Parents self-diagnosing 'tongue-tie' in their babies fuel rise in surgery
Some babies have difficulty breastfeeding, for a variety of reasons. /CFP/File

Some babies have difficulty breastfeeding, for a variety of reasons. /CFP/File

Doctors are warning that the use of frenotomies to treat 'tongue-tied' babies is the latest example of the public self-diagnosing medical conditions on the internet and pursuing unnecessary treatment. In most cases, babies grow out of 'tongue tie' – or ankyloglossia – a condition that can make breastfeeding painful for them.

A frenotomy involves snipping the thin band of tissue that connects the bottom of the tongue to the floor of the mouth. Its popularity has exploded in recent years but doctors warn it is often unnecessary, backed by little research and being pushed by for-profit consultants without medical training.

France's National Academy of Medicine warned last month that this "aggressive and potentially dangerous procedure for newborns and infants" has seen a "spectacular increase" throughout the world.

A 2018 study found that the diagnosis of ankyloglossia had increased more than 10-fold in numerous countries in just a decade.

The increased awareness of the condition propelled a surge in procedures to fix it. A report in Australia found that the number of frenotomies increased by 420 percent from 2006 to 2016.

Lyndsay Fraser, an ear, nose and throat surgeon in Scotland, warned that there were "potentially significant risks" from a deeper dissection at the tongue's base to divide posterior tongue tie and that, in her opinion, it "has no evidence base and should not be routinely offered."

Fraser said she believed its rising popularity has been driven by mothers finding information on the internet, "often factually incorrect and driven by private industry," as well as "extreme pressure on mums to breastfeed and a natural inclination to medicalize every difficult aspect of childcare rather than just providing support.

Breastfeeding pain can be due to a range of issues but Fraser says, "many mothers will see private practitioners who will then divide a tongue-tie for a sum of money."

Lea had no problems breastfeeding her newborn son when she took him to see an osteopath in Paris, who nonetheless recommended surgery to cut a "too thick" strip of tissue under his tongue.

She said the osteopath indicated that "we don't really know why, but it's always better to have it cut."


"Serious methodological shortcomings"

Virginie Rigourd, a pediatrician at a Paris hospital, said that osteopaths and breastfeeding counselors had contributed to the rise in frenotomies.

The website of one French breastfeeding counselor claims that not having a frenotomy "jeopardizes breastfeeding and the health of both babies and mothers," offering a 100-euro ($105) training course on the subject.

"It's not something new, it's been going on several years now," Rigourd said. "It probably started in the U.S. and Canada and spread."

Cochrane, a British organization that reviews medical research, found that existing research on the procedure had "serious methodological shortcomings."

"No study was able to report whether frenotomy led to long‐term successful breastfeeding," Cochrane said.

The Academy of Breastfeeding Medicine, a global organization of doctors, said that "frenotomy can be effective," but the decision to undertake the procedure "requires a high level of clinical skill, judgment and discernment."

Yet the procedure is still being offered to mothers without breastfeeding issues.

Lea turned down her osteopath's suggestion of a "preventative" frenotomy in 2018, but said she understood how other new parents might give in to the pressure.

"You want what's best for your child -- if someone tells you that having part of your child's tongue cut is best, even for no obvious reason, you go for it," she said.

Source(s): AFP

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