February 2020

Can Surgery Solve Breastfeeding Woes?

The phrase tongue-tied calls to mind an anxious public speaker. But for many infants and parents, the term has medical significance. Up to 12% of babies have a condition formally known as ankyloglossia. The membranes securing their tongues are thick, tight, short, or attached to the front of the organ. As a result, their tongues can’t move freely.

If your child’s tongue-tied, you may have problems breastfeeding. Latching on can prove difficult. Your nipples may crack or bleed, which can then affect milk flow. Other babies have what’s called a lip tie—when the upper lip is tethered tightly to the upper gum. This may also interfere with nursing.

Your child’s healthcare provider, dentist, or a lactation consultant may spot a tongue-tie or a lip tie. Or, you might want to ask about it if you’re having trouble feeding your child.

Untangling the tongue-tie debate

The most common tongue-tie operation is a simple clip of the membrane with scissors or lasers, called a frenotomy. It’s generally safe and usually done with local or no anesthesia. And as breastfeeding regains popularity, tongue-tie diagnoses and surgeries have also spiked.

Yet some experts question whether they’re always necessary. A recent research review found frenotomy in infants eased mothers’ nipple pain in the short term. However, the surgery didn’t consistently improve breastfeeding. What’s more, these clips come at a cost. Insurance doesn’t always cover them. And sometimes, patients require additional surgical procedures.

When it comes to releasing lip ties, very few studies have examined the procedure. In fact, it isn’t even clear that doctors all define the problem in the same way. For that reason, it’s difficult to research if lip-tie surgery is an effective solution.

Assess your alternatives

When deciding if one of these surgeries is right for your baby, remember that you don’t have to rely on one provider’s advice. With any nonemergency surgery, you can get a second opinion.

Many different types of providers evaluate these conditions, including speech therapists, lactation consultants, pediatricians, pediatric dentists, and otolaryngologists. You can consult more than one, ask for a thorough breastfeeding assessment, and try other tactics before choosing surgery.