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Electromyographic patterns of breastfeeding infants with normal lingual frenulum attachment – a longitudinal pilot study

Vanessa Machado, Luciano Maia Alves Ferreira, Luciana Vitaliano Voi Trawitzki, Selma Siéssere, José João Mendes, Luísa Lopes, Sónia Fonseca, Ana Rita Monteiro, Luís Proença, João Botelho, Roberta Lopes de Castro Martinelli, Simone Cecílio Hallak Regalo

Frontiers in Oral Health · 2026-11-04 · 7

DOI: 10.3389/froh.2026.1936226 ↗
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Abstract

Background Breastfeeding is a complex process involving coordinated activation of the orofacial musculature and dynamic mother–infant interactions, although little is known about longitudinal electromyographic (EMG) activity during early breastfeeding. Aim We aimed to characterize EMG patterns of orofacial muscle activity during breastfeeding in infants with normal lingual frenulum anatomy and function and explore their relationship with maternal breastfeeding self-efficacy, breastfeeding-related pain and difficulties, and infant gastrointestinal discomfort. Methods Thirteen mother-infant dyads were followed from birth to 3 months. Lingual frenulum anatomy and function were assessed using the Martinelli protocol. Surface EMG of bilateral masseter and suprahyoid muscles was recorded during breastfeeding at days 5–7, 1 month, and 3 months. Maternal self-efficacy and infant colic-related outcomes were assessed using Breastfeeding Self-Efficacy Scale–Short Form and Infant Colic Questionnaire tolls, respectively. Longitudinal changes and associations were analyzed using repeated-measures and correlation analyses. Results Bilateral masseter activity progressively increased during follow-up, while suprahyoid activity increased at 1 month and decreased at 3 months postpartum, without significant longitudinal differences. Mothers presented high breastfeeding self-efficacy scores (62.1 ± 6.8). Infant and parental ColiQ scores significantly improved between 1 and 3 months postpartum ( p < 0.05). No significant correlations were identified between EMG activity, breastfeeding self-efficacy, and ColiQ scores. Conclusions Infants with normal lingual frenulum anatomy and function showed relative stability of orofacial muscle activity during early breastfeeding. Maternal self-efficacy was high, infant and parental well-being improved over time, and neither BSES-SF nor ColiQ scores were significantly associated with EMG activity.

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