Clinical and instrumental evaluation of non-nutritive sucking in newborns before and after frenotomy: a case report

ABSTRACT Changes in the lingual frenulum can impair breastfeeding, leading to poor weight gain and/or early weaning. This study aimed to investigate the influence of frenotomy on the clinical and instrumental parameters of non-nutritive sucking in newborns. It is a case series study with six full-term newborns, three males and three females, diagnosed with ankyloglossia through the Lingual Frenulum Evaluation Protocol for Infants and the Bristol Tongue Assessment Tool. Clinical assessment of non-nutritive sucking was conducted using the Non-Nutritive Sucking Assessment Protocol, and instrumental assessment was performed using an instrument that records sucking pressure. Both assessments were conducted before frenotomy and up to 48 hours after the procedure, respectively, comparing the parameters between these moments. The number of suctions, suction groups, and the mean pressure increased significantly. The evaluation scores also changed significantly after surgery, with a decrease in the lingual frenulum assessment protocol score and an increase in the Bristol Tool score. Instrumental parameters (number of suction groups, total suctions, and mean pressure) and clinical parameters (lip sealing, tongue cupping, tongue dorsum elevation and lowering, mandible elevation and lowering, sucking strength, sucking rhythm, bites, exaggerated mandible excursions, and signs of stress) improved after frenotomy.