Thermographic analysis of infants faces during breastfeeding before and after lingual frenotomy

Silva, Midiane Gomes da; Gomes, Erissandra; Lima, Danielle Pereira de; Santana, Paula Fernanda Rocha de Assis; Lima, Ana Paula Alves Figueiredo; Almeida, Aline Natallia Simões de; Ferreira, Sara Loureiro de Souza; Cunha, Daniele Andrade da; Martinelli, Roberta de Castro; Haddad, Denise Sabbagh; Brioschi, Marcos Leal; Silva, Hilton Justino da

doi:10.1590/2317-1782/e20240396en

person Midiane Gomes da Silva

conceptualization · formal analysis · investigation · data curation · writing – original draft · writing – review & editing

schoolUniversidade Federal de Pernambuco – UFPE - Recife (PE), Brasil.

0000-0003-0972-0576

person Erissandra Gomes

conceptualization · methodology · formal analysis · investigation · data curation · writing – original draft · writing – review & editing and project administration

schoolUniversidade Federal do Rio Grande do Sul – UFRGS - Porto Alegre (RS), Brasil.

0000-0002-2379-7345

person Danielle Pereira de Lima

investigation

schoolUniversidade Federal de Pernambuco – UFPE - Recife (PE), Brasil.

0000-0001-5680-4372

person Paula Fernanda Rocha de Assis Santana

investigation · writing – review & editing

schoolUniversidade Federal de Pernambuco – UFPE - Recife (PE), Brasil.

0000-0002-8932-6802

person Ana Paula Alves Figueiredo Lima

investigation

schoolUniversidade Federal de Pernambuco – UFPE - Recife (PE), Brasil.

0000-0003-0821-0486

person Aline Natallia Simões de Almeida

methodology · validation · formal analysis and investigation

schoolUniversidade Federal de Pernambuco – UFPE - Recife (PE), Brasil.

0000-0002-3343-2892

person Sara Loureiro de Souza Ferreira

validation and formal analysis

schoolUniversidade Federal de Pernambuco – UFPE - Recife (PE), Brasil.

0000-0003-0361-4705

person Daniele Andrade da Cunha

writing – review & editing

schoolUniversidade Federal de Pernambuco – UFPE - Recife (PE), Brasil.

0000-0002-3987-9740

person Roberta de Castro Martinelli

writing – review & editing

schoolUniversidade de São Paulo – USP - São Paulo (SP), Brasil.

0000-0002-5791-2575

person Denise Sabbagh Haddad

writing – review & editing

schoolUniversidade de São Paulo – USP - São Paulo (SP), Brasil.

0000-0001-7053-0881

person Marcos Leal Brioschi

conceptualization · writing – review & editing

schoolUniversidade de São Paulo – USP - São Paulo (SP), Brasil.

0000-0003-4822-8314

person Hilton Justino da Silva

conceptualization · methodology · investigation · resources · writing – original draft · writing – review & editing · supervision and project administration

schoolUniversidade Federal de Pernambuco – UFPE - Recife (PE), Brasil.

0000-0002-6852-3233

Conflict of interests:

nothing to declare.

personCorrespondence address: Paula Fernanda Rocha de Assis Santana Laboratório Integrado de Motricidade Orofacial, Departamento de Fonoaudiologia, Universidade Federal de Pernambuco – UFPE Av. Prof. Artur de Sá, 267, Cidade Universitária, Recife (PE), Brasil, CEP: 50740-520. E-mail:
paula.rsantana@ufpe.br

Editor:

Ana Carolina Constantini.

	Before LF	After LF	p-value
Lip posture at rest – n (%)
Closed lips (points=0)	32 (80)	36(90)
Parted lips (points=0)	4 (10)	4(10)
Open lips (points=1)	4 (10)	-

Total of lip posture at rest – mean (min-max)	0 (0-1)	0 (0-1)	0.206*

Tongue position tendency when crying – n (%)
Tongue in the midline (points=0)	-	23(57.5)
Lifted tongue (points=0)	2(5)	13(32.5)
Tongue in the midline, lifting its sides (points=2)	27(67.5)	3(7.5)
Lowered tongue tip, lifting its sides (points=2)	11(27.5)	1(2.5)

Total of the tongue position tendency when crying – mean (min-max)
	2 (0-2)	0 (0-2)	<0.001*
Lifted tongue-tip shape when crying or in lifting maneuver – n (%)
Rounded (points=0)
Slightly dipped tongue tip (points=2)	2(5)	12(30)
Heart-shaped (points=3)	22(55)	28(70)
	16(40)	-

Total of the lifted tongue-tip shape when crying or in lifting maneuver – mean (min-max)
	2 (0-3)	2 (0-2)	<0.001*
Frenulum thickness – n (%)
Thin (points=0)	38(95)	24(60)
Thick (points=2)	2(5)	16(40)

Total of the frenulum thickness – mean (min-max)	0 (0-2)	0 (0-2)	<0.001#

	Before LF	After LF	p-value
	n (%)	n (%)	p-value
General
Mother			<0.001
Without signs of difficulties	25 (62.5)	39 (97.5)	0.250
With signs of difficulties	15 (37.5)	1 (2.5)
Infant
Without signs of difficulties	36 (90.0)	39 (97.5)
With signs of difficulties	4 (10.0)	1 (2.5)
Breasts			0.003
Without signs of difficulties	26 (65.0)	37 (92.5)
With signs of difficulties	14 (35.0)	3 (7.5)
Infant’s position			-
Without signs of difficulties	40 (100)	40 (100)
With signs of difficulties	0 (0.0)	0 (0.0)
Infant’s latch			-
Without signs of difficulties	0 (0.0)	0 (0.0)
With signs of difficulties	40 (100)	40 (100)
Suction			< 0.001
Without signs of difficulties	6 (15.0)	32 (80.0)
With signs of difficulties	34 (85.0)	8 (20.0)

After vs. before LF Region of the temporal muscle	After vs. before LF Region of the masseter muscle	After vs. before LF Region of the buccinator muscle
Increased (n = 24)	Increased (n = 26)	Increased (n = 19)
Decreased (n = 15)	Decreased (n = 14)	Decreased (n = 20)
Unchanged (n = 1)	Unchanged (n = 0)	Unchanged (n = 1)

	Before LF ºC	After LF ºC	Difference (95% CI) ºC	p
1^st minute
Temporal ROIs - mean±SD	33.8±0.8	34±0.7	0.2 (-0.10 to 0.46)	0.203*
Masseter ROIs - mean±SD	33.4±0.9	33.4±0.8	0.0 (-0.34 to 0.32)	0.963*
Buccinator ROIs - mean±SD	32.6±1	32.6±0.9	0.0 (-0.36 to 0.40)	0.905*
Difference between temporal and masseter ROIs - mean (min-max)	0.5 (-0.7-1.4)	0.6 (-0.3-2.0)	-	0.056#
Difference between temporal and buccinator ROIs - mean (min-max)	1.1 (-0.1-2.8)	1.3 (0.3-3.0)	-	0.036^#
Difference between masseter and buccinator ROIs - mean (min-max)	0.6 (0.1-1.5)	0.7 (0.1-1.5)	-	0.737^#
3^rd minute
Temporal ROIs - mean±SD	33.9±0.8	34±0.9	0.1 (-0.18 to 0.49)	0.347*
Masseter ROIs - mean±SD	33.4±1	33.5±1	0.1 (-0.29 to 0.44)	0.684*
Buccinator ROIs - mean±SD	32.8±1	32.8±1	0.0 (-0.39 to 0.43)	0.923*
Difference between temporal and masseter ROIs - mean (min-max)	0.3 (-0.6-1.4)	0.5 (-0.7-1.9)	-	0.052^#
Difference between temporal and buccinator ROIs - mean (min-max)	1.1 (-0.4-2.7)	1.2 (-0.2-2.9)	-	0.393^#
Difference between masseter and buccinator ROIs - mean (min-max)	0.6 (-0.1-1.6)	0.6 (-0.5-1.6)	-	0.975^#
5^th minute
Temporal ROIs - mean±SD	34±0.8	34.1±0.8	0.1 (-0.15 to 0.44)	0.334*
Masseter ROIs - mean±SD	33.5±1	33.5±0.9	0.0 (-0.28 to 0.39)	0.749*
Buccinator ROIs - mean±SD	32.8±1.1	32.9±1	0.0 (-0.41 to 0.44)	0.944*
Difference between temporal and masseter ROIs - mean (min-max)	0.4 (-0.3-1.5)	0.5 (-0.3-1.9)	-	0.952^#
Difference between temporal and buccinator ROIs - mean (min-max)	1.1 (-0.1-2.7)	1.3 (-0.2-2.6)	-	0.068^#
Difference between masseter and buccinator ROIs - mean (min-max)	0.5 (-0.1-1.5)	0.6 (0.1-1.5)	-	0.587^#

[TFN1] ^*
Wilcoxon test;

[TFN2] ^#
Student’s t-test for paired samples;

[3] Caption: mean±SD = mean+standard deviation; mean (min-max) = mean (minimum and maximum)