In 2008, less than a hundred newborns were registered who had their tongue tied in a public hospital. In the peak year 2020, there were over 1,200. In addition, there are all the interventions that are carried out by private practitioners. The aim of the clipping is to make it easier for the newborn babies to get milk from the mother’s breast. Pediatrician Ingrid Moldestad works at the hospital in Levanger. She is surprised by how many parents come to them to have a tight tongue tie investigated. – There is a clear trend that more people want assessment and cutting of tongue ties, says Moldestad. Breastfeeding problems Babies use their tongues to milk the mother’s breast. Several people believe that a tight tongue tie can be a reason why they are not able to do it. If counseling does not help, cutting the thin strip under the tongue can be considered, according to a national supervisor. – I just want my child to be able to eat without being bothered. That’s what Cathrine Saasen Pedersen says. She has had the tongue ties of both her children cut. When she had her first child, it was a nurse who suggested that a tight tongue tie could be the reason why she struggled with breastfeeding. The nurse had the doctor take a clip. Cathrine Saasen Pedersen has struggled with breastfeeding both of her children and found that cutting a tight tongue tie helped with both. Photo: Sverre Lilleeng / news But the problems did not go away. The son still had air in his stomach, he screamed a lot and was in pain. One month after the birth, the son’s tongue tie was cut again. – Then all my son’s symptoms improved within a day. He calmed down, stopped screaming and got a better grip, says Cathrine. Three months ago she gave birth to a little daughter. Saasen Pedersen quickly noticed that she too had breastfeeding problems. As a result, the daughter’s tongue tie was also cut. A debate post in Midtnorsk debate started a discussion about tight tongue ties, where several of the sources have written posts. Believes the documentation is lacking. Pediatrician Ingrid Moldestad does not think cutting a tight tongue tie is a good solution to breastfeeding problems. She believes there is a lack of research showing that the procedure helps. Several professors and doctors have also criticized the lack of documented effect. – Until there is a large scientific study that proves that this has an effect, we as paediatricians must be restrained. We can’t just follow the trend, she says. She also believes that the guide for when to cut a tongue tie is too vague. Thus, it is up to each individual doctor to assess whether it is necessary, says Moldestad. Pediatrician Ingrid Moldestad believes there is a need for more research that demonstrates that cutting a tight tongue tie has a good effect to improve breastfeeding. Photo: Privat Vulnerable mothers The pediatrician himself believes that increasing breastfeeding problems may be related to shorter hospital stays after birth. Her experience is that vulnerable mothers who struggle with breastfeeding can be sent home too early from the maternity ward. Googling, stories from various Facebook groups and private actors who are ready to exploit the vulnerability, reinforces the effect, the pediatrician believes. – Then a perfect storm begins with you finding what you want and ending up making that diagnosis yourself, she says. Tight tongue tie A tight tongue tie (ankylglossia) is defined as a tongue tie that reduces the mobility of the tongue so that the function of the tongue is negatively affected and symptoms arise. A tight tongue tie can reduce tongue mobility and make sucking and swallowing more difficult. This can cause problems during breastfeeding. A sign of a tight tongue tie is that the child has problems latching onto the breast and does not get enough milk. The mother may experience pain on the nipple when breastfeeding. International figures indicate that 4-11% of infants are born with a tight tongue-tie The Institute of Public Health estimates that 25-60% of children with a tight tongue-tie may have breastfeeding problems FHI recommends that breastfeeding guidance be offered if a child has a tight tongue-tie that causes challenges. If that does not help, the tongue tie can be cut, but if there is uncertainty as to whether the tongue tie is tight, further follow-up should be offered. In 2021, a guide for diagnostics and treatment of tight tongue tie in infants came. – Has an effect Ann-Magrit Lona is a senior adviser at FHI and a certified breastfeeding supervisor. She has been part of a working group that has prepared the guide on tongue-tie cutting published by the Norwegian Institute of Public Health. She says all other reasons why mothers struggle with breastfeeding must be checked out before it is considered whether a child’s tongue tie should be cut. The senior adviser says it is well documented that clipping can improve breastfeeding and cause less pain in the mother. The studies that have been done on this are not very good, but they point in the same direction, according to Lona. – The recommendation is actually very clear, she says. Ann-Magrit Lona, senior advisor at FHI, believes it is well documented that cutting a tight tongue tie can help breastfeeding. Photo: Sverre Lilleeng / news She thinks many people wish it were possible to see and measure whether the tongue tie prevents breastfeeding. – But it doesn’t work, because it’s about function. It’s about how the tongue works, along with the mother’s anatomy. Maybe that’s where the problem lies. Lona says it is often midwives and health nurses who spend time assessing how breastfeeding works. They are also the ones who have the most knowledge about this and can most easily discover whether tight tongue ties cause challenges. – What is a bit controversial is that there is no consensus on how tight the tongue tie should look before a clipper. That has not been achieved, and that is a big problem. First, exercises Monica Kristoffersen Skog is a trained nurse and works as a private lactation consultant. – Very often parents come who have tried everything, and nothing works. If the breastfeeding supervisor suspects that a child has a tight tongue tie, she first recommends exercises to improve breastfeeding. She often refers the child to an osteopath, chiropractor or manual therapist. Breastfeeding supervisor Monica Kristoffersen Skog says the knowledge about tight tongue tie is mainly found in the private healthcare system. Photo: Marthe Svendsen / news If this does not improve, she recommends the parents a specialist who can make a diagnosis and carry out a clip. – Not many people have good knowledge of it in Norway and the Nordic countries, and everything is privatised, unfortunately, she says. Skog believes that knowledge about tight tongue ties is too low in the public sector. She points out that, for example, it is not part of the training for doctors. – We have to refer to others where we know that the knowledge does not extend far enough, she says. Made breastfeeding easier Mother-of-two Cathrine Saasen Pedersen thinks it would have been worse for the children if they hadn’t had their tongue ties cut. – I don’t mean that they should mow at all costs and mow regardless of the weather. She says that no one would do something like that to their children without it being necessary. – I wish people would stop calling it a trend, she says.
ttn-69
Large increase in controversial interventions on newborns – news Trøndelag
