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Increase in Tongue Tie Operations Outpaces Evidence
Dr Krystyna de Lange
In September, 2017, in an article in the Medical Observer, Possums founder Dr Pamela Douglas wrote:
Now the evidence is in, with the release of an article in the Medical Journal of Australia this month revealing that Medicare-funded frenotomy (tongue tie release surgery) rates have increased 420% in a decade from 2006 to 2016. Even this figure is likely to under-estimate the total number of frenotomies being performed Australia-wide given it is only capturing procedures performed under Medicare funding. Those procedures being performed in the public hospital sector or privately with dentists will not be captured in this data. In fact, in the ACT, where there were no dentists performing this procedure during the time studied, there was a 3710% rise in frenotomies being performed. This suggests even the 420% rise nationwide is likely an under-estimate of the true numbers.
These increased numbers are likely a reflection of an underlying commitment to helping women breastfeed, and it's true that classic tongue-tie was missed for decades. Unfortunately the evidence is just not there to show that frenotomies, particularly those done for posterior tongue ties, improve outcomes. In fact, in another paper that's just come out, Dr Douglas and Associate Professor Donna Geddes analyse the most recent ultrasound studies performed around the world of breastfeeding mother-baby pairs. They demonstrate that the structural model of infant suck dysfunction, upon which the decision to proceed to frenotomy in the absence of classic tongue-tie is based, is inaccurate.
For a genuine alternative to frenotomy (in the absence of classic tongue-tie) parents might be interested in trying gestalt breastfeeding, based on a completely new evidence-based model of infant suck. Book an appointment with one of our Possums accredited GPs or Lactation Consultants.
“Our breastfeeding babies appear to be in the grip
of a tongue-tie epidemic.
Or more accurately, in the grip of a tongue- and upper lip-tie epidemic”
of a tongue-tie epidemic.
Or more accurately, in the grip of a tongue- and upper lip-tie epidemic”
Now the evidence is in, with the release of an article in the Medical Journal of Australia this month revealing that Medicare-funded frenotomy (tongue tie release surgery) rates have increased 420% in a decade from 2006 to 2016. Even this figure is likely to under-estimate the total number of frenotomies being performed Australia-wide given it is only capturing procedures performed under Medicare funding. Those procedures being performed in the public hospital sector or privately with dentists will not be captured in this data. In fact, in the ACT, where there were no dentists performing this procedure during the time studied, there was a 3710% rise in frenotomies being performed. This suggests even the 420% rise nationwide is likely an under-estimate of the true numbers.
These increased numbers are likely a reflection of an underlying commitment to helping women breastfeed, and it's true that classic tongue-tie was missed for decades. Unfortunately the evidence is just not there to show that frenotomies, particularly those done for posterior tongue ties, improve outcomes. In fact, in another paper that's just come out, Dr Douglas and Associate Professor Donna Geddes analyse the most recent ultrasound studies performed around the world of breastfeeding mother-baby pairs. They demonstrate that the structural model of infant suck dysfunction, upon which the decision to proceed to frenotomy in the absence of classic tongue-tie is based, is inaccurate.
For a genuine alternative to frenotomy (in the absence of classic tongue-tie) parents might be interested in trying gestalt breastfeeding, based on a completely new evidence-based model of infant suck. Book an appointment with one of our Possums accredited GPs or Lactation Consultants.