In recent years, increasing numbers of women struggling with breastfeeding have turned to dentists to perform a procedure known as a tongue-tie release. This surgery involves cutting the tissue under the baby’s tongue. However, a new report from the American Academy of Pediatrics (AAP), representing 67,000 doctors, questions the necessity of these procedures for most infants.
The AAP’s report, released on Monday, highlights that there is limited evidence supporting the widespread use of tongue-tie releases. The report advises that these procedures should be reserved for the small number of infants with severely restricted tongue movement. The cost of the surgery, which can run into several hundred dollars, has been a significant concern for many parents.
Dr. Jennifer Thomas, a pediatrician from Wisconsin and the lead author of the report, noted that she and her team began researching this issue nearly nine years ago after noticing a rise in parents requesting tongue-tie evaluations for their babies. A study revealed an 800 percent increase in tongue-tie procedures from 1997 to 2012.
A New York Times investigation last year uncovered that some dentists and lactation consultants have been aggressively promoting the surgery despite potential side effects. While serious complications are rare, there have been cases where the procedure caused such severe pain that babies refused to eat, leading to dehydration and malnutrition. There have also been reports of infants experiencing airway blockages due to newly loosened tongues.
Supporters of tongue-tie releases argue that a restricted tongue can hinder breastfeeding and potentially lead to future issues like sleep apnea and speech delays. However, the AAP report points out that the tissue connecting the tongue to the bottom of the mouth is a normal anatomical feature. For the few babies with significant restrictions, the surgery might be beneficial. Nonetheless, the report suggests that using a medical laser, often promoted as advanced technology, offers no clear advantage over traditional scissors, which are associated with fewer side effects.
Tongue-tie releases are often recommended in the early days of breastfeeding, a period known for its challenges. A recent survey of over 1,400 women found that nearly 40 percent experienced nursing problems, such as latching pain and cracked nipples. These issues often resolve on their own without the need for surgery.
The AAP recommends that mothers seek support from lactation specialists, pediatricians, and feeding therapists to address breastfeeding difficulties. However, accessing these resources can be challenging due to their high cost.
Dr. Thomas emphasized the need for improved support for breastfeeding families, acknowledging progress but noting that there is still room for improvement. The report also advises against unnecessary procedures sometimes performed alongside tongue-tie releases, such as cutting “cheek ties” or engaging in extensive mouth-stretching exercises. These recommendations align with guidelines from the American Academy of Otolaryngology-Head and Neck Surgery issued in 2020.
As a practicing pediatrician and certified lactation consultant, Dr. Thomas frequently checks for tongue-ties in babies, even when not explicitly asked by parents. “We usually don’t announce a negative,” she said. “But we see so many people asking about it.”
This report aims to help parents make informed decisions and avoid unnecessary procedures that may not benefit their babies.
