Bring back the routine frenectomy

AKA  the tongue tie snip.

When I was younger I worked a few years at the Northern California Renaissance Faire. The good one that was in Novato, CA and got bought out by Disney, then the land was sold and turned into a golf course and I got on with my life.

You meet all kinds of people at those things. One night over supper my friends and I were chatting with one of the security guards. Nice guy. Anyhow, he mentioned his mother was a maternity nurse and had been for years. He gave us a factoid of the ‘bad old days’ that as part of the routine of newborn cleanup alongside having noses suctioned and being wiped off, babies would just have lingual frenectomies right then and there. He didn’t call it that of course and was completely ignorant of the reasons why it had been done. He posed it as having us all show him the underside of our tongues. Having had a look at us he said, ‘you weren’t snipped, you were’ and so on. He said that his mother (the maternity nurse) had been horrified at the practice and had prevented him from having it done when he was born. Being about 19 and not having any idea why such a thing would be necessary we all agreed that it was great they didn’t do that sort of thing any more. We gave ourselves a mental pat on the backs for ‘progress’ and went back to our lives.

Why bring it back?  Because it fell out of practice there is now a huge gap in being able to identify tongue ties that inhibit breastfeeding. This, along with a largely bottle feeding culture it’s seen as unnecessary surgery. In other parts of the world birth attendants supposedly keep one long fingernail to quickly tear any lingual frenulum they see in the newborn. Diagnosis isn’t necessary because it’s taken care of.

What effects can tongue and lip ties cause?

  • Breastfeeding difficulties
  • Speech issues
  • Dental hygiene issues
  • Gastrointestinal issues (I’ve had these a large part of my adult life as a result of my undiagnosed tongue tie)

Doing a lingual frenectomy in the infant is much easier than doing it in an older baby, child or adult. In infants, no anaesthetic is required, pain is quickly forgotten and it’s easier for the infants to learn to correctly use the tongue. With older babies and children a general anaesthetic is often required, it can take them longer to learn to use the tongues range of motion, and in adults the surgery can damage nerve bundles.

It seems like any publicly health minded populace would add how-to training for attendant professionals and this action to all newborn post-birth care. But most people now don’t know about the tongue tie, let alone the issues it can cause.


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