Fatores associados ao padrão de aleitamento em neonatos submetidos à frenotomia lingual

Abstract

The evaluation of the lingual frenulum in newborns is of fundamental importance, as it allows the early identification of abnormalities and contributes to the clinical decision of immediate intervention, focusing on the practice of breastfeeding. The objective of the first stage of the study was to identify and explore the methods for assessing ankyloglossia in full-term neonates referred to as lingual frenotomy, through a mapping of scientific research resulting from the application of the scope review methodology proposed by Joanna Briggs Institute. After applying the methodological filters, 234 articles were found, of which nine studies were included in the review. A case report, three observational cross-sectional studies, and five observational cohort studies identified five anatomical and functional lingual frenulum assessment methods: Kotlow, Coryllos, Halzebaker, Bristol, and Assessment of the Lingual Frenulum for Infants. In the second stage, the objective was to analyze the evolution of the clinical practice of breastfeeding in newborns identified with the abnormality of the lingual frenulum and submitted to lingual frenotomy in a teaching hospital. This is an analytical, observational prospective study nested within a cohort in a maternal and child university hospital inserted in the public health system. The target population of this study included mother-newborn binomials admitted to lingual frenotomy in a hospital environment in the initial consultation, which occurred in the first 49 hours postpartum, and accompanied to the post-frenotomy consultation, performed approximately ten days after the hospital procedure, with the maintenance of exclusive breastfeeding. Data were collected from information in a database maintained by the hospital dentistry service and clinical records of the mother-infant binomial attended from August 2020 to July 2021. Data extraction and verification were

conducted by a single calibrated researcher with affinity with the research theme. Four semi- structured guide instruments were used, adapted from validated instruments, which addressed,

respectively, maternal and neonatal variables in the initial consultation and post-frenotomy consultation. Data analysis was carried out by going through the stages of the Knowledge Discovery Process in the Database. The final sample consisted of 108 mother-newborn binomials who underwent frenotomy. It was possible to identify the association of the clinical parameters "baby's lips turned inward" and "the baby's chin does not touch the breast" with the chances of the degree of difficulty presented during breastfeeding in the initial consultation, as well as the association of "use of bottle” and the maternal perception after frenotomy in the breastfeeding pattern presented in the post-frenotomy consultation. It is concluded that there was high maintenance of the pattern of exclusive breastfeeding and without intercurrences associated with the surgical procedure after ten days. Although there are limitations, these findings make an important contribution to our understanding of the effect of frenotomy on the mother-infant binomial.