Ankyloglossia is a congenital anomaly which may reduce or restrict the tongue tip mobility. The restricted mobility is caused by an unusual short, thick lingual frenum. This condition may cause various problems in infants including breastfeeding in the new-borns. This case report describes 3 cases of ankyloglossia affecting breastfeeding and highlights the experiences of the mothers and their difficulties in breastfeeding babies with it. Comprehensive feeding examination was accomplished, the primary cause of feeding issues was identified, and frenotomy intervention was provided. Post frenotomy, infants were able to breastfeed easily and this was beneficial in continuation of breastfeeding and pain reduction in mothers.

Introduction: Earlier attempts to stabilise an emulsion, intended for chronic periodontitis treatment which composed of doxycycline hyclate (DH), Nigella sativa oil (NSO), eugenol and several combinations of surfactants failed. To solve the issue, we investigated the ability of lecithin alone and its combination with hydroxypropyl methylcellulose (HPMC) to stabilise the emulsion. Method: Compatibility between DH and other ingredients was first investigated using DSC and ATR-IR. The emulsion was characterised, firstly by preparing three phases: doxycycline/preservatives with or without HPMC (varying quantities), NSO/eugenol and lecithin/surfactants as aqueous, oil and emulsifier phases, respectively. The phases were added and emulsified sequentially at 7000 rpm (10 min) with an overhead stirrer and then at 3000 rpm (15min) using a high-shear mixer. DH assay was performed using validated HPLC method. Results: All ingredients were found to be compatible with doxycycline based on DSC, ATR-IR and supported by acceptable recovery (98.2±2.2 %) of DH from the emulsion. Stable emulsions were produced with particle size of 198.6±8.2 to 279.3±10.7 nm and zeta potential of -48.2±0.4 to -64.0±3.9 mV. The emulsions showed high viscosity (~200 Pa.s) at zero shear rate and exhibited shear-thinning flow upon increased in shear stress yielding viscosity of ~3 Pa.s at 100 s-1 indicating pseudoplastic behaviour suitable for pre-filled syringe packaging intended for delivery into periodontal pocket. Conclusion: Lecithin is an excellent emulsifier that can also impart pseudoplasticity for a complex emulsion constitute of drug and natural oils. This could pave the way for a more complex emulsion formulation fusing contemporary and therapeutic oils

Introduction: Tongue-tie is a congenital condition of a thickened, tightened or shortened frenulum. This condition may cause breastfeeding difficulties to both mother and infant, such as ineffective suckling and painful nipple. In older children, it can cause speech difficulties. Although many studies have investigated the problems associated with tongue-tie and its treatments, there are limited studies on the mother’s experiences of tongue-tie and post frenotomy. This study aimed to explore the mother’s experiences of tongue-tie associated problems, frenotomy and the outcome. Methods: In-depth interviews were conducted in a one-on-one setting with fifteen mothers whose infant and children underwent frenotomy. Data were collected, transcripted, translated and analysed according to themes. Results: The analysis revealed a common story of stressful challenges and difficulties of breastfeeding. The mothers described that tongue-tie caused poor latching, nipple pain and bleeding, prolong feeding and lack of sleep. Their infant had poor weight gain, sleeping problems, insufficient milk transfer, fatigue and constant crying. For the older children, mothers complained of restricted tongue movement, difficulty in licking ice cream and speech problems. All of them agreed that the frenotomy procedure was easy, simple and less invasive and the outcome was positive. Furthermore, mothers continued breastfeeding without any difficulties and complications. Conclusion: Mothers in this study had difficulties with breastfeeding. However, all of the reported symptoms improved after frenotomy. They considered frenotomy was a simple and safe procedure that was highly recommended for symptomatic tongue-tie.