Does your baby need tongue-tie surgery?
Many pregnant women plan to breastfeed their infant only to be met with difficulties and frustrations when the time comes.
Pain while breastfeeding can cause premature cessation of breastfeeding as well as poor milk transfer, leading to inadequate infant weight gain. People frequently believe tongue-tie is the cause of breastfeeding pain and encourage parents to seek out surgery for their baby. But that doesn’t always resolve the issue. In fact, it isn’t clear whether the procedure actually improves breastfeeding.
Tongue-tie, or ankyloglossia, is the condition of a congenitally tight lingual frenulum that limits the tongue’s motion. Recent studies suggest the rates of ankyloglossia diagnoses as well as frenotomies, the surgical procedure to release tongue-ties, are on the rise. Many believe this is a result of economic incentives as well as pressures from social media and online communities.
A new clinical report from the American Academy of Pediatrics offers guidance to pediatricians for advising parents about breastfeeding struggles. The recommendations center around prioritizing nonsurgical interventions and a collaborative care model to promote breastfeeding success.
If lactation support does not improve your breastfeeding problems, a diagnosis of symptomatic ankyloglossia can then be made for the infant. If breastfeeding problems continue after clinician evaluation of the infant and treatment, surgical intervention is then considered a reasonable option.
The report includes these additional recommendations:
- Families of infants with tongue tie should be directed toward evidence-based practices and have a collaborative care team, including lactation consultants and speech-language pathologists.
- Surgical intervention should only be used when other options have failed and the baby is experiencing significant functional impairments, such as limited tongue movement.
- The laser method for frenotomy is not supported over other methods, and evidence supporting the procedure remains limited.
- Stretching exercises post-frenotomy are not recommended.
Dr. Jennifer Thomas is a pediatrician with Aurora Health Care.
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