Snip eases breastfeeding for some babies

U. FLORIDA (US)—Many doctors don’t perform a simple procedure that would make breastfeeding easier for some babies because they believe it’s not medically necessary.

Studies show about 2 percent to 5 percent of babies have tongue tie—a condition when the connective tissue under the tongue is too tight—and about half of those babies have problems with breastfeeding, in some cases so severe that new mothers give up breastfeeding altogether.

“It is called a frenotomy, and it is far simpler than a circumcision, which we do fairly routinely,” says Sandra Sullivan, assistant professor of pediatrics at the University of Florida.

“It literally takes longer to fill out the consent form for the procedure than to do the actual procedure itself.”

The study appears online in the journal Pediatrics.

For babies to breastfeed effectively, the tongue has to be able to perform a more complex type of sucking than what it takes to drink from a bottle, Sullivan says. Tongue tie can hinder a baby’s efforts to move his tongue up, down, and out, which is necessary to nurse.

“If you take a bottle with an artificial nipple, there is not a lot a baby has to do to get milk,” Sullivan explains.

“To get milk out of the breast, they have to make a vacuum and if they cannot get their tongue to the roof of their mouth, they cannot do this. They also need to use their jaw and tongue to move the milk along through the milk ducts in the breast.

“If they just bite on the nipple (like a bottle), first, it hurts (the baby’s mother) a lot and second, it blocks off all those little tubes, which keeps the milk stuck in the breast.”

About 4 million babies are born in the United States annually, meaning that between 40,000 and 100,000 babies are born each year with a tongue tie problem, says Isabella Knox, associate professor of pediatrics at the University of Washington.

“That’s a lot of babies,” Knox says. “I don’t think general pediatrics training gives us a lot of skills in supporting breastfeeding.

“A lot of pediatricians have lactation consultants, but we don’t really know how to help somebody and for some people it is not always a priority.”

According to the American Academy of Pediatrics, breast milk is considered the optimal food for babies. Studies have shown that exclusive breastfeeding offers infants some protection against diseases and common childhood illnesses, such as ear infections.

“Breastfeeding is best for babies, and we want to encourage mothers to breastfeed and do it successfully for as long as they would like,” says Jerry Isaac, a pediatrician and past president of the Florida chapter of the American Academy of Pediatrics.

“This (paper) is an important piece of information adding to the body of knowledge that this may be a significant problem in some babies.”

Sullivan is part of an international organization focused on issues related to tongue ties. She and other members of the group’s screening committee are working to develop a screening tool that would help nurses quickly screen for a tongue tie while assessing the baby after birth.

“There is not a lot of literature about frenotomy, and there are still a lot of doctors who say, ‘Is this really necessary?’” Sullivan says.

“Whether or not there is an epidemic or whether we ignored tongue ties and are looking for them now, this is something that is coming up more often in nurseries.”

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chat4 Comments


  1. Bettina at Best for Babes

    Kudos for reporting on this important study and the critical lack of awareness of “tongue-tie”. A lack of education among pediatricians and health professionals, and a lack of truly qualified lactation consultants 24/7 in hospitals is a major “booby trap” that keeps moms who want to breastfeed from achieving their personal breastfeeding goals, let alone the minimum 6 months recommended. We will be sharing this to educate our following.

  2. Debbie at East Valley Lactation

    As a board certified lactation consultant, I recognize many babies with tongue restrictions and unfortunately get very mixed responses from their health care providers. I’m so tired of moms being told, “It’ll stretch, it’ll grow, it’ll tear,” or “Let’s wait a few months and see,” while moms are forced to continue pumping and supplementing baby away from the breast and are at risk of weaning. I’m eager to spread this article far and wide; hopefully it will make a difference for these families.

  3. Julius Rombough

    Yes, breastfeeding should be more publicity,My children are grown up breastfeeding.He was very healthy

  4. Eric

    The reference to circumcision was unnecessary. The tongue surgery they propose has a clear clinical indication, whereas routine circumcision has NO clinical indication and is driven primarily by cultural forces. The fact that circumcision is routine is due to an irresponsible and dysfunctional medical establishment that allows genital cutting in baby boys. The two situations are completely different.

    Whether or not the tongue snip should occur is a genuine debate.

    Whether or not circumcision should occur is a manufactured debate.

    Genital cutting in all children is wrong, and the medical reasons used to justify routine neonatal male circumcision in the United States are merely a cover for the true cultural reasons behind the practice.

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