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Purpose: To analyze the influence of ankyloglossia on the prevalence and duration of exclusive breastfeeding of full-term infants up to the sixth month of life., Methods: Prospective cohort study, carried out with 225 mother-infant dyads who were followed up in the first six months of life in a center specialized in breastfeeding in a tertiary hospital. Full-term infants with asymptomatic ankyloglossia (no need for surgery) were compared with infants without change at monthly follow-up. Ankyloglossia was diagnosed using the Bristol Tongue Assessment Tool, with a positive diagnosis being considered for those with a score less than or equal to 5 considering functional and anatomical aspects. Statistical analyzes were performed using descriptive statistics, logistic regression (weaning determinants), relative risk, and survival curves (to analyze breastfeeding duration between groups with and without ankyloglossia)., Results: Ankyloglossia was associated with weaning (considered even partial) before the sixth month of life. After adjusted analysis, a higher risk of weaning was detected in infants with this alteration, with a risk present from the second month of life. In the survival analysis, the duration of breastfeeding in infants with ankyloglossia was shorter when compared to children without alterations., Conclusion: Compared to infants with normal lingual frenulum, babies with ankyloglossia had shorter exclusive breastfeeding time, but well above the average observed in the general population. The risk of weaning for this group was also higher.

Congenital Zika Syndrome (CZS) is a condition that has emerged only recently, bringing together multiple changes, including significant changes in the stomatognathic system, which may compromise sucking behavior and consequently the breastfeeding practice. The aim of this study was to investigate the breastfeeding behaviors in children with CZS. A longitudinal study was carried out in two reference centers in Northeastern Brazil. The nonprobabilistic sample consisted of 79 children diagnosed with physical, neurological, and behavioral alterations compatible with CZS. Information regarding the child, nutritive, and nonnutritive sucking behavior and changes related to the sucking reflex was collected. Data were presented through descriptive and inferential statistics. In the bivariate analyses, the chi-squared test was used and 5% significance level was adopted. The majority of children had severe microcephaly (59.7%). Breastfeeding was performed at birth in most of CZS children (89.9%) but only 36.6% of them presented exclusive breastfeeding in the six months of life. Bottle feeding and pacifier were used in 89.9% and 55.7%, respectively. Sucking and swallowing difficulties and occurrence of gastroesophageal reflux were observed in 27.8%, 48.0%, and 29.2% of children, respectively. Early weaning was associated with bottle feeding (p = 0.005) and pacifier sucking (p = 0.003). Although breastfeeding practice at birth constitutes a behavior adopted by most of mothers, adherence to this exclusive habit until the first six months of life was low since the children presenting a large number of comorbidities with direct interference in the suction reflex, sucking, and swallowing difficulty. [ABSTRACT FROM AUTHOR]

Introduction: In Brazil, the law 13.002/2014 states that all newborns in the country must undergo lingual frenulum assessment before hospital discharge. Objective: To validate the Lingual Frenulum Protocol for Infants. Material and Methods: The study used data from 100 infants assessed at 30 days of life at Santa Therezinha Hospital, in Brotas, SP, Brazil. The LFPI was administered to the 30-day-old infants and all assessments were registered in patient records and videotaped. Live exams, assessments and re-assessments using images of the infants were performed by two examiners experienced in Orofacial Myofunctional Disorders. The study included healthy full-term infants of both genders, who were being breastfed exclusively. Prematurity, perinatal complications, craniofacial anomalies, neurological disorders, and visible genetics syndromes were the exclusion criteria. The validation process included the analysis of content validity, criterion validity, construct validity, reliability, sensitivity, specificity, positive predictive value, and negative predictive value. Results: Concerning content validity, the percentage of agreement was 100%. The criterion validity was measured by comparing the common items of the LFPI and BTAT. The agreement percentage for the analyzed items was 100%. The construct validity was analyzed by comparing the partial and total scores from the assessment of infants with and without lingual frenulum alteration at 30 and 75 days of life. Results demonstrated similarity of scores between the control group and the group that underwent frenotomy. The results from the inter-rater and intra-rater agreement analysis indicated perfect agreement. The values of sensitivity, specificity, positive predictive value, and negative predictive value were 100%. Conclusion: The study concluded that the LFPI was a valid and reliable assessment tool, that ensures accuracy when diagnosing lingual frenulum alterations within the investigated parameters. [ABSTRACT FROM AUTHOR]

Introduction: Ankyloglossia is a congenital anomaly that can restrict tongue movements. It affect habitual position of lips and tongue and impacts the functions of chewing, speech and suction. Objective: Purpose of this study, aproved to Ethical Comitee Research, is to present a case repor of a three months old infant with ankyloglossia and congenital torticollis affecting breastfeeding assessed clinically and by surface electromyography (SEMG) before and after frenotomy. Resumed report: The clinical evaluation was performed through protocol for the evaluation of the lingual frenulum in infants, validated for application in Brazil. Initially, lip posture half-open and tongue in floor of mouth during sleep was observed. Tendency to tongue position during crying in the midline with sides in elevation. SEMG evaluations of the right and left suprahyoid muscles were collected for four minutes during bottle feeding. The averages in RMS values collected were 49.44 microvolts in left suprahyoid muscles and 25.32 microvolts in right suprahyoid muscles. After frenotomy, closed resting lip posture was observed, a tendency to position the tongue during crying in midline with the body in elevation and the tongue positioned on the palate during sleep. Suction with coordinated movements, reduction of feeding time from 18 to 8 minutes on average with no noise and choking and SEMG of left suprahyoid muscles 34.72 microvolts and right suprahyoid muscles 32.72 microvolts. Conclusion: After frenotomy, the lip was closed, tongue was in palate during sleep and suction was adequated confirmed by clinical and electromyographic evaluation. [ABSTRACT FROM AUTHOR]

Background: Outbreaks of orally transmitted Trypanosoma cruzi continue to be reported in Brazil and are associated with a high mortality rate, mainly due to myocarditis. Methods: This study is a detailed report on the disease progression of acute Chagas disease in 13 patients who were infected during two micro-outbreaks in two northeastern Brazilian towns. Clinical outcomes as well as EKG and ECHO results are described, both before and after benznidazole treatment. Results: Fever and dyspnea were the most frequent symptoms observed. Other clinical findings included myalgia, periorbital edema, headache and systolic murmur. Two patients died of cardiac failure before receiving benznidazole treatment. EKG and ECHO findings frequently showed a disturbance in ventricular repolarization and pericardial effusion. Ventricular dysfunction (ejection fraction <55%) was present in 27.3% of patients. After treatment, EKG readings normalized in 91.7% of patients. Ventricular repolarization abnormalities persisted in 50% of the patients, while sinus bradycardia was observed in 18%. The systolic ejection fraction normalized in two out of three patients with initially depressed ventricular function, while pericardial effusion disappeared. Conclusions: Myocarditis is frequently found and potentially severe in patients with acute Chagas disease. Benznidazole treatment may improve clinical symptoms, as well as EKG and ECHO findings. Author Summary: Chagas disease is caused by a parasitic protozoan transmitted to humans by the contaminated feces of blood-feeding assassin bugs from the Triatominae subfamily. It may also be transmitted from mother to baby during pregnancy, by breastfeeding, blood transfusion or organ transplant. In rare cases, the disease can also be caused by accidental ingestion of contaminated food (sugar cane or açaí juice, drinking water, etc.). Acute Chagas disease often presents itself as a mononucleosis-like syndrome, with symptoms including fever, lymph node enlargement and muscle pain. The mortality rate of acute Chagas disease is high, mainly due to heart failure as a consequence of cardiac fiber lesions. There are few studies describing clinical outcomes and the disease progression of patients who receive therapeutic treatment, especially with regard to cardiac exam findings. In this report, the authors describe clinical findings from two micro-outbreaks occurring in impoverished towns in northeastern Brazil. Prior to receiving treatment, patient mortality rate was 28.6% in one of the outbreaks, and one pregnant woman experienced a spontaneous abortion due to the disease in the other outbreak. Most patients complained of fever, dyspnea, myalgia and periorbital edema. After receiving a two-month course of treatment, clinical symptoms improved and the number of abnormalities in cardiac exams decreased. [ABSTRACT FROM AUTHOR]

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Purpose: To diagnose ankyloglossia in newborns and compare two lingual frenulum assessment instruments., Methods: This cross-sectional study was carried out in Recife, Pernambuco, Brazil, in 2018, with 147 mothers/newborns aged up to 30 days. The Bristol Tongue Assessment Tool and the Lingual Frenulum Evaluation Protocol for Infants were the instruments used. Sociodemographic data were also recorded. The two ankyloglossia diagnostic methods were compared using the McNemar test, obtaining the kappa agreement value and the confidence interval., Results: Ankyloglossia was present in 4.8% when diagnosed with the Bristol Tongue Assessment Tool, and in 17.0% with the Tongue-Tie Test. Regarding sex, 53.1% of the newborns were males and 46.9% were females; however, there was no association between ankyloglossia and the newborn's sex in either of the assessment methods., Conclusion: The ankyloglossia diagnosis in newborns varied depending on the assessment instrument used.

Purpose: To analyze the quality indicators of the hearing screening program and to evaluate lingual frenulum in newborns, in terms of coverage rates, duration of hearing screening, referral indexes and prevalence of ankyloglossia in a university hospital specializing in mother and child care., Method: This is a cross-sectional study, in which we analyzed the database of the newborn hearing screening and lingual frenulum assessment program for the period between September 2015 and August 2016., Results: During the study period, 2,345 babies were born at the institution, 1,380 (58.8%) underwent newborn hearing screening and 1,350 (57.6%) were diagnosed with a lingual frenulum. Mean gestational age was 39 weeks (± 1.6), birth weight 3478g (± 469.2) and 69% were boys. In newborn hearing screening, 95.7% of the 1,380 babies screened were discharged with guidance, 2.4% were referred for auditory monitoring and 1.9% of babies were referred for auditory diagnosis. In lingual frenulum assessment, 123 (9.1%) of the 1,350 evaluated, had ankyloglossia, 85 were boys and 47 girls., Conclusion: The indicators of the time of life in which the hearing screening is performed, the referral indices and ankyloglossia prevalence are in line with those reported in the literature; however, coverage rates were lower than recommended and do not comply with Brazilian law.

Background: Ankyloglossia is characterized by abnormal tongue movements that can possibly interfere with breastfeeding due to incorrect latching, pain, nipple fissure, and ineffective suction. Objective: To determine the prevalence of ankyloglossia in newborns and its association with exclusive breastfeeding and early breastfeeding difficulties. Materials and Methods: This is an analytical cross-sectional study conducted in seven public maternity hospitals in the city of Recife, PE, Brazil. The study sample consisted of 822 mothers/newborns of both genders. The diagnosis of ankyloglossia was confirmed by comparing two previously standardized and validated lingual frenulum assessment tools. Information on the mother's socioeconomic profile and breastfeeding difficulties were also collected. The data were analyzed using bivariate and multivariate logistic regression models. Results: The prevalence of ankyloglossia was 2.6% when using the Bristol Tool and 11.7% with the Assessment Tool for Lingual Frenulum Function (Neonatal Tongue Screening Test-NTST). The agreement between the two assessment tools was 2.2%, with a significant difference between them ( p  < 0.001). There was an association between the occurrence of ankyloglossia and breastfeeding difficulties (odds ratio = 1.99), but no association with exclusive breastfeeding practice was found. Conclusions: The diagnostic tools used herein revealed different prevalence rates of ankyloglossia in newborns. This condition was associated with breastfeeding difficulties, and the NTST was more effective in determining such an association.

Purpose: To determine the prevalence of oral anomalies in newborns and the influence of maternal and neonatal factors on the development of these anomalies. Methods: Four hundred newborns were included in the study conducted at the Hospital and Maternity Dom Orione (HMDO) in the city of Araguaína, Tocantins, Brazil. After collecting demographic data and information about the newborns from the medical records, an oral examination was performed by a single examiner. Results: The prevalence of oral anomalies was 50 percent. Cysts of the oral cavity were the most prevalent anomalies (43 percent), with palatine cysts (26 percent) and alveolar cysts (23 percent) being the most common. Ankyloglossia was present in nine percent of newborns, and congenital eruption cysts and neonatal teeth were present in 0.5 percent and 0.2 percent, respectively. No statistically significant correlation was observed between the prevalence of palatine cysts, alveolar cysts, or ankyloglossia and maternal or neo-natal factors. Conclusion: Oral anomalies in newborns are not uncommon, making essential the presence of a dentist, especially a pediatric dentist, in the multidisciplinary team of hospitals and maternal wards. [ABSTRACT FROM AUTHOR]