The predisposing factors of a child having ankyloglossia are genetics and cocaine use of the

mother. In the case of our patient, it is genetics. In embryonic development, if there is not enough tissue
in the lip area, the tissue available in the lips will not join properly resulting in a cleft lip and this cleft lip
will contribute to the inadequate seal of the infant during breast feeding. Due to incomplete apopotosis
(programmed morphologic cell death) of the bilateral tissue buds, there is failure of these buds to
separate from the floor of the mouth resulting to lingual frenum. The lingual frenum restricts tongue
movement which interferes with tongue function.
A disruption in tongue function will also contribute to the inadequate seal during breast feeding
and the infant will have an inability to manipulate the mother’s nipple/areola position resulting to poor
latching of the infant to the breast of the mother. This will result to ineffective milk transfer from the
mother to the infant which will result to the infant’s decrease intake of breast milk.
Since breast milk is the primary food for infants, a decrease in its intake will have many effects.
First, the infant is at risk for dehydration and for the case of our patient, the infant is already dehydrated
resulting to a decrease in systemic blood volume circulation. Organs will be affected due to this
decrease. A decrease in blood volume to the brain will result to irritability and restlessness. A decrease
in the blood supply to the kidneys results in glomelular injury which increases the kidneys’ permeability
to plasma protein leading to proteinuria which is exhibited in the urinalysis of our patient having the
result of albumin trace in the urine. And the decrease in the systemic blood volume will also result to
sunken eyes as manifested by the patient.
Breast milk also contains certain antibodies which helps the infant protect itself from infection.
A decrease in the intake of breast milk decreases the infant’s chance to fight off infection. The presence
of infection will result to fever, an increase of the infant’s lymphocyte count (value: 72.3; normal value:
19-48) and the presence of pus cells in the urine (value: 4-8).
Breast milk is also where the infant gets its nutrients especially iron, so a decrease in its intake
will result in an increase platelet count (value: 486; normal value: 150-400) and a decrease in
hemoglobin (value: 102; normal value: 120-180). A decrease in hemoglobin synthesis will result to a
decrease in hematocrit count (value: 0.31; normal value: 0.37-0.54) and a decrease in RBC production
(value: 3.5; normal value: 4.7-6.1). Since the RBC give us the pinkish color, a decrease of it will result to
pallor.