{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T10:26:45Z","timestamp":1787826405166,"version":"build-2784847793"},"reference-count":34,"publisher":"MDPI AG","issue":"22","license":[{"start":{"date-parts":[[2023,11,13]],"date-time":"2023-11-13T00:00:00Z","timestamp":1699833600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.mdpi.com"],"crossmark-restriction":true},"short-container-title":["Diagnostics"],"abstract":"<jats:p>To effectively address breastfeeding issues for neonates and mothers, one must understand the physiology of breastfeeding and the anatomical components involved in sucking, swallowing, and respiration. This study compared the tongue position and movement of neonates with tongue ties versus healthy controls during sucking. A new objective ultrasonography diagnostic approach was also introduced for the orofacial region. This retrospective study evaluated B-mode and M-mode ultrasonography images from 30 neonates clinically diagnosed with tongue tie, and a control group of 30 neonates. B-mode ultrasound images were used to examine several characteristics to locate the nipple in the oral cavity during breastfeeding. Anatomic M-mode ultrasound images were used to assess tongue movement during sucking. The nipple moved farther from the intersection of the hard and soft palates during the sucking cycle in the ankyloglossia group than in the control group (p &lt; 0.05). Compared to the control group, neonates with ankyloglossia have a lower capacity to lift the anterior tongue toward the palate when sucking (p &lt; 0.05). There was no significant difference in tongue movement metrics between the two groups (p &gt; 0.05). Our findings were consistent with earlier research. The novel measurement method will offer a new perspective on breastfeeding.<\/jats:p>","DOI":"10.3390\/diagnostics13223435","type":"journal-article","created":{"date-parts":[[2023,11,13]],"date-time":"2023-11-13T02:30:29Z","timestamp":1699842629000},"page":"3435","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Evaluation of the Breastfeeding Dynamics of Neonates with Ankyloglossia via a Novel Ultrasonographic Technique"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7771-0380","authenticated-orcid":false,"given":"Arzu","family":"Alan","sequence":"first","affiliation":[{"name":"Ankara 75th Year Oral and Dental Health Hospital, Ministry of Health, Ankara 06230, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayse Isil","family":"Orhan","sequence":"additional","affiliation":[{"name":"Department of Pediatric Dentistry, Faculty of Dentistry, Ankara Yildirim Beyazit University, Ankara 06220, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6768-0176","authenticated-orcid":false,"given":"Kaan","family":"Orhan","sequence":"additional","affiliation":[{"name":"Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Ankara University, Ankara 06560, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,11,13]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"407","DOI":"10.17796\/1053-4625-42.6.1","article-title":"All Tied Up! Influences of Oral Frenulae on Breastfeeding and their Recommended Management Strategies","volume":"42","author":"Patel","year":"2018","journal-title":"J. Clin. Pediatr. Dent."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1017\/S0954422408100749","article-title":"Evolution of lactation: Nutrition v. protection with special reference to five mammalian species","volume":"21","author":"McClellan","year":"2008","journal-title":"Nutr. Res. Rev."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1016\/j.midw.2017.12.007","article-title":"Practice-based interpretation of ultrasound studies leads the way to more effective clinical support and less pharmaceutical and surgical intervention for breastfeeding infants","volume":"58","author":"Douglas","year":"2018","journal-title":"Midwifery"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"S69","DOI":"10.1542\/peds.2008-1315i","article-title":"Why mothers stop breastfeeding: Mothers\u2019 self-reported reasons for stopping during the first year","volume":"122","author":"Li","year":"2008","journal-title":"Pediatrics"},{"key":"ref_5","unstructured":"Arvedson, J. (2006). Swallowing and feeding in infants and young children. GI Motil. Online."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"344","DOI":"10.1111\/j.1469-8749.1998.tb15387.x","article-title":"Development of perioral muscle activity during suckling in infants: A cross-sectional and follow-up study","volume":"40","author":"Tamura","year":"1998","journal-title":"Dev. Med. Child. Neurol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"471","DOI":"10.1016\/j.earlhumdev.2007.12.008","article-title":"Tongue movement and intra-oral vacuum in breast-feeding infants","volume":"84","author":"Geddes","year":"2008","journal-title":"Early Hum. Dev."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"156","DOI":"10.1259\/0007-1285-31-363-156","article-title":"A cineradiographic study of breastfeeding","volume":"31","author":"Ardran","year":"1958","journal-title":"Br. J. Radiol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"422","DOI":"10.1136\/bmj.2.5093.422","article-title":"Sucking and swallowing in infants","volume":"2","author":"Colley","year":"1958","journal-title":"Br. Med. J."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"164","DOI":"10.1016\/S0266-6138(86)80041-9","article-title":"The anatomy of infant sucking","volume":"2","author":"Woolridge","year":"1986","journal-title":"Midwifery"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1111\/j.1469-8749.1986.tb03825.x","article-title":"An ultrasonographic study of the organization of sucking and swallowing by newborn infants","volume":"28","author":"Weber","year":"1986","journal-title":"Dev. Med. Child. Neurol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"635","DOI":"10.1016\/j.earlhumdev.2013.04.009","article-title":"Real-time 3D ultrasound imaging of infant tongue movements during breast-feeding","volume":"89","author":"Burton","year":"2013","journal-title":"Early Hum. Dev."},{"key":"ref_13","first-page":"76","article-title":"Imaging evaluation of the human nipple during breast-feeding","volume":"142","author":"Smith","year":"1988","journal-title":"Am. J. Dis. Child."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"5230","DOI":"10.1073\/pnas.1319798111","article-title":"Biomechanics of milk extraction during breast-feeding","volume":"111","author":"Elad","year":"2014","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"6","DOI":"10.14740\/ijcp246w","article-title":"Aerophagia Induced Reflux in Breastfeeding Infants with Ankyloglossia and Shortened Maxillary Labial Frenula (Tongue and Lip Tie)","volume":"5","author":"Siegel","year":"2016","journal-title":"Int. J. Clin. Pediatr."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1217","DOI":"10.1002\/lary.26306","article-title":"Breastfeeding improvement following tongue-tie and lip-tie release: A prospective cohort study","volume":"127","author":"Ghaheri","year":"2017","journal-title":"Laryngoscope"},{"key":"ref_17","first-page":"216","article-title":"Ankyloglossia and Its Influence on Growth and Development of the Stomatognathic System","volume":"35","author":"Ilinsky","year":"2017","journal-title":"Rev. Paul. Pediatr."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1001\/archotol.126.1.36","article-title":"Ankyloglossia: Incidence and associated feeding difficulties","volume":"126","author":"Messner","year":"2000","journal-title":"Arch. Otolaryngol. Head Neck Surg."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1177\/089033449000600318","article-title":"Neonatal frenotomy may be necessary to correct breastfeeding problems","volume":"6","author":"Marmet","year":"1990","journal-title":"J. Hum. Lact."},{"key":"ref_20","first-page":"1027","article-title":"Prevalence, diagnosis, and treatment of ankyloglossia: Methodologic review","volume":"53","author":"Segal","year":"2007","journal-title":"Can. Fam. Physician."},{"key":"ref_21","first-page":"332","article-title":"Assessing infant suck dysfunction: Case management","volume":"16","author":"Marmet","year":"2000","journal-title":"J. Hum. Lact."},{"key":"ref_22","first-page":"439","article-title":"Factors associated with weaning in the first 3 months postpartum","volume":"51","author":"Schwartz","year":"2002","journal-title":"J. Fam. Pract."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1177\/08903344090250011501","article-title":"Breastfeeding and tongue-tie","volume":"25","author":"Genna","year":"2009","journal-title":"J. Hum. Lact."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"379","DOI":"10.1148\/radiology.156.2.3892576","article-title":"Physiology of sucking in the normal term infant using real-time US","volume":"156","author":"Smith","year":"1985","journal-title":"Radiology"},{"key":"ref_25","first-page":"1","article-title":"Ankyloglossia: A review of current status","volume":"12","author":"Hooda","year":"2010","journal-title":"Internet J. Otorhinolaryngol."},{"key":"ref_26","first-page":"96","article-title":"Tongue tie: Exploding the myths","volume":"2","author":"Johnson","year":"2006","journal-title":"Infant"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"340","DOI":"10.1177\/0890334415626152","article-title":"Ultrasound imaging of breastfeeding\u2014A window to the inside: Methodology, normal appearances, and application","volume":"32","author":"Geddes","year":"2016","journal-title":"J. Hum. Lact."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1797","DOI":"10.1016\/j.ultrasmedbio.2010.08.005","article-title":"Validation of nipple diameter and tongue movement measurements with B-mode ultrasound during breastfeeding","volume":"36","author":"McClellan","year":"2010","journal-title":"Ultrasound Med. Biol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1177\/0890334412452933","article-title":"Ultrasound imaging of infant sucking dynamics during the establishment of lactation","volume":"29","author":"Sakalidis","year":"2013","journal-title":"J. Hum. Lact."},{"key":"ref_30","first-page":"e17284","article-title":"The Use of Angle-Independent M-Mode in the Evaluation of Diaphragmatic Excursion: Towards Improved Accuracy","volume":"13","author":"Schleifer","year":"2021","journal-title":"Cureus"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"2408","DOI":"10.12998\/wjcc.v8.i12.2408","article-title":"Assessment of diaphragmatic function by ultrasonography: Current approach and perspectives","volume":"8","author":"Boussuges","year":"2020","journal-title":"World J. Clin. Cases"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"e188","DOI":"10.1542\/peds.2007-2553","article-title":"Frenulotomy for breastfeeding infants with ankyloglossia: Effect on milk removal and sucking mechanism as imaged by ultrasound","volume":"122","author":"Geddes","year":"2008","journal-title":"Pediatrics"},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Geddes, D.T., Gridneva, Z., Perrella, S.L., Mitoulas, L.R., Kent, J.C., Stinson, L.F., Lai, C.T., Sakalidis, V., Twigger, A.J., and Hartmann, P.E. (2021). 25 Years of Research in Human Lactation: From Discovery to Translation. Nutrients, 13.","DOI":"10.3390\/nu13093071"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1177\/0890334406297184","article-title":"Normal nipple position in term infants measured on breastfeeding ultrasound","volume":"23","author":"Jacobs","year":"2007","journal-title":"J. Hum. Lact."}],"updated-by":[{"DOI":"10.3390\/diagnostics14060608","type":"correction","label":"Correction","source":"publisher","updated":{"date-parts":[[2023,11,13]],"date-time":"2023-11-13T00:00:00Z","timestamp":1699833600000}}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/13\/22\/3435\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,3]],"date-time":"2025-08-03T14:32:00Z","timestamp":1754231520000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/13\/22\/3435"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,11,13]]},"references-count":34,"journal-issue":{"issue":"22","published-online":{"date-parts":[[2023,11]]}},"alternative-id":["diagnostics13223435"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics13223435","relation":{"correction":[{"id-type":"doi","id":"10.3390\/diagnostics14060608","asserted-by":"object"}]},"ISSN":["2075-4418"],"issn-type":[{"value":"2075-4418","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,11,13]]}}}