"My baby is not growing up." "She's not taking the bottle." "Breastfeeding is painful, am I doing something wrong?"
These are some of the questions and comments that mothers ask in breastfeeding support groups, Online forums and in the waiting rooms of pediatrician practices. Often, the first advice given to mothers is to test for "tongue bonding" or ankyloglossia – tying a child's tongue to the floor of the mouth through a small piece of tissue called a frenulum, which makes proper tying and tying difficult.
The condition can be remedied with a simple surgical procedure in which the tissue is cut or cut off. But is it necessary for most babies?
Researchers at the Massachusetts Eye and Ear Pediatric Airway, Voice and Swallowing Center in Boston responded to this question after seeing an influx of parents asking, in second and third opinions, if their babies needed the procedure which lasts for about a minute and is usually performed without anesthesia.
"We've seen that the number of tongue and top band loosening operations has increased dramatically across the country without the need for meaningful data to show that they are effective for breastfeeding," said lead author Dr. Christopher Hartnick, Director of the Department of Pediatric ENT at Mass. Eye and Ear, in a statement.
They therefore started a study of 1
For 63% of infants, the procedure was not required, according to results published on Thursday in the journal JAMA Otolaryngology – Head & Neck Surgery. Breastfeeding was learned after a thorough feeding study by teams of doctors, including a speech pathologist.
The study did not indicate if the children were misdiagnosed or if they were receiving alternative non-surgical treatments to relieve their tongue problems.
"We do not have a crystal ball that can tell us which babies could benefit the most from tongue attachment or upper lip release," said Hartnick. "However, this preliminary study provides concrete evidence that this pathway to a multidisciplinary feeding assessment helps babies not get this procedure."
The findings raise the question of whether many babies do not require Tongue Banding, why many of these surgeries are performed ?
Does a tongue binding procedure help?
According to a 2017 Cochrane resurgence, 4-11 percent of newborns have tongue attachments. Tongue-binding operations or frenectomies are performed in babies with a tight frenulum.
However, previous studies have shown that tongue bonding does not always make breastfeeding difficult and dissolution does not always improve breastfeeding. In fact, it is possible that the improvement seen by the parents is sometimes due to wishful thinking – in other words, the placebo effect.
Most experts say that the increase in Tongue Tongue operations is linked to successful worldwide efforts to increase breastfeeding. In fact, more than 80 percent of US mothers start breastfeeding after birth, but less than half are breastfed exclusively after three months, according to the breastfeeding report of the Centers for Disease Control and Prevention.
"As a new mother You can not go to a parent or breastfeeding support website without learning that tongue bonding is the main reason your baby has trouble pinching or why breastfeeding is painful," said Drs. Jonathan Walsh, a pediatric ENT specialist and neck surgeon and assistant professor at the Johns Hopkins School of Medicine.
Some mothers may check tongue attachment to determine if the baby has a malformed tongue or has difficulty sticking out tongue. However, it can be difficult for mothers to recognize a tongue bond on their own, causing the condition to go unnoticed until after several weeks of painful breastfeeding, Walsh said.
The number of these interventions has increased rapidly in recent years, said Walsh, who in 2017 authored a study examining the frequency of tongue-bonding operations from 1997 to 2012. Walsh was not involved in the new research.
In general, the rate of Tongue Diagnosis in the US and worldwide is increasing dramatically, leading to more children being treated, "Walsh told NBC News. His 2017 study found an estimated 10-fold increase in lingual surgeries from 1997 to 2012.
According to Walsh, the increase in lingual surgeries is not only the result of public health efforts to improve breastfeeding practices, but also the result more Lactation services, more awareness and a more comprehensive definition of tongue attachment.
What should mothers do?
Some mothers who have trouble nursing can adjust their breastfeeding position or check the locking techniques with a lactation specialist.
As with any surgical procedure, complications such as bleeding, infection or damage to the tongue or salivary glands can occur. Although the complications are rare, Walsh advised mothers to seek a second opinion on the diagnosis or undergo surgery to protect babies from unnecessary discomfort.
"If you step back and critically examine those children, you often find another diagnosis or alternative treatment," Walsh said. "Just because you have the diagnosis does not mean you have to undergo surgery," Walsh said.