Is a scalpel under a baby’s tongue really necessary? In addition, more and more parents are allowing this surgery, which is supposed to facilitate breastfeeding, but the medical community considers it largely ineffective and is concerned about a trend fueled by professionals who are not very skilled in this field.
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“One can only wonder about the spectacular increase, in France and in the world, of lingual frenotomy” in infants, which the Academy of Medicine regretted in a press release at the end of April, the body that reviewed the consensus of medical knowledge in France.
What does this technical term mean? To the fact that you blow under the tongue with a scalpel or laser to give it more freedom by cutting the frenulum that connects it to the bottom of the mouth.
It is “an aggressive and potentially dangerous gesture for newborns or infants”, emphasizes the Academy of Medicine, while many health care providers – pediatricians, ENT, speech therapists … – were already concerned in a joint press release at the beginning of this year.
Everyone agrees on one observation: more and more parents have such an operation performed on their child, despite the fact that in most cases there is no interest in it.
“It probably started in the United States and Canada and then spread,” said AFP Virginie Rigourd, a pediatrician at Paris Necker Hospital. A sign of its popularity in the English-speaking world, the number of frenotomies has increased fivefold in Australia over the past decade.
Without being able to give such precise figures, the French doctors note that the movement also wins the parents they see in consultation.
A simplistic answer
“It’s not something new, it’s been a few years since there’s been a craze,” says Dr. Rigord.
Where did this idea come from among parents? According to the pediatrician, there are usually two types of actors involved, both outside the medical sphere: osteopaths and lactation consultants.
In fact, it is usually to facilitate breastfeeding that parents request this operation, even if there are sometimes other considerations at work: avoiding pronunciation abnormalities, digestive problems…
The frenotomy trend is part of a resurgence in the popularity of breastfeeding in recent years, encouraged by public health institutions such as the World Health Organization (WHO).
“There is a return to breastfeeding (but) there is a lack of well-trained staff to educate mothers, so there has been an increase in problems,” notes Virginie Rigourd, citing, for example, maternal pain. †
But frenotomy is a simplistic answer to problems that are often difficult to treat, contrary to what many breastfeeding counselors claim.
“Missing a restraining brake jeopardizes breastfeeding and the health of both babies and mothers,” assures a lactation consultant on her website, who offers online training on the subject for $100.
However, according to a study conducted by Cochrane, an organization highly respected in the scientific world that compiles numerous works on the same subject by regularly updating its conclusions, this is far from the case.
“Always better for cutting”
“No study has been able to prove that frenotomy enables successful long-term breastfeeding,” concludes this work, which also underscores the low quality of studies conducted on the subject.
The importance of this operation is thus far from proven in a breastfeeding problem. Even more unusual, however, is that some parents are offered to have it performed when they have not reported any concerns.
This is the case of Léa, who saw a Parisian osteopath when her son was born in 2018 for a simple check-up. His interlocutor suggested that he cut a tongue piece in the child that is considered “too fat”.
“It was a bit preventive: ‘We don’t know exactly why, but it’s always better to have it cut,'” reports Léa, who did not follow up on this suggestion, but understands that other young parents give in to it. “You need everything that is best for your child: when you are told that your child’s brake is best, even for no apparent reason, you go for it”.