Is Tongue-Tie Surgery Necessary?

Reviewed on 3/26/2021

The best person to answer this query would be the doctor.
The best person to answer this query would be the doctor.

The best person to answer this query would be the doctor. The doctor and lactation consultant will examine the baby thoroughly and suggest the best treatment for the baby with a tongue-tie. A tongue-tie surgery may or may not be necessary, and this depends on the extent of the tongue-tie and other complications.

A tongue-tie surgery helps the infant latch on to the mother’s breasts naturally. Doctors had been performing the surgeries right away after the condition is detected in infants. The number of surgeries performed for tongue-tie increased 10 times (from 1200 to 12,400) between 1997 and 2012. Some studies have demonstrated significant improvement in breastfeeding after tongue-tie surgery. Babies have gained weight after the surgery.

It is only in recent years that doctors have started to look at whether the surgery is really necessary and if alternative methods to correct the problem can help.

A 2019 study published in the Journal of the American Medical Association (JAMA) analyzed 115 newborns with a tongue-tie. It found that 63% of babies didn’t need tongue-tie surgery to improve breastfeeding. All they needed was a thorough examination and treatment by a pediatric speech and language pathologist (SLP). Often the surgery has its own set of problems. The mothers need their babies/infants to do tongue exercises after these extensive procedures to prevent scarring and speech problems in the future.

The mothers should consult a lactation consultant to see if certain techniques can work to make breastfeeding easier for the infant with a possible tongue-tie. The problem of tongue-tie may also resolve on its own (the frenulum loosens over time). It may also persist without causing any problems to the infant and the mother. Experts have started to use the wait-and-see approach before recommending the surgery.

What is tongue-tie?

About 10 out of 100 babies are born with a condition known as ankyloglossia, popularly known as tongue-tie. The condition makes it difficult for the infant to properly latch on the mother’s breasts for breastfeeding. This may lead to the baby not getting adequate nutrition. The mother’s breast may also get engorged, swell, and pain due to inadequate emptying of the breasts.

There is a thin band of tissue known as the frenulum that connects the base of the tongue to the floor of the mouth. In infants with tongue-tie, the frenulum is short or thick. Due to this, the infants cannot move their tongues freely in their mouths and have delayed development of proper speech and words.

What are the complications of tongue tie surgery?

A tongue-tie surgery is relatively safe but some extensive procedures, such as frenuloplasty carry the risk of:

  • Delayed healing
  • Scarring of wound
  • Dehydration
  • Feeding difficulty
  • Damage to the tongue muscles or salivary glands
  • Speaking difficulties in later life

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References
Schlatter SM, Schupp W, Otten JE, et al. The Role of Tongue-Tie in Breastfeeding Problems-A Prospective Observational Study. Acta Paediatr. 2019 Dec;108(12):2214-2221. https://pubmed.ncbi.nlm.nih.gov/31265153/

Srinivasan A, Al Khoury A, Puzhko S, et al. Frenotomy in Infants With Tongue-Tie and Breastfeeding Problems. J Hum Lact. November 2019;35(4):706-712. https://pubmed.ncbi.nlm.nih.gov/30543756/

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