Dentists and midwives across the US have been increasingly slicing off tissue around babies’ tongues to make breastfeeding easier — but some critics claim the surgery is nothing but a dangerous “money grab.’’
The practice, known as “tongue tie surgery,” involves using a laser to burn off excessive tissue under the tongue or webbing that connects lips and cheeks.
It was originally supposed to be used only when babies had a genuine defect that prevented them from feeding properly. But it has become increasingly popular over the past 20 years, with some doctors claiming it can prevent a litany of future problems including sleep apnea and speech impediments.
Now other members of the medical community — and moms — say the trend is extremely worrisome, leaving some babies unable to eat for so long that they become malnourished.
“It was touted as this miracle cure,” Tess Merrell, a Boise mother, recently told The New York Times.
“We felt really stupid afterward because we paid to hurt our baby,” she said of herself and her husband, Allan.
She said an Idaho-based lactation consultant recommended in a Facebook message that she get the procedure for her daughter, Eleanor, despite never seeing the infant personally and although a pediatrician, physical therapist and other lactation consultant insisted that tongue tie was not the cause of Eleanor’s inability to nurse comfortably.
The baby soon became dehydrated and malnourished.
Some other babies who have undergone the procedure have even had to be hooked up to feeding tubes when they began to have difficulty sucking or swallowing, critics said.
A few doctors have contended that the newly freed, floppy tongues could even block an infant’s airway, the Times said.
Between 1997 and 2012, the rate of these surgeries ballooned by 800%, from around 1,280 surgeries to more than 12,000, a 2017 study found.
Google searches for “tongue tie” reached a record in June, more than doubling over the past five years.
The trend toward these surgeries seems to have begun after a 2004 article in the newsletter of the American Academy of Pediatrics suggested that a wider range of babies might benefit from the operation, even if they are not among the 4% to 11% of babies born with an unusually short, thick or tight band of tissue tethering the tongue to the floor of the mouth.
Most doctors say the condition is harmless, but in the article, a pediatric surgeon and lactation consultant wrote that some tiny patients had more subtle tethers at the back of their tongues or had tissue tightly connecting their lips to their gums. Any of these issues could impede breastfeeding, the experts argued.
Since then, lactation consultant Alison Hazelbaker said the rate of diagnoses of tied tongues, cheeks and lips has skyrocketed.
“Everything started to go to hell in a handbasket,” she said.
By 2020, a panel of 16 leading ear, nose and throat specialists published guidelines warning that tongue ties were being over-diagnosed and that cheek-tie releases simply “should not be performed.”
Even one of the authors of the original 2004 article, Catherine Watson Genna — a lactation consultant in New York — admitted she started to “have huge concerns.”
She said newer research has proven that some of the infants being diagnosed with tongue ties have other conditions that restrict tongue movement.
“Everything looks like a nail because everybody’s got a hammer now,” she told the Times.
Dentists who perform the surgery can receive $600 to $900 a pop, with the Times reporting that one “well-known dentist in Manhattan” rakes in millions of dollars a year off the operations.
In April, Biolase — which sells an $80,000 machine — hosted a conference for more than 100 pediatric dentists and colleagues at a resort in Scottsdale, Ariz., entitled “Tequila and Tongue Ties.”
Attendees were trained on how to use the machine and how to employ social media to build their businesses — before they engaged in rounds of tequila shots and margaritas, the Times reports.
Company CEO John Beaver reportedly boasted that his firm’s financing plan for the machines’ purchase meant that doctors need to only perform three surgeries a month to break even and could generate a “huge” return on their investment.
Kentucky-based Pediatric Associates Dr. Charles Cavallo said he eventually decided to speak up in response to what he saw as a “money grab.”
He warned last year on his Web site about the growing number of dentists offering the surgery “at very high prices,” and claimed, “We have seen babies in severe pain after this procedure sometimes refusing in oral aversion (refusing to eat).”
A mother in Montana who signed her baby up for the procedure in November 2022 said her child lost its ability to suck afterward and dropped from the 97th percentile to the 15th percentile in weight in just three months.
A pediatric ENT in Delaware said she recently treated an 11-day-old who was hospitalized for severe weight loss after the surgery.
Some parents said their guilt from seeing their babies suffer after the surgery tipped them into depression, while others revealed they spent thousands of dollars on speech therapists whose services were necessary for their child’s recovery.
In Idaho, former clients of the lactation consultation on Facebook say she worsened their babies’ pain by rooting around in their mouths and increasing pressure at various points.
The consultant would often refer patients exclusively to the same dentist and hold the babies down while he performed the surgery, the Times said.
The lactation expert also reportedly insisted to wary parents that without the surgery, their babies would never breastfeed again or eat solid foods. She also reportedly warned that untreated tongue ties could lead to learning disabilities, scoliosis and sleep apnea.
Since 2020, the International Board of Lactation Consultant Examiners has received at least three complaints about the consultant, including one from pediatric physical therapist Kelly Strickland, who said she “was getting referred to parents who were uncomfortable, who went in for [a] follow-up and said it was traumatic, that she pushed so hard on their baby’s mouth.”
But the lactation board has not taken any disciplinary actions against the worker, with a spokeswoman telling the Times, “Some complaints take significantly longer than others due to the nature of the allegations and related investigation.”
The lactation consultant has insisted she gave careful attention to each client.
“I have literally thousands of people who are thrilled with what I’m doing,” she told the Times.
At least one mother has also filed a complaint against the dentist that the consultant worked with to the Idaho board of dentistry, which later informed her that it “didn’t feel that further investigation was warranted” and that the dentist was not at fault.