None listed
Conditions
Brief summary
Breastfeeding should be the biological norm in the newborn since it brings many benefits to both the mother and the baby. The World Health Organization recommends offering the baby exclusively breast milk until six months; From this age, complementary feeding would begin to be introduced. There may be different circumstances that cause difficulty in establishing breastfeeding, such as an alteration in the level of the skeletal or cranial muscle in the baby derived from a complicated delivery. Physiotherapy specialized in breastfeeding relates the problems that may arise from such a process in the baby along with the difficulty that may exist in adapting to the mother's body or the inability of the orofacial structure to develop the action of suckling. The objective of the work is to identify these problems in the baby a priori, carry out an assessment and treat these difficulties as soon as possible, since the first days are the key to successfully establishing breastfeeding. Parents often go to a physical therapy consultation to assess these structures too late, when there is already a problem in the production of breast milk. That is why it is important to intervene early when an erroneous suction pattern has not yet been established. For this, a Controlled Clinical Trial has been proposed with two groups: an experimental group, which will be assessed using the Hazelbacker scale to identify that there is an ankyloglossia that makes it difficult to hold on to the chest correctly. Subsequently, a physiotherapy intervention will be carried out applying the Lip Out method for a period of one month and, finally, we will evaluate again using the same scale to check if there is improvement or not, after carrying out the treatment. The control group will not receive physiotherapy treatment to assess whether, after this month, the structures will recover spontaneously without receiving any treatment. It is necessary to investigate the benefits of physiotherapy treatment in problems related to breastfeeding in order to create evidence and establish treatment protocols in the first days of the newborn's life. The hypothesis of the study is as follows: Full-term newborns who present ankyloglossia and receive early physiotherapy treatment will benefit from learning a correct suction pattern, which will be reflected in a good start to breastfeeding. The development of the "Lip Out" physiotherapy technique in patients who present difficulties in breastfeeding will be reflected in the improvement of the mobility, strength and function of the orofacial structures; as a consequence, the pain reflected by the mother during attachment to the breast and/or during feeding will decrease.
Interventions
The day after birth, the newborns and the mother will be evaluated using the Hazelbaker, Lach and VAS scales: based on the score obtained, it is checked whether there are difficulties in breastfeeding and, therefore, it is optimal to participate in the study.
You will be randomly (randomly) assigned to one of two study groups. The intervention group will begin the Physiotherapy treatment based on the "Lip Out" method prior to hospital discharge.
This method consists of specifically addressing th
The day after birth, the newborns and the mother will be evaluated using the Hazelbaker, Lach and VAS scales: based on the score obtained, it is checked whether there are difficulties in breastfeeding and, therefore, it is optimal to participate in the study. You will be randomly (randomly) assigned to one of two study groups. The intervention group will begin the Physiotherapy treatment based on the "Lip Out" method prior to hospital discharge. This method consists of specifically addressing the function of breastfeeding in terms of the seal that is made between the baby's mouth and the mother's breast. Oral motor dysfunctions that may be related to ankyloglossia (difficulty in tongue mobility due to a short and/or restrictive frenulum and also due to other alterations) that generate an incorrect sucking pattern will be addressed. The treatment will be carried out both during suction and at the moment of grasping. What is intended is to relax tensions that may be related to compensatory structures that make it difficult for the tongue to perform a correct function when sucking. Specifically, the posture of the mother at the time of breastfeeding the baby will be corrected, the accessory muscles of the mouth (orbicularis oculi, masseter muscles) will be relaxed and digital longitudinal stretching of the frenulum. Before hospital discharge, these exercises will be taught to the parents and an exhaustive follow-up will be carried out for one month. The frequency of the sessions will be one hour a week during the first month of life (4 sessions of one hour in total). This follow-up of the baby will be carried out until the first month of life. After this month of treatment, it will be evaluated again with the same scales to check whether or not there are differences with respect to the initial scores. Who performs the intervention is a physiotherapist who has 10 years of experience.
Sponsors
Gemma Mª López Segura
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Prevention
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
1 Days to 7 Days
Healthy volunteers
Yes
Inclusion criteria
1. Term newborns (between 37 and 41 weeks of gestation). 2. Both men and women will be selected. 3. Both normal delivery and cesarean section. 4. Infants who have a low score on the initial assessment scale and, therefore, a problem in breastfeeding. 5. The parents of the babies must authorize their participation in the clinical trial, as well as subjecting the baby to low-intervention physiotherapy treatment, signing said authorization in the Informed Consent.
Exclusion criteria
1. Preterm, post-term and low birth weight newborns (less than 2,500 Kg). 2. Newborns who present pathology or have had problems during the immediate prenatal or postnatal period. 3. Patients who do not understand and are unable to fill in the Visual Analogue Scale (VAS). 4. Mothers who trigger problems in the immediate postpartum period and, as a consequence, prevent them from being with the baby in the first hours after birth. 5. Patient who does not want and does not authorize to participate in the study, does not adequately understand the Spanish language.
Outcome results
None listed