Posterior ankyloglossia as cause of breastfeeding difficulties

a case report

Abstract

Ankyloglossia or tongue-tie, is a congenital condition usually characterized by a lingual frenulum that can limit tongue movements. The literature has shown an association between ankyloglossia and difficulties in breastfeeding and with considerable improvement after treatment by the frenotomy procedure. Ankyloglossia has been classified according to the localization of the lingual frenum insertion, being anterior when it is inserted from the tip of the tongue (heart shape) to the middle portion in its ventral part (type I and II) and which is more easily recognized. Posterior ankyloglossia is located from the middle portion to the posterior portion and less obviously identified. Normally, posterior ankyloglossia is characterized by a thick, non-elastic brake (Type III) or also presents as a submucosal brake against the inelastic base of the tongue, which is visualized by maneuver and restricts movement at the base of the tongue ( Type IV). This change in the frenulum for the newborn causes feeding difficulties, dyspnea on the forward movement of the epiglottis and larynx, decreased capacity for oral sealing, loss of weight and maternal nipple pain. This study reinforces the concept of the importance of early diagnosis of posterior ankyloglossia, reporting a case of newborns with breastfeeding difficulties, in a public hospital located in Goiânia - Goiás, whose diagnosis of posterior ankyloglossia led to treatment by lingual frenotomy, which improved breastfeeding and its continuity, bringing weight gain to the baby, as well as greater comfort for the mother, with the resolution of nipple pain, increasing the chances of establishing the ideal exclusive breastfeeding for the newborn