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More babies get their tongue cut to breastfeed

"My baby is not gaining weight." "She will not take a bottle." "Breastfeeding is painful, am I doing something wrong?"

Here are some of the questions and comments from mothers in breastfeeding support groups, online forums and in the waiting rooms of pediatric surgeries. The first tip that mothers get is often to check if they are "knotted," or ankyloglossia – attach the infant's tongue to the floor of the mouth with a small piece of tissue called the frenulum that makes it difficult to maintain the breast. suck.

This condition can be corrected by simple surgery of cutting or cutting tissue. But is it necessary for most babies?

That's the question that researchers at the Massachusetts Eye and Ear's Boston Eye and Ear Pediatric Airway, Voice and Swallow Center have been trying to answer after seeing an influx of parents asking for second and third opinions about to to know if their baby needed the procedure, which takes about a minute. and is usually done without anesthesia.

"We have seen the number of surgeries release the tongue and lip increased dramatically nationally, with no real evidence that these interventions are effective for breastfeeding," said Dr. Christopher Hartnick, lead author, director of pediatric otolaryngology division at mass. Eye and Ear, said in a statement.

They initiated a study of 115 babies, who were referred to a pediatric surgeon for nose and throat surgeries, for surgery on the tongue and / or upper lip ties. The upper lip tie occurs when a small piece of tissue attaches the upper lip to the gums.

The procedure was not necessary for 63% of infants, according to their findings published Thursday in the journal JAMA Otolaryngology – Head & Neck Surgery. Babies have learned to breastfeed successfully after thorough evaluation of feeding by teams of clinicians, including a speech therapist.

The study did not specify whether the children had been misdiagnosed or had undergone other non-surgical treatments to relieve their language problems.

"We do not have a crystal ball that can tell us which babies could benefit the most from loosening the tongue or upper lip," Hartnick said. "But this preliminary study provides concrete evidence that this multidisciplinary nutritional assessment stream is helping to prevent babies from undergoing this procedure."

The results raise the question: if many babies do not need tongue surgery, why are so many of these surgeries done?

Does the language attachment procedure help?

A language link occurs in 4 to 11% of all newborns, according to a 2017 Cochrane report. Tongue surgeries, or frenectomies, are performed on babies who have a tight frenulum.

However, previous studies had suggested that a tongue link did not always complicate breastfeeding and that releasing it did not always improve breastfeeding. Indeed, it is possible that the improvement observed by the parents is sometimes due to wishful thinking, in other words to the placebo effect.

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