Tongue-tie diagnoses have increased dramatically in the past few years, but research indicates doctors may be acting too quickly.
An Increase in Surgery
Data indicates that 11 percent of newborns throughout the country are diagnosed with ankyloglossia, commonly referred to as tongue tie. This has led to a corresponding increase in the number of surgical tongue-tie revisions, called frenotomies, that are performed.
The number of frenotomies has increased from a little over 1,200 in 1997 to more than 12,400 in 2012. Experts believe it is unlikely that the number of babies being born with tongue-tie has increased by 1,000 percent. This leads them to believe that the condition is being over-diagnosed.
Mothers of babies with tongue-tie experience pain when trying to nurse their newborns. The short or tight tissue limits the infant’s range of motion, making it difficult to latch onto the nipple and swallow. If left untreated, tongue-tie can lead to problems with speech and other oral activities.
A frenotomy resolves the issue by cutting the tissue of the frenulum to improve movement. The inpatient procedure is quick and requires no anesthesia. But experts believe it is often unnecessary, especially in milder cases of tongue-tie.
Is the Surgery Necessary?
A 2019 study, led by Dr. Christopher Hartnick of Massachusetts Eye and Ear and published in JAMA Otolaryngology-Head & Neck Surgery, found that 63 percent of babies referred to a specialist for surgery to correct a tongue-tie ended up not needing the procedure after a comprehensive evaluation with a speech-language pathologist. These same babies eventually were able to breastfeed successfully without undergoing a surgical procedure.
The small sample size of this study was small—only 115 babies were examined. Dr. Hartnick is quick to admit that additional research into the issue is needed. But he feels it’s an important topic to look into, given the uptick in the number of referrals he and his colleagues see on a weekly basis. While the frenotomy is simple and straightforward, there is always some risk with any surgery.
Tongue-tie has been an increasingly controversial topic in the medical community for years. Much of the skepticism over the validity of the diagnoses is countered by data showing a significant increase in the number of women breastfeeding nowadays. Jumping to conclusions either way is risky; a 2017 Cochrane review concluded that there simply haven’t been enough studies to make a strong case for or against frenotomy or to establish guidelines for the procedure.
Still, given its ability to provide nursing moms with immediate relief from breastfeeding pain, it’s little wonder the procedure has become so popular.
Dr. Sipp recommends seeing a lactation consultant if you are experiencing pain while breastfeeding. It’s a good idea to get a second opinion before opting for a surgery that might not even be necessary.