But the tongue-tie madness in pediatricians’ offices, lactation rooms, and online groups has some researchers wondering whether people are all twisted up over nothing.
Moms might start worrying about tongue tie when breastfeeding fails to be the peaceful bonding experience they envisioned, when they’re dealing with cracked nipples and the pain of trying to nurse a baby who can’t latch properly.
They might call a local lactation consultant to help. If the consultant suspects a tongue tie, she’ll typically refer mom and baby to a pediatric dentist or an otolaryngologist (an ear, nose, and throat doctor), who will perform a procedure to “clip” the stringlike piece of tissue underneath the tongue. In some cases, the child’s pediatrician is not involved in the decision.
The procedure, called a frenotomy, frenulotomy, or tongue-tie revision, is a relatively straightforward one. A doctor or dentist holds the baby’s tongue taut toward the roof of his mouth and cuts the lingual frenulum to “release” it, usually with a laser or sterile scissors. This allows for greater range of motion for the tongue, provided the frenulum doesn’t reattach.
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During the procedure, the baby will be restrained with a swaddle, but there’s no need for general anesthesia (just a topical numbing), and the risk of possible complications—bleeding, infection, damage to the tongue or salivary glands, reattachment, or airway compromise—is low. Babies tend to be quite young when the procedure is performed, typically less than three months old. As medical procedures go, it’s quick and easy. And the results can be immediate. After a frenotomy, some babies have an improved latch, which makes breastfeeding less painful for mothers.
While the popularity of frenotomies has exploded in recent years, many medical professionals and researchers say it’s not totally clear whether they address the issues they’re supposed to—or whether a lot of babies are having an unnecessary procedure.
My son has both a tongue and lip tie, as diagnosed by a lactation consultant shortly after his birth. After helping my newborn son latch, she spent the next 20 minutes telling my husband and I that we needed to take him to a pediatric dentist immediately to have his tongue tie lasered, or he would never latch properly, would have trouble eating, would need braces and probably develop a speech impediment, and could develop craniofacial issues or sleep apnea.
After his feed, the consultant weighed my son, and was astonished to find that he ate three ounces in 12 minutes—a huge amount for a four-day-old. My husband and I talked it over and decided that if our son didn’t have issues eating, and the pain of breastfeeding went away, then we would forgo the lasering. Plus, our pediatrician was unconcerned about it.