14 Jan 2021

New guidelines over tongue-tie surgery welcomed by specialists

12:36 pm on 14 January 2021

Doctors are welcoming new guidelines on when and if it is appropriate to snip babies with a tongue-tie.

Dr Bryan Betty of Porirua Union and Community Health.

Medical director for the Royal New Zealand College of General Practitioners, Dr Bryan Betty. Photo: RNZ / Karen Brown

As many as one-in-10 babies are born with a tongue-tie each year, which can cause breastfeeding difficulties.

The new guidelines want to ensure anyone providing surgical treatment is following the same advice to treat the condition.

Babies born with the abnormality have a very tight or short band of tissue attached under their tongue - restricting the ability to waggle.

The medical director for the Royal New Zealand College of General Practitioners, Dr Bryan Betty, said one of the issues of tongue tie is that it can interfere with latching on and that breastfeeding in the early part of an infant's life was very important.

But he said in the past there had been concerns the surgical procedure frenotomy to correct tongue-tie was being over-used.

Dr Betty said the guidelines now made it clear how and when different procedures to correct tongue tie should be used.

"I think it clears up where surgery for tongue-tie should be used and shouldn't be used. There's some very clear guidance on the clinical pathway to making a decision on tongue-tie, so I think they will be welcomed."

Also in favour of the guidelines was the President of the Paediatric society, Dr Nicola Austin.

She said it still allowed DHB's to have their own process for tongue tie, but offered an overarching tool to assess it.

"Lactation supporters and breastfeeding support are fairly integral to the first step in assessing any breast-feeding difficulty."

Having a standardised assessment tool has brought down surgery rates in the past, she said.

"Canterbury had a higher incidence of releasing and they have been reduced by having a standardised assessment tool and process, which has ensured that the feeding is addressed by that patient consultant midwife before a frentonomy is considered."

Dr Austin hoped the guidelines would reassure parents of babies struggling with tongue tie.

"They can be reassured that there has been a good review of the evidence in the literature and some safety aspects in care provision has been identified."

Associate Minister of Health Dr Ayesha Verrall says the new guidance should reduce the need for a surgery which is minor, but not risk free.

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