SynthesisInternational breastfeeding journal2025
Frenectomy for ankyloglossia in children under five: a systematic review and meta-analysis on breastfeeding outcomes.
Synthesis in International breastfeeding journal, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
1 citing paper in PubMed.
- Lingual frenotomy for breastfeeding difficulties: indications, surgical techniques and multidisciplinary care in infants and young children.European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery · 2026Review
Corrections and comments
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Authors and funding
4 authors.
Funding
Abstract
backgroundTo systematically evaluate the clinical effectiveness of lingual frenectomy in children under five years of age, specifically regarding its impact on breastfeeding difficulties.
methodsA systematic review and meta-analysis were conducted following PRISMA guidelines. A comprehensive search of PubMed, Scopus, Web of Science, LILACS/BBO, Cochrane Library, Epistemonikos, and ProQuest identified clinical studies assessing breastfeeding performance before and after frenectomy in children with ankyloglossia. Data extraction and analysis were completed on 24 October 2024, encompassing all available evidence published up to that date. Methodological quality was appraised using an adapted NICE tool for cohort and cross-sectional studies.
resultsFrom 2,961 records screened, 55 studies were included in the qualitative synthesis, and 6 provided sufficient data for meta-analysis. The pooled analysis indicated that frenectomy improved breastfeeding outcomes (RR 1.42; 95% CI: 1.32, 1.53). However, substantial heterogeneity was observed (I² = 74.8%). Sensitivity analysis excluding one outlier study markedly reduced heterogeneity but yielded a non-significant effect (RR = 0.99; 95% CI: 0.98–1.01), underscoring the impact of methodological variability. Subgroup analysis by sample size showed no significant effect modification. Qualitative assessment revealed notable methodological weaknesses. Selection bias was identified in 33% of studies and detection bias in 93%, primarily due to heterogeneity in diagnostic criteria and outcome measurements. Only 28.6% of studies applied validated diagnostic tools. Diagnostic methods most frequently used were the Coryllos classification (27%) and the Hazelbaker Assessment Tool for Lingual Frenulum Function (19%). Breastfeeding-related outcomes were often assessed through maternal self-reports, including nipple pain (VAS, 33%), LATCH (20%), and IBFAT (13%). These inconsistencies limited comparability across studies.
conclusionsLingual frenectomy may enhance breastfeeding outcomes in children under five with ankyloglossia; however, the limited number of eligible studies, heterogeneity, and methodological shortcomings preclude firm clinical recommendations. Ankyloglossia can compromise breastfeeding, a critical factor for infant health and development. While frenectomy represents a potential therapeutic option, standardized diagnostic tools and evidence-based guidelines are needed to optimize patient selection and minimize both over- and under-treatment in this population.
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