Inside the Booming Business of Cutting Babies’ Tongues

Last Updated on December 18, 2023 by admin

Inside the Booming Business of Cutting Babies’ Tongues
Lauren Lavelle with her daughter, June, who had to go to the emergency room days after a tongue-tie release, at their home in Boise, Idaho, Oct. 9, 2023. (Natalie Behring/The New York Times)

Tess Merrell, a seasoned mother of three, expected a smooth journey with her fourth baby. However, a month of struggles led her to seek help from Melanie Henstrom, a lactation consultant. Henstrom quickly identified the issue: the newborn’s tongue was tethered to the bottom of her mouth, a common problem often resolved with a brief dental procedure.

“It was seen as this miraculous fix,” shared Merrell, a high school soccer coach from Boise, Idaho.

Henstrom directed Merrell to a dentist who performed a laser procedure under the baby’s tongue in December 2017. Within days, baby Eleanor rejected feeding and became severely dehydrated, spending her first Christmas relying on a feeding tube.

For ages, midwives and doctors have addressed these “tongue-ties” to facilitate breastfeeding. However, in the past decade, the procedure has gained immense popularity, driven by the mounting pressure on women to breastfeed. This trend has led lactation consultants and dentists to promote the procedure aggressively, sometimes for babies without genuine tongue-ties, despite potential risks.

While a fraction of babies are born with tissue attaching their tongue tip to the mouth’s bottom, many of these cases are harmless. Yet, some professionals market laser surgeries as a universal solution, claiming benefits like improved breastfeeding and preventing various health issues, like sleep apnea or speech impediments, despite limited evidence supporting these claims.

The push extends beyond snipping the tissue under the tongue; it involves targeting the webbing connecting lips and cheeks to gums, creating a specialized industry. This surge in procedures, often not covered by insurance, has led to an exponential rise, overwhelming hospitals and specialists across the country.

Studies note a staggering 800% increase in hospital-based tongue releases between 1997 and 2012, surpassing 12,000 cases nationally. Ear, nose, and throat specialists in 25 states report a surge in tongue-tie consultations, while online searches for “tongue tie” doubled in the last five years, indicating the soaring demand for these procedures.

Tongue-tie procedures, once a niche medical practice, have surged in popularity over the years, with families touting their benefits for infants struggling with breastfeeding. However, this burgeoning trend has sparked concern among pediatricians nationwide, raising critical questions about its efficacy and the risks involved.

In 2020, a New Jersey-based practice flagged a concerning trend—babies undergoing these procedures, dubbed as “clipped, snipped, and lasered,” at an alarming rate. This pattern was echoed by an office in Kentucky, citing severe pain and feeding issues post-laser procedures. Dr. Charles Cavallo expressed concerns, decrying what he perceived as a “money grab” by local dentists and lactation consultants.

While severe complications are rare, instances emerged where infants experienced excruciating pain, leading to feeding refusal, dehydration, and malnourishment. In certain cases, these procedures caused airway blockages and led to unexpected consequences.

The controversy surrounding tongue-tie procedures isn’t new. Historical records highlight the debate’s existence for centuries. Despite the age-old belief in the interference of tongue-ties with breastfeeding, medical professionals have long warned against the procedure’s potential for misuse driven by profit, greed, and ignorance.

The resurgence of interest in tongue-tie procedures came with the revival of breastfeeding in the 1970s. As breastfeeding gained traction, specialized lactation consultants emerged to aid nursing techniques. While these consultants initially assisted babies with obvious tongue-ties hindering nursing, the landscape shifted in 2004 when an influential article broadened the spectrum of infants potentially benefiting from the procedure.

However, concerns arose as diagnoses of tied tongues, cheeks, and lips accelerated, proliferating through social media groups dedicated to tongue-ties. Despite conflicting viewpoints, many women attributed easier nursing experiences to these procedures, blurring the line between causation and correlation.

Recent guidelines by leading ear, nose, and throat specialists have cautioned against over-diagnosing tongue-ties, emphasizing that some babies might be misidentified with other conditions restricting tongue movement. This complexity makes it challenging to gauge the true impact of these procedures.

Despite the rarity of lasting problems post-surgery, the few cases with adverse effects have been harrowing for families. Instances of infants losing the ability to suck, experiencing significant weight loss, or requiring prolonged feeding therapy have been documented, sparking concerns among medical professionals.

Amid this debate, practitioners have evolved their approaches, some leaning toward caution and reevaluating their practices due to worries about the overstatement of benefits. Yet, the industry continues to expand, fueled by practitioners, companies manufacturing the laser equipment, and conferences that promote these procedures as beneficial without substantial medical evidence.

At the heart of this debate lies the dilemma faced by families grappling with the decision to opt for these procedures. Stories abound of families feeling pressured into surgeries by consultants, facing unexpected complications, and shouldering significant financial burdens due to these interventions.

Instances of practitioners overstepping professional boundaries, diagnosing without thorough examination, and recommending unverified techniques to prevent reattachment of tissues have led to emotional distress for families and concerns within the healthcare community.

Despite complaints and concerns raised against practitioners like Henstrom, the lack of stringent regulation in this realm poses challenges. Boards and oversight bodies face limitations in addressing grievances, leaving families vulnerable and without adequate recourse in case of unsatisfactory outcomes.

The journey of families like the Merrells, Wambekes, and Nobilis serves as a stark reminder of the far-reaching implications of these procedures. The emotional toll, financial burden, and enduring consequences faced by these families shed light on the need for comprehensive oversight and a balanced approach in navigating the realm of tongue-tie interventions.

The controversy surrounding tongue-tie procedures underscores the complexities of medical interventions, urging a closer examination of practices, thorough research, and robust oversight to ensure the well-being of infants and the support of families navigating these critical decisions.

This post originally appeared in The New York Times