{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T09:56:10Z","timestamp":1777456570883,"version":"3.51.4"},"reference-count":28,"publisher":"SAGE Publications","issue":"10","license":[{"start":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T00:00:00Z","timestamp":1759276800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Breastfeeding Medicine"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>Surgical correction of ankyloglossia through frenotomy has increased over 10-fold in the past decade, despite not seeing any significant improvement in breastfeeding rates. Due to heightened attention to this diagnosis and lack of consensus on treatment, we sought to evaluate our regional practice and standardize the screening for ankyloglossia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>A retrospective cohort study of frenotomy practice within the birth hospital stay was conducted from June 1, 2019, to June 30, 2021. Patients were identified through billing data and grouped according to race, ethnicity, and health insurance status. The Tongue-tie and Breastfed Babies pictorial tool was then implemented regionally to test for differences. Post-intervention data was analyzed from June 1, 2023, to December 31, 2024. Chi-squared analysis was performed to test for differences.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Pre-intervention, there were significant disparities in frenotomy rates, with privately insured patients 2.75 times more likely than those with public insurance to receive a frenotomy during their birth hospitalization (OR 2.75, 95% CI: 2.43\u20133.12,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; 0.0001). Non-Hispanic White infants were 2.3 times more likely than non-Hispanic Black patients (OR 2.31, 95% CI: 1.94\u20132.74,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; 0.0001) and 3.9 times more likely than Hispanic infants to undergo the procedure (OR 3.87, 95% CI: 2.19\u20136.86,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; 0.0001). After the standardization, there were no longer any statistically significant disparities in frenotomy rates by insurance payor status as well as those between non-Hispanic White and non-Hispanic Black patients. Non-Hispanic White infants were still slightly more likely than Hispanic patients to undergo the procedure, but the odds ratio decreased significantly to just 1.37 (OR 1.37, 95% CI: 1.04\u20131.80,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.0265).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>These findings suggest that standardizing the assessment of ankyloglossia can improve disparities among those who receive a frenotomy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/15568253251360779","type":"journal-article","created":{"date-parts":[[2025,9,26]],"date-time":"2025-09-26T21:11:56Z","timestamp":1758921116000},"page":"715-721","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Reducing Racial, Ethnic, and Socioeconomic Disparities in Frenotomy Practice"],"prefix":"10.1177","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-0697-6396","authenticated-orcid":false,"given":"Annemarie","family":"Kelly","sequence":"first","affiliation":[{"name":"Division of Neonatology and Pulmonary Biology, Cincinnati Children\u2019s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Scott","family":"Wexelblatt","sequence":"additional","affiliation":[{"name":"Division of Neonatology and Pulmonary Biology, Cincinnati Children\u2019s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5356-0026","authenticated-orcid":false,"given":"Laura","family":"Ward","sequence":"additional","affiliation":[{"name":"Division of Neonatology and Pulmonary Biology, Cincinnati Children\u2019s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nichole","family":"Nidey","sequence":"additional","affiliation":[{"name":"Assistant Professor of Epidemiology, University of Iowa College of Public Health, Iowa City, Iowa, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer","family":"McAllister","sequence":"additional","affiliation":[{"name":"Division of Neonatology and Pulmonary Biology, Cincinnati Children\u2019s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,10,14]]},"reference":[{"key":"e_1_3_4_2_2","unstructured":"Center for Disease Control and Prevention Results: Breastfeeding Rates: Breastfeeding Among U.S. Children Born 2012\u20132019 CDC National Immunization Survey: Results. National Immunization Survey (NIH). 2022. Available from: https:\/\/www.cdc.gov\/breastfeeding-data\/survey\/results.html?CDC_AAref_Val=https:\/\/www.cdc.gov\/breastfeeding\/data\/nis_data\/results.html [Last accessed: March21 2025]."},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2023.1256432"},{"key":"e_1_3_4_4_2","unstructured":"U.S. Department of Health and Human Services Office of Disease Prevention and Health Promotion. Healthy People 2020. Increase the proportion of infants who are Breastfed exclusively through age 6 months. Available from: https:\/\/odphp.health.gov\/healthypeople\/objectives-and-data\/browse-objectives\/infants\/increase-proportion-infants-who-are-breastfed-exclusively-through-age-6-months-mich-15\/data [Last accessed: March11 2025]."},{"key":"e_1_3_4_5_2","unstructured":"AAP 2022. Newborn and Infant Breastfeeding. Available from: https:\/\/www.aap.org\/en\/patient-care\/newborn-and-infant-nutrition\/newborn-and-infant-breastfeeding\/#:\u223c:text=For%20the%20best%20health%20outcomes and%20beyond%20as%20mutually%20desired [Last accessed: January29 25]."},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1089\/bfm.2014.0152"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2020-030502"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10995-025-04065-y"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1177\/0194599820915457"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.otc.2019.06.008"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1089\/bfm.2021.29179.ylf"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.110.5.e63"},{"issue":"3","key":"e_1_3_4_13_2","first-page":"CD011065","article-title":"Frenotomy for tongue-tie in newborn infants","volume":"3","author":"O\u2019Shea JE","year":"2017","unstructured":"O\u2019Shea JE, , Foster JP, , O\u2019Donnell CPF, et al. Frenotomy for tongue-tie in newborn infants. 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