Tongue-Tie. A Modern Epidemic. Part 7

Tongue-Tie. A Modern Epidemic

Where does the responsibility lie?

Part 7 (of 7) of the presentation.

Part 1.

Part 2.

Part 3.

Part 4.

Part 5.

Part 6.


Amir, L. H., James, J. P., & Donath, S. M. (2006). Reliability of the Hazelbaker Assessment Tool for Lingual Frenulum Function. International Breastfeeding Journal, 1(1), 3. doi:10.1186/1746-4358-1-3 (Unreliability of assessment tool.)

Australian Collaboration for Infant Oral Research (ACIOR). (4 October, 2017). Position Statement 1. Upper lip-tie, buccal ties, and the role of frenotomy in infants. (No reason exists to classify diverse variants as ‘upper lip ties’ or buccal ties.)

Australian Dental Association (July 2017). Frenotomy in newborns: Has increased awareness led to unnecessary treatment?

Bambery, D. Dental Council NZ, Practitioners Corner. (July 2017). (Dentists need to be certain that they are clear of the indications for the surgery following adverse outcomes of a serious nature.)

Braithwaite, J. (2014). The medical miracles delusion. Journal of the Royal Society of Medicine, 107(3), 92–93. doi:10.1177/0141076814523951 (We are more like army ants than we think. ‘Throughout history, mass delusions have been aligned with mass desires for favourable outcomes.’)

Brody, H., & Miller, F. G. (2011). Lessons from recent research about the placebo effect—from art to science. JAMA, 306(23), 2612. doi:10.1001/jama.2011.1850 (Power of the mind to bend reality as a result of faith, hope and expectation is very strong.)

Brooks, E. (2013). Legal and ethical issues for the IBCLC. Burlington, MA: Jones & Bartlett. (Who is responsible?)

Brownlee, S., Chalkidou, K., Doust, J., Elshaug, A. G., Glasziou, P., Heath, I., … Korenstein, D. (2017). Evidence for overuse of medical services around the world. The Lancet, 390(10090), 156–168. doi:10.1016/s0140-6736(16)32585-5

Buryk, M., Bloom, D., & Shope, T. (2011). Efficacy of neonatal release of ankyloglossia: A randomized trial. PEDIATRICS, 128(2), 280–288. doi:10.1542/peds.2011-0077 (Effect of frenotomy is immediate. Placebo effect on nipple pain)

Coryllos E, Watson Genna C, Salloum A. (2004, Summer). Congenital tongue-tie and its impact on breastfeeding. Breastfeeding: Best for mother and baby, American Academy of Pediatrics Newsletter, 1–6. (Idea of posterior ties introduced.)

Douglas, P. (2013). Diagnosing gastro-oesophageal reflux disease or lactose intolerance in babies who cry a lot in the first few months overlooks feeding problems. Journal of Paediatrics and Child Health, 49(4), E252–E256. doi:10.1111/jpc.12153 (The idea of medicalising fussing.)

Douglas, P. (2017). Making sense of studies that claim benefits of frenotomy in the absence of classic tongue-tie. Journal of Human Lactation, 33(3), 519–523. doi:10.1177/0890334417706694 (Studies confuse association with causation.)

Douglas, P., & Geddes, D. (2018). The latest practice-based interpretation of ultrasound studies leads the way to more effective clinical support and less pharmaceutical and surgical intervention for breastfeeding infants. Midwifery, 58,145–155. doi:10.1016/j.midw.2017.12.007 (Abandons previous sucking model and adopts one that illustrates tied babies can breastfeed with better positioning and attachment.)

Geddes, D. T., & Sakalidis, V. S. (2016). Ultrasound imaging of breastfeeding—A window to the inside. Journal of Human Lactation, 32(2), 340–349. doi:10.1177/0890334415626152 (Description of the tongue movements during sucking as seen in new ultrasound images.)

Geddes, D. T., Langton, D. B., Gollow, I., Jacobs, L. A., Hartmann, P. E., & Simmer, K. (2008). Frenulotomy for breastfeeding infants with ankyloglossia: Effect on milk removal and sucking mechanism as imaged by ultrasound. PEDIATRICS, 122(1), e188–e194. doi:10.1542/peds.2007-2553 (Nipple compression resolving immediately after frenotomy).

Haham, A., Marom, R., Mangel, L., Botzer, E., & Dollberg, S. (2014). Prevalence of breastfeeding difficulties in newborns with a lingual frenulum: A prospective cohort series. Breastfeeding Medicine, 9(9), 438–441. doi:10.1089/bfm.2014.0040 (A lingual frenulum is a normal anatomical finding whose insertion point and Coryllos classification are not correlated with breastfeeding difficulties.)

Hatfield, L. (2014). Neonatal pain: What′s age got to do with it?
Surgical Neurology International, 5(14), 479. doi:10.4103/2152-7806.144630 (The neurobiology of neonatal pain processing.)

Hazelbaker, A. K. (1993). The assessment tool for lingual frenulum function: use in a lactation consultant private practice (Master’s thesis). Pacific Oaks College, Pasadena, CA.

Hoffmann, T. C., & Del Mar, C. (2017). Clinicians’ expectations of the benefits and harms of treatments, screening, and tests. JAMA Internal Medicine, 177(3), 407. doi:10.1001/jamainternmed.2016.8254 (We can’t trust clinicians’ perceptions about the benefits and harms of surgical interventions. Unjustified enthusiasm for treatment.)

Hoffmann, T. C., & Del Mar, C. (2015). Patients’ expectations of the benefits and harms of treatments, screening, and tests. JAMA Internal Medicine, 175(2), 274. doi:10.1001/jamainternmed.2014.6016 (Patients have inaccurate expectations, and most think that interventions will help more and harm less than they actually do.)

Hong, P., Lago, D., Seargeant, J., Pellman, L., Magit, A. E., & Pransky, S. M. (2010). Defining ankyloglossia: A case series of anterior and posterior tongue ties. International Journal of Pediatric Otorhinolaryngology, 74(9), 1003–1006. doi:10.1016/j.ijporl.2010.05.025 (Retrospective case series mentioning posterior ties.)

Ingram, J., Johnson, D., Copeland, M., Churchill, C., Taylor, H., & Emond, A. (2015). The development of a tongue assessment tool to assist with tongue-tie identification. Archives of Disease in Childhood – Fetal and Neonatal Edition, 100(4), F344–F349. doi:10.1136/archdischild-2014-307503

Isaacs, D. Tongue-tie and frenotomy. (2015). Journal of Paediatrics and Child Health, 51(2), 227–228. doi:10.1111/jpc.12846_3 (If frenotomy is being performed despite evidence that it is ineffective, this raises ethical concerns. Report of neonatal Staphylococcus aureus septicaemia as a major complication suggests frenotomy may not be as safe as some claim.)

Joseph, K. S., Kinniburgh, B., Metcalfe, A., Razaz, N., Sabr, Y., & Lisonkova, S. (2016). Temporal trends in ankyloglossia and frenotomy in British Columbia, Canada, 2004–2013: A population-based study. CMAJ Open, 4(1), E33–E40. doi:10.9778/cmajo.20150063 (Diagnostic suspicion bias and increasing use of potentially unnecessary surgical procedures.)

Kapoor, V., Douglas, P. S., Hill, P. S., Walsh, L. J., & Tennant, M. (2018). Frenotomy for tongue-tie in Australian children, 2006-2016: an increasing problem. The Medical Journal of Australia, 208(2), 88–89. doi:10.5694/mja17.00438 (An epidemic.)

Kaptchuk, T. J. (2003). Effect of interpretive bias on research evidence. BMJ, 326(7404), 1453–1455. doi:10.1136/bmj.326.7404.1453 (E.g. the failure to control for multiple potential confounders and the effects of expectation; the effects of time on confidence, nipple pain and milk transfer; and the effects of caring attention and breastfeeding support.)

Kicinski, M. (2014). How does under-reporting of negative and inconclusive results affect the false-positive rate in meta-analysis? A simulation study. BMJ Open, 4(8), e004831–e004831. doi:10.1136/bmjopen-2014-004831 (Negative results are extremely important in science because they indicate what doesn’t work.)

Kotlow, L. (2011). Diagnosis and treatment of ankyloglossia and tied maxillary fraenum in infants using Er:YaG and 1064 diode lasers. European Archives of Paediatric Dentistry, 12(2), 106–112. doi:10.1007/bf03262789 (Kotlow was an early user of lasers to treat posterior ties.)

Kotlow, L. (2011). Infant reflux and aerophagia associated with the maxillary lip-tie and ankyloglossia (Tongue-tie). Clinical Lactation, 2(4), 25–29. doi:10.1891/215805311807011467 (He thinks babies with ties swallow air.)

Martinelli, R. L. de C., Marchesan, I. Q., Lauris, J. R., Honório, H. M., … Gusmão, R. J. (2016). Validade e confiabilidade da triagem: “teste da linguinha.” Revista CEFAC, 18(6), 1323–1331. doi:10.1590/1982-021620161868716

Matosin, N., Frank, E., Engel, M., Lum, J. S., & Newell, K. A. (2014). Negativity towards negative results: a discussion of the disconnect between scientific worth and scientific culture. Disease Models & Mechanisms, 7(2), 171–173. doi:10.1242/dmm.015123 (Too many failed frenotomies go unreported.)

Morgan, D. J., Brownlee, S., Leppin, A. L., Kressin, N., Dhruva, S. S., Levin, L., … Elshaug, A. G. (2015). Setting a research agenda for medical overuse. BMJ, h4534. doi:10.1136/bmj.h4534

NZ Dental Association. (April, 2018) Position statement. Ankyloglossia and frenal attachments. (Substantial and unjustified increase in surgical management. Condition resolves with growth in most cases. Data suggest the majority do not exhibit breastfeeding problems.)

O’Shea, J. E., Foster, J. P., O’Donnell, C. P., Breathnach, D., Jacobs, S. E., Todd, D. A., & Davis, P. G. (2017). Frenotomy for tongue-tie in newborn infants. Cochrane Database of Systematic Reviews. doi:10.1002/14651858.cd011065 (‘No consistent positive effect on infant breastfeeding’.)

Palmer, G. The politics of breastfeeding: When breasts are bad for business. ISBN: 9781905177165 and Why the politics of breastfeeding matter ISBN: 9781780665252 (I see parallels between what Palmer writes on the promotion of artificial formula and ties surgery.)

Power, R. F., & Murphy, J. F. (2014). Tongue-tie and frenotomy in infants with breastfeeding difficulties: achieving a balance: Table 1. Archives of Disease in Childhood, 100(5), 489–494. doi:10.1136/archdischild-2014-306211 (50% of babies with ties encounter no problems breastfeeding.)

Reid N, & Rajput N. (2014). Acute feed refusal followed by Staphylococcus aureus wound infection after tongue‐tie release. Journal of Paediatrics and Child Health, 50(12) 10301031. (Case report highlights that ‘simple’ scissors frenotomy is not always effective and can result in significant adverse effects. The presence of mastitis or nipple infection in the mother may increase risk of wound infection.)

Santa Maria, C., Aby, J., Truong, M. T., Thakur, Y., Rea, S., & Messner, A. (2017). The superior labial frenulum in newborns: What is normal? Global Pediatric Health, 4, 2333794X1771889. doi:10.1177/2333794×17718896 (Given the lack of knowledge surrounding the function of the upper frenulum, the ubiquity of its presence, and level of attachment in most infants, the release of the superior labial frenulum based on appearance alone cannot be endorsed at this time.)

Smith, G., Australian Dental Association Queensland President (September 2017) ADA News Bulletin. (Raises concerns about the procedures on infants.)

Smith, G., Australian Dental Association Queensland President (December 2017) ADA News Bulletin, 643, 5–6. (‘Not surprisingly, there are many half-truths and fallacies pushed by those who promote tongue tie surgery for financial gain.’)

Teixeira da Silva, J. A. (2015). Negative results: negative perceptions limit their potential for increasing reproducibility. Journal of Negative Results in Biomedicine, 14, 12. doi:10.1186/s12952-015-0033-9

Tracy, L. F., Gomez, G., Overton, L. J., & McClain, W. G. (2017). Hypovolemic shock after labial and lingual frenulectomy: A report of two cases. International Journal of Pediatric Otorhinolaryngology, 100, 223–224. doi:10.1016/j.ijporl.2017.07.013  (The dreadful damage that does happen.)

USLCA, The tongue-tie controversy. (2017) Clinical Lactation 8(3), 87–143. (Round-table discussion amongst tie experts. I refer to the question about prevalence and incidence of the condition and the assessment tool references are here.)

Walsh, J., Links, A., Boss, E., & Tunkel, D. (2017). Ankyloglossia and lingual frenotomy: National trends in inpatient diagnosis and management in the United States, 1997–2012. Otolaryngology-Head and Neck Surgery, 156(4), 735–740. doi:10.1177/0194599817690135 (Epidemic.)

Tongue-Tie. A Modern Epidemic