"date-parts":[[2022,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>Tongue tie is a common problem affecting breastfeeding due to poor infant latch and\/or maternal pain. Evidence of whether treatment improves breastfeeding outcomes is conflicting. We conducted a systematic review and meta\u2010analysis to examine the effectiveness of tongue\u2010tie treatment on breastfeeding difficulties.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We searched peer\u2010reviewed and grey literature in MEDLINE (OVID), PubMed, CINAHL Plus, EMBASE and PsycINFO, from 01\/1970 to 09\/2019. Inclusion: randomised and non\u2010randomised clinical trials, and quasi\u2010experimental study designs, involving breastfeeding interventions for full\u2010term singleton infants, using standardised measure of breastfeeding difficulty. Exclusion: qualitative and purely observational studies, lacked operational definition of breastfeeding difficulty, lacked control\/comparison group. We assessed risk of bias, summarised study quality and results and conducted meta\u2010analysis using random effects modelling.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Six studies on tongue\u2010tie division were included (4 randomised and 2 non\u2010randomised). Meta\u2010analysis of standardised mean differences in breastfeeding difficulty scores in four studies showed statistically significant differences in favour of frenotomy (Pooled SMD +2.12, CI:(0.17\u20134.08)<jats:italic>p<\/jats:italic>\u00a0=\u00a00.03). Similarly, a statistically significant difference in favour of frenotomy was observed for pain (Pooled SMD \u22121.68, 95% CI: (\u22122.87\u2010 \u22120.48).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Results support that infant frenotomy is effective for improving standardised scores on breastfeeding difficulty and maternal pain scales and could improve breastfeeding outcomes.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apa.16289","type":"journal-article","created":{"date-parts":[[2022,2,12]],"date-time":"2022-02-12T16:32:52Z","timestamp":1644683572000},"page":"940-947","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":31,"title":["Systematic review of the evidence for resolution of common breastfeeding problems\u2014Ankyloglossia (Tongue Tie)"],"prefix":"10.1111","volume":"111","author":[{"given":"Talitha L.","family":"Bruney","sequence":"first","affiliation":[{"name":"Department of Obstetrics &amp; Gynecology and Women\u2019s Health Montefiore Medical Center The University Hospital of Albert Einstein College of Medicine  Bronx NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5811-7661","authenticated-orcid":false,"given":"Natalie V.","family":"Scime","sequence":"additional","affiliation":[{"name":"Department of Community Health Sciences Cumming School of Medicine University of Calgary  Calgary Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ada","family":"Madubueze","sequence":"additional","affiliation":[{"name":"Department of Community Health Sciences Cumming School of Medicine University of Calgary  Calgary Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7596-6019","authenticated-orcid":false,"given":"Kathleen H.","family":"Chaput","sequence":"additional","affiliation":[{"name":"Department of Obstetrics &amp; Gynecology and Community Health Sciences Cumming School of Medicine University of Calgary  Calgary Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,2,21]]},"reference":[{"key":"e_1_2_8_2_1","volume-title":"Guidelines on Infant Feeding 2020; Principles and recommendations for infant feeding in the global context and a summary of evidence","author":"World Health Organization","year":"2020"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(16)30534\u20107"},{"key":"e_1_2_8_4_1","unstructured":"Division of Nutrition Physical Activity and Obesity C. 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