Tongue-Tie Procedures in Infants: A Growing Concern Among Health Professionals

AUSTRALIA: A recent article by Claudia Williams on the ABC News website has shed light on the complex and often controversial topic of tongue-tie procedures in newborns. The piece explores the increasing rates of these surgeries and the ongoing debate among health professionals regarding their necessity.

Rising Numbers Raise Eyebrows

According to the article, Medicare data reveals a significant increase in claims related to tongue-tie releases over the past decades. The number of claims rose from a mere 1,487 in 1995 to an astounding 9,720 in 2023, with a peak of 11,304 claims in 2017. This surge has prompted some health professionals to question whether there is an overdiagnosis and overtreatment of the condition.

Dr. Pamela Douglas, a Brisbane-based GP and researcher quoted in the article, expresses her concern: “The reason why we’ve moved into such overdiagnosis and overtreatment, I think, is because clinical breastfeeding support still remains a research frontier.”

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Defining the Problem

A tongue-tie, or ankyloglossia, occurs when the tissue under an infant’s tongue restricts its movement and function. This can potentially impact breastfeeding, leading to issues such as low weight gain in babies and discomfort for mothers. However, the definition and diagnosis of tongue-ties remain subjects of debate among healthcare providers.

The article presents the personal story of Galen Elliott, a first-time mother and midwife who was told her newborn had a minor tongue-tie. Despite her professional background, Elliott found herself overwhelmed by the diagnosis. “I work with postnatal mums, but [it is different] to actually be in the experience of being completely sleep deprived … and wanting to do everything right,” she shared.

Call for Evidence-Based Approach

Health professionals interviewed in the piece emphasise the need for a measured, evidence-based approach to tongue-tie management. Dr. Mihiri Silva, a paediatric dentistry lecturer at the University of Melbourne, points out that “There’s actually got to be a process to look for a functional problem,” rather than solely relying on the appearance of the tongue.

A consensus statement published by the Australian Dental Association in 2020, which Dr. Silva chaired, advocates for considering surgery only after non-surgical management has failed.

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The Other Side of the Debate

The article also presents contrasting viewpoints. Some practitioners argue that denying treatment could prevent mothers and infants from receiving the care they need. The piece cites a rebuttal to the ADA’s statement from Enhance Dentistry, expressing concerns about potential conflicts of interest and incomplete literature review.

All sides agree on the need for more research and a multidisciplinary approach to tongue-tie management. The article concludes with advice from Elliott to other mothers: “Follow your intuition. You’re working with your baby. You see all the things all the time, at 2am, and you get to know your baby.”

This balanced exploration of the tongue-tie debate underscores the complexity of the issue and the importance of individualised care in infant health management.