1. INTRODUCTION METHODS PURPOSE RESULTS CONCLUSION
VALIDATION OF THE TONGUE FRENULUM EVALUATION PROTOCOL FOR INFANTS:
ANATOMICAL AND FUNCTIONAL ASPECTS
Roberta Lopes de Castro Martinelli, Irene Queiroz Marchesan, Antonio de Castro Rodrigues, Giédre Berretin-Felix
INTRODUCTION
METHODS
The lingual frenulum may restrict the movements of the tongue depending on the amount of residual tissue that did not undergo apoptosis during embryonic development. That may justify the anatomical variation of the frenulum. In 1993, a tongue frenulum evaluation protocol, for infants up to six months was proposed, but not validated. There is controversy in literature about its feasibility and complexity. In 2012, another protocol was proposed to correlate the variations of the lingual frenulum with the oral functions of sucking and swallowing.
the protocol was applied in 100 term-born healthy babies.
the assessment was conducted by two SLPs specialized in orofacial motricity experienced in lingual frenulum evaluation.
the video images taken during the evaluation were analyzed.
for qualitative and quantitative analyses, the following tests were applied: Chi-squared test, Fisher's exact test and Analysis of variance.
PURPOSE
To re-define the tests for evaluating the lingual frenulum for infants, from the protocol proposed by Martinelli et al (2012), which considers the anatomical and functional aspects of the tongue.
RESULTS
A relationship with fatigue during breastfeeding was observed in infants who had the apex of the tongue V-shaped or heart-shaped, as well as less than one hour between feedings, fewer sucks and longer pauses between groups of suction. In infants whose frenulum was attached between the midline of the tongue and the apex, or on the apex, the lips tended to remain half-open or open at rest, the tongue tended to be in the midline or lowline position during crying, and the movements of the tongue during non-nutritive sucking were not coordinate. Those findings made re-defining tests possible, adding scores to indicate tongue frenulum alterations.
CONCLUSION
A new protocol with scores for evaluating the frenulum of the tongue in infants was designed showing to be efficient to diagnose the anatomical variations of the frenulum that can interfere with the functions of sucking and swallowing during breastfeeding.