Effects of Frenulotomy on Outcomes Associated with Breastfeeding Practice

<b>Background/Objectives</b>: This study aimed to evaluate the effects of frenulotomy in mother-infant pairs with problematic tongue-tie. <b>Methods</b>: A 2-year prospective observational cohort study was performed. Mother-infant pairs were divided into frenulotomy and non-frenulotomy groups by maternal choice. Four breastfeeding practice outcomes were evaluated: reduced latching pain scores, improved LATCH scores, regained birth weight within 2 weeks post-partum, and successful exclusive breastfeeding (EBF) at 3 months of age. The comparison between groups was performed using multivariable risk regression with propensity score analysis. <b>Results</b>: A total of 350 mother-infant pairs were included. There were 226 mother-infant pairs who underwent frenulotomy and 124 pairs in the non-frenulotomy group. The median latching pain scores significantly decreased from 6 to 3 at 24 h post-operatively and from 6 to 0 at 1 week post-operatively (<i>p</i> < 0.001). The median LATCH scores increased significantly from 5 to 9 at 1 week post-operatively (<i>p</i> < 0.001). LATCH scores within 2 weeks were improved in the frenolotomy group (risk ratio = 1.31, <i>p</i> = 0.017). The success rate of EBF at 3 months was 72.12% in the frenulotomy group and 76.61% in the non-frenulotomy group, with no statistically significance. <b>Conclusions</b>: Short-term breastfeeding outcomes and LATCH scores in mother-infant pairs with tongue-tie improved faster in those who underwent the procedure, with no complications.