Is a scalpel really necessary under a baby’s tongue? In addition, more and more parents are having this surgery, which is said to make breastfeeding easier, but the medical world believes it is largely ineffective and fears a trend fueled by professionals who are not very competent in the field.
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“One can only marvel at the spectacular increase in lingual frenotomy in France and in the world” in infants, deplored in a press release at the end of April the Academy of Medicine, the body that carries the consensus of medical knowledge in France.
What does this technical term mean? The fact that a scalpel or laser punch is placed under the tongue to give it more freedom by incising the frenulum that connects it to the floor of the mouth.
It was “an aggressive and potentially dangerous gesture for newborns or young children,” stresses the Academy of Medicine, while many caregivers — paediatricians, ENT doctors, speech therapists… — were concerned in a joint press release earlier this year.
Everyone agrees on one observation: More and more parents are having their children operated on, despite a lack of interest.
“It probably started in the United States and Canada and then spread,” says AFP Virginie Rigourd, a pediatrician at Necker Hospital in Paris. As a sign of its popularity in the English-speaking world, the number of frenotomies in Australia has increased fivefold over the past decade.
Without being able to give such exact figures, the French doctors note that the movement is also winning over the parents they see in consultations.
A simplified answer
“This is nothing new, it’s been several years since this madness existed,” says Dr. Rigord.
Where did this idea come from in the parents? According to the pediatrician, there are generally two types of actors involved, both outside the medical field: osteopaths and lactation consultants.
In fact, it is mostly the case that parents want this operation to facilitate breastfeeding, even if sometimes there are other considerations at play: avoiding pronunciation errors, avoiding digestive problems…
The frenotomy trend is part of a resurgence in breastfeeding popularity in recent years, encouraged by public health bodies such as the World Health Organization (WHO).
“There is a return to breastfeeding (but) there is a lack of well-trained staff to be able to inform mothers, so the problems are increasing,” notes Virginie Rigourd, citing, for example, pain in the mother.
But frenotomy is a simplified answer to issues that are often complex to treat, contrary to what many lactation consultants claim.
“Not using a restrictive brake endangers breastfeeding and the health of babies and mothers alike,” assures a lactation consultant on her website and offers online training courses on the subject for a hundred euros.
However, this is far from the case, according to a study by Cochrane, an organization highly respected in the scientific world, which compiles numerous works on the same topic and regularly updates its conclusions.
“Always cut better”
“No study was able to prove that frenotomy enables successful long-term breastfeeding,” concludes this work, which also underlines the low quality of the studies carried out on this topic.
The benefit of this operation for breastfeeding problems is far from proven. Even more divergent, however, is that some parents are offered to have them done if they have not reported a concern.
This is the case of Léa, who, after the birth of her son in 2018, went to an osteopath in Paris for a simple check-up. The person he was talking to suggested cutting into the child’s tongue frenulum, which he felt was “too thick”.
“It was a kind of prevention: ‘We don’t know exactly why, but it’s always better to have it cut,'” says Léa, who did not follow up on this suggestion but understands that other young parents give in. “You need everything that is best for your child: if you are told that your child’s horsefly is for the best, even for no apparent reason, then go for it.”