In recent years, surging numbers of infants have gotten minor surgeries for “tongue tie,” to help with breastfeeding or prevent potential health issues. But research suggests many of those procedures could be unnecessary.
Why So Many Babies Are Getting Their Tongues Clipped
Ann Marie Presberg says
March 12, 2019 at 9:06 pmCouldn’t agree more. Fair article. So much need for research to make a better differential of who will/won’t benefit. So many concerns that parents are hearing predictive info and associations w speech, future feeding and even airway issues, which are absolutely not evidence based in the least… very misleading…not a shred of literature to support these claims. And picky eaters being dx w this… again not a shred of evidence. I’ve seen plenty of picky eaters and older kids w feeding issues who had frenectomies as infants (sometimes even twice). And it’s as if the oral motor pre feeding skills we have as normed based information is being completely overlooked when 9-15 month olds are getting diagnosed w tongue tie bc they aren’t taking chewable solids and lack rotary chew. Hopefully we can begin to add our layer of feeding and swallowing physiology to this and find better ways to research it to truly guide families along this possible intervention path.
Rowena Bennett says
March 12, 2019 at 9:20 pmBased on my experience with babies with feeding aversions, during the past 3 years, I have seen a HUGE increase in the number of bottle-fed babies having frenectomies for posterior tongue tie because of baby’s feeding refusal. Most feeding-averse babies fed just fine before developing a feeding aversion (typically around 2 to 3 months of age), and many feeding-averse babies also feed well in drowsy state or while asleep (a time when they are unaware they are being fed and therefore have their guard down). Either or both demonstrate that a tongue-tie is not affecting a bottle-fed baby’s ability to feed.
Tongue tie has in recent years become a popular diagnosis to explain problematic feeding behavior displayed by both breast and bottle fed babies. As a result, countless numbers of babies who have a minor posterior tongue tie are having unnecessary frenectomies (sometimes done more than once), which creates a raw wound and requires parents to place their fingers into their baby’s mouth to stretch 2-3 times per day for a number of weeks to prevent re-adherence. In many cases, a needless frenectomy makes an infant feeding problem significantly worse, more so for feeding-averse babies, who more often than not originally became averse to feeding due to being pressured or forced to feed against their will. And now, as a result of having a frenectomy, parents are sticking their fingers into baby’s mouth against his will to stretch a wound, and in doing so cause him pain and distress.
I just wish health professionals would ask more questions about baby’s feeding history rather than assume that just because baby has some degree of tongue tie that this must be the cause of problematic feeding behavior.
Ann Marie Presberg says
March 13, 2019 at 12:17 amAgree! I also like your book “Your baby’s bottle feeding aversion”. A colleague introduced me to it.
Rowena Bennett says
March 13, 2019 at 7:23 amThank you Ann Marie.
Lera says
March 13, 2019 at 12:46 pmthanks for sharing! it seems like tongue clipping is very controversial right now, and each SLP has varying opinions. any insight into why there’s such a divide? do you think opinions change when it comes to 3-5 year olds that have tongue ties and do have limited diets/speech issues? i’ve heard that some FB groups don’t want this even mentioned on there and i don’t understand why!
thanks!
Ann Marie Presberg says
March 13, 2019 at 1:34 pmI agree it is very confusing. I think there’s so much controversy bc theories are being presented as facts and parents are given misinformation like predictive indicators when they are completely unfounded. . I also think at times it’s not part of a differential diagnosis but rather a go to for any and all feeding issues. It’s structure/restriction so if a baby can feed while asleep but not while awake that is not structure. That’s usually pain/aversion/trauma that needs to be problem solved. Speech I don’t do in my practice any more. But I have seen kids in the 3-5 year range being diagnosed w tongue tie when their articulation is totally within developmental norms. It’s as if tongue tie is the solution to speed up development or something. And oral motor developmental norms we have are also being overlooked. Kids as early as 10 months getting a tongue tie dx bc they gag on solids. I’ve seen all these kids progress within reasonable time frames w solids and chewables w the right feeding guidance. And picky eater or kids w limited food repertoire that can chew Apples and hard candy but don’t like vegetables… is this really a “structural” issue? Tongue tie is structure and I feel if structure is impacted then maybe it’s rwasonabke. But if it’s more sensory and they can chew other things it doesn’t make sense. Hope that helps. Lot that needs to be researched to determine trends and patterns versus posing theories as facts. My two cents.
Ann Marie says
March 13, 2019 at 3:28 pmSorry for another reply but can’t figure out how to edit/add to other comment. I don’t mean to suggest this procedure should never be considered… there could be scenarios. And I’ve informed parents on this. But parent needs to be honestly informed of variability w outcomes. Often I see the opposite and I have so many cases I could describe. The other point is there’s nothing to show picky eaters or speech kids who receive this intervention have a quicker go w speech or feeding therapy- does it speed things up? Not necessarily. But if it makes sense then maybe if the child isn’t responding to traditional intervention, consider it. But is 80-90% of speech and feeding caseload gets the tongue tie release Rex, I see that as problematic. Finally we need to weigh the risk/ benefit. A child whose already anxious w meals, crying going to the table… is release of tongue reasonable (which requires sedation at that age) and will the follow up stretches parents have to perform after procedure to avoid reattachment cause more aversion?