Breastfeeding babies are undergoing painful tongue and lip tie cutting procedures unnecessarily, health experts warn.
Tongue-tie is a condition where the thin tissue membrane under a person's tongue - the lingual frenulum - restricts movement. A lip tie is the tissue joining the upper lip to the centre of the gum.
The Australian Breastfeeding Association says a tie can impact breastfeeding when "the tongue is not free or mobile enough for the baby to attach properly to the breast."
In response, breastfeeding advocates and some dentists have been recommending a highly controversial procedure.
The surgery uses either scissors or surgical laser to cut the ties, often without anaesthetic.
The popularity of the procedure has skyrocketed in recent years, with the Medical Journal of Australia reporting a 420 per cent increase in the decade up to 2016.
Doctors say the real number could be far higher, as the figures don't include data from private dentists.
“Oral laser surgery hurts babies”
The former president of the Australian Dental Association (Queensland Branch) Professor Laurie Walsh warns some forms of the procedure shouldn't be carried out on babies.
He says the benefits are limited, even for a 'simple cut' - a relatively uncontroversial procedure affecting visible tongue-ties stretching to the tip of the tongue. Such impacts are:
Source: The Feed
"...mostly on nipple pain in young mothers, but no long-term benefit on infant feeding."
Professor Walsh says risks from cutting the base of the tongue - a posterior cut - include unnecessary pain, distress and haemorrhage when scissors are used.
It can even worsen breastfeeding problems, if the infant develops oral aversion.
Brisbane-based GP and lactation expert Pam Douglas agrees.
She argues that we're in the grip of a 'tongue tie epidemic'.
“There is evidence, it’s not peer reviewed yet”
But not all dental professionals are against the laser procedure.
Melbourne dentist Jeff Kestenberg says there is enough evidence to support tongue-tie cutting.
"There's over 500 articles in the medical and dental literature about treating tongue tie."
Dr Kestenberg says he treats hundreds of babies a year and sees "wonderful results".
Source: The Feed
"It's very rewarding work for me".
Marjan Jones, who runs the Tongue Tie Institute in Brisbane, has labelled the growing criticism 'disappointing'.
There is evidence... it's not peer reviewed yet.
"I'm always open to further dialogue and for them [the Australian Dental Association] to come and observe what we do," she said.
New research
Off the back of his own concerns with tongue tie cutting, Professor Walsh sent a letter to the Dental Board of Australia, calling for action.
"It's up to the regulator to say, "Here are some definite don't do's," and apply some sticks if that's necessary," he said.
In particular, he highlights alleged misinformation on the Tongue Tie Institute website, including an image linking ties to other medical issues such as sleep apnea, or face growth issues.
A spokesperson for the Australian Health Practitioner Regulation Agency says the Dental Board of Australia reviewed the letter and found it already has the "appropriate regulatory framework" in place.
Graphic taken from the Tongue Tie Institute website. Source: The Feed
In the meantime, Professor Walsh says new ultrasound-informed research of breastfeeding is upending previous thinking of how the tongue functions - In other words, deep tongue-tie cutting for breastfeeding purposes may be totally unnecessary.
