NYT article on Tongue Tie

Many of us have seen this article already and if you haven’t I recommend taking a look. It provides an interesting view of a procedure that has become very commonplace in our profession. It would be easy to quickly become dismissive and upset but we need to understand how our work is viewed and understood. Everything we do and recommend can have positive and/or negative ramifications. I myself have seen a great increase in the number of children coming to feeding team having had some type of release (often with the parental hope that it would fix the feeding issue). I have seen infants and children benefit from tongue or lip tie release with improved feeding but I have also seen children who have been hospitalized after the procedure because they stopped eating, had complications, or were incorrectly diagnosed (ie., 2 soft palate clefts, Prader-Willi syndrome, and an H type fistula causing air swallowing). I suspect that as a feeding team therapist, I do not see the children who have improvement after the procedure. However, I do see children who continue to need help.

There are no guaranteed fixes in health care. This article reminds us that there is always risk. Risk in doing a procedure as well as consequences of not intervening. We see this everyday in our feeding clinic. Pediatric feeding disorders are complicated. Sometimes we make a recommendation and it is not enough, the child may need several strategies for improved feeding. As a profession, we make the best recommendation we can based on the information we have.

I do not like to be controversial professionally (although I am opinionated) and pride myself on staying neutral, open, and informative with my work and with this blog. I have been in this field for 30 years and know that we do not have all the answers. We use strategies and techniques that lack substantial evidence. It doesn’t mean that they do not work, just means we haven’t studied them rigoriusly in a research context. My take is this- stay open to all opinions, continue to learn from successes and failures, and more research evidence in all that we do and recommend couldn’t hurt either.

Tess Merrell had breastfed three babies and never expected trouble with her fourth. But after a month of struggling with her newborn, she hired Melanie Henstrom for help. Read more here