Assessment of Maternal Perceptions on Post-Surgical Follow-up in Managing Tethered Oral Tissues

Background: Breastfeeding rates have increased over several decades. During that time period, diagnoses of infants’ tethered oral tissue anomalies (i.e., “tongue-tie”, “lip-tie”) and clipping of these tissues, increased exponentially. Expert opinion is that increased breastfeeding rates explain much of this increase, though there is little research to support or refute the practice. Limited evidence indicates that, in part, increases appear to be driven by patient demand possibly resulting from exposure to the procedure via social media and informal peer-networks. To-date, there has been little direct exploration of maternal experiences with breastfeeding and diagnosis/treatment of infants with tethered oral tissue anomalies.

Objective: The objective was to explore, among mothers of infants < 6 months, their experience breastfeeding an infant diagnosed with and receiving surgical intervention for at least one tethered oral tissue anomaly

Methods: This was a cross sectional, observational study, conducted online via survey. Recruitment occurred via social media posting, from August to September 2020. Mothers (>18 years), currently or previously breastfeeding/chestfeeding an infant (< 6 months old), and with an infant diagnosed with and received treatment for >1 tethered oral tissue anomaly were eligible. The survey instrument consisted of demographic and breastfeeding/chestfeeding questions and questions about tethered oral tissue concerns/resolution

Results: Of 266 eligible screens, 49 responses were considered valid and complete. The sample was homogeneous in terms of maternal race (96% white), marital status (96% married), ethnicity (96% non-Hispanic/non-Latinx), and breastfeeding status (94% providing breastmilk, in some form, at time of survey). Forty-one mothers reported more than one tissue was released, most were confident in their ability to identify these tissues, and most felt involved in the decision to conduct the procedure. Lactation consultants were the most common source of information about tethered oral tissue anomalies (n=31) and referrals for treatment (n=18), and pediatric dentists were most likely to perform the intervention (n=28). Perceived breastfeeding pain improved in nearly all cases.

Conclusions: Results of this study indicate that lactation consultants are frequently serving as both information and referral sources for clipping of tethered oral tissues and mothers feel involved in the process and report pain resolution post-procedure.