Aerophagia Induced Reflux Associated with Lip and Tongue Tie in Breastfeeding Infants

Monday, October 26, 2015
Marquis Salon 6 (Marriott Marquis)
Scott Siegel, M.D., D.D.S., Stony Brook University

Purpose: Ankyloglossia and shortened maxillary labial frenuli are a common malady that can have a negative impact on breastfeeding infants.  These issues have been correlated to poor latch and potential aerophagia. The current GI and pediatric literature does not clearly delineate between aerophagia induced reflux, GER, and/or true GERD. The purpose of this study is to Differentiate between aerophagia induced reflux and gastroesphageal reflux disease.  This will result in reduction in misdiagnosis of GERD and decrease the prescribing of reflux medication and minimize invasive testing.  

Methods:  Retrospective analysis of 1000 charts and history of breastfeeding infants treated with labial frenectomy, lingual frenectomy or combination due to breastfeeding problems.

Presence of lip and tongue tie evaluated using Hazelbaker score, Kotlow and Coryllos scoring was documented.

The questionnaires pre and post procedure were evaluated as to specific questions of: post feed colic, presence of post feed stomach distention, post feed reflux symptoms. 

The pre operative assessment and procedures all performed by myself as one provider.

Post procedure questions: Reduction of signs and symptoms of reflux? 

Reduction or elimination in prescription H2 blocker. Prevention of further testing.

Results:  Of the 1000 charts reviewed from a three year period, 200 had symptoms and signs associated with 'reflux' these were further analyzed and showed a correlation with type 3 and 4 lip and tongue ties.  Reduction and elimination of symptoms of reflux was temporally noted in 150 of these infants within 1 week post procedure.

Conclusion:  Given reduction in signs and symptoms of reflux, and the potential to eliminate, reduce, and/or prevent medication prescription in this population,  further evaluation of the potential for lip and tongue tie as a contributing factor in aerophagia induced reflux is warranted.  These results warrant a further analysis and potential prospective study.