Lingual frenulum evaluation protocol for infants: relationship between anatomic and functional aspects
Protocolo de avaliação do frênulo lingual para bebês: relação entre aspectos anatômicos e funcionais
Roberta Lopes de Castro Martinelli; Irene Queiroz Marchesan; Giédre Berretin-Felix
Abstract
Purpose: to observe the lingual frenulum characteristics that may interfere with the functions of suction and deglutition in full-term infants in order to have a final version of the protocol designed by Martinelli et al (2012).
Method: the lingual frenulum evaluation protocol was administered to a 100 healthy full-term infants. Two speech-language pathologists experienced in lingual frenulum evaluation analyzed the films taken during the evaluation. Chi-squared test, Fisher test and Analysis of Variance test were used considering qualitative and quantitative data respectively.
Results: 16 infants had lingual frenulum alteration. It was observed that there was a relationship between: a) tendency of tongue position during crying and time between feedings; b) the shape of the tongue when elevated and fatigue during feeding; c) lingual frenulum attachment to the tongue and the tongue movement during non-nutritive sucking. By analyzing the data of the infants with frenulum alteration it was possible to define the indicating characteristics of alteration. Those characteristics made the re-designing of the protocol and the scores attribution possible.
Conclusions: the shape of the tongue when elevated during crying interferes with the tongue movement during the non-nutritive sucking. The place of frenulum attachment to the tongue interferes with the suction rhythm during breastfeeding. The new protocol with scores is considered to be an effective tool to assess and diagnose anatomical alterations of the lingual frenulum and its possible interference with breastfeeding.
Keywords
Resumo
Objetivo: verificar quais características do frênulo da língua influenciam nas funções de sucção e deglutição em bebês nascidos a termo, com a finalidade de propor adequações no protocolo proposto por Martinelli et al (2012).
Método: foi aplicado o protocolo de avaliação do frênulo da língua em 100 bebês saudáveis nascidos a termo. Os filmes obtidos na avaliação foram analisados por duas fonoaudiólogas especialistas em MO, com experiência em avaliação de frênulo lingual. Foram aplicados os testes Qui-quadrado seguido do teste exato de Fisher, além da análise de variância, considerando os dados qualitativos e quantitativos, respectivamente.
Resultados: nos 16 bebês que apresentaram alteração do frênulo lingual, verificou-se a relação entre: a tendência do posicionamento da língua durante o choro e o tempo entre as mamadas; a forma da língua quando elevada e o cansaço para mamar; bem como a fixação do frênulo na língua e o movimento da língua na sucção não nutritiva. Pela análise dos dados dos bebês com alteração de frênulo lingual, foi possível definir as características indicativas de alteração, que possibilitaram a adequação do protocolo inicial, e a atribuição de escores.
Conclusão: a forma da língua, quando elevada durante o choro, influencia o movimento da língua durante a sucção não nutritiva, e o ponto de fixação do frênulo na língua influencia o ritmo da sucção durante a amamentação. O novo protocolo com escores é uma ferramenta efetiva para avaliar e diagnosticar alterações anatômicas do frênulo da língua e suas possíveis interferências na amamentação.
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References
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Submitted date:
09/21/2011
Accepted date:
01/19/2012
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