Suck swallow breathe coordination in term breastfed infants with and without oral anomalies.

Breastfeeding is distinctive to all newborn mammals and provides babies with optimal nutrition, protection from disease and enhanced development. Coordination of sucking swallowing and breathing (SSB) is critical for efficient feeding. The tongue plays major role in infant sucking, facilitating milk removal from the breast and safe swallowing of the milk bolus. Current evidence suggests that SSB coordination in breastfeeding babies with ankyloglossia differs to those without oral anomalies and they are likely to experience breastfeeding difficulties including maintaining attachment at the breast and reduced milk transfer. Further, their mothers may experience nipple pain and trauma that can result in early weaning. Although frenotomy is associated with decreased maternal nipple pain and improved breast attachment, the impact of ankyloglossia and frenotomy on SSB coordination and associated breastfeeding difficulties is not well understood. We aim to compare the following measures in age-matched healthy infants between those without and those with ankyloglossia and breastfeeding difficulties (pre and post frenotomy) 1. Intra-oral vacuum strength, 2. SSB coordination, 3. Tongue movement 4. Milk transfer (total mL) 5. Maternal nipple pain, and breastfeeding confidence 6. Breastfeeding duration We hypothesize that for infants with ankyloglossia more than one component of the SSB coordination will change post frenotomy to be comparable with those of the control group