Effects of Frenulotomy on Outcomes Associated with Breastfeeding Practice

Background/Objectives: This study aimed to evaluate the effects of frenulotomy in mother–infant pairs with problematic tongue-tie. Methods: 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. Results: 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 (p < 0.001). The median LATCH scores increased significantly from 5 to 9 at 1 week post-operatively (p < 0.001). LATCH scores within 2 weeks were improved in the frenolotomy group (risk ratio = 1.31, p = 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. Conclusions: 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.