Tongue tie releases are under criticism—for my kids, they were a lifeline

My baby just wouldn’t latch. My nipples were raw, bleeding, and full of thrush, a yeast infection that we were passing back and forth. My baby would try to breastfeed for a few minutes, unlatch, and scream. My breasts would get engorged with milk that wasn’t being removed effectively. I knew something wasn’t right.

A lactation consultant took one look in my baby’s mouth and recommended I have a consultation with an occupational therapist and pediatric dentist to check for lip and tongue ties.

I could have switched to formula instead, except my baby wasn’t latching onto anything very well, so it didn’t seem to be a helpful alternative. What was helpful, is when the dentist diagnosed multiple ties, explained that this was why the baby was trying to latch and couldn’t and offered to do a tongue tie release, called a frenectomy, in his office. The procedure took minutes, but was quite expensive, and not covered by insurance. $700 after an already unpaid maternity leave type expensive. That was a dilemma.

t’s a dilemma that the New York Times recently investigated as a part of their deep-dive into the tongue tie release industry, a procedure that’s risen significantly in popularity in recent years. The article, called “Inside the Booming Business of Cutting Babies’ Tongues” was something I found difficult to read for a few reasons: it led with a story of an uncommon reaction as a significant portion of the story.I didn’t see my own family’s journey, which was an opposite experience, represented in the article.

In the article, the authors detail a baby who didn’t have proper care before and after the procedure, and ended up dehydrating and on a feeding tube. They shed light on the procedure through a lens of “pressure to nurse” and say that lactation consultants are “aggressively” pushing parents into the procedure. But what isn’t really covered is the exceptional benefits my family saw personally from this procedure — three kids who went on to have year-long breast and bottle feeding journeys with less pain for both me and them.   A procedure that saved my own child’s feeding journey, my own raw boobs, and two more kids of mine after that.

While I wish the article covered more of the benefits of the procedure, I realize the need for better oversight, research, and communication between pediatricians, lactation consultants, therapists, dentists, and parents — a must for the future of tongue ties.

I reached out to my babies’ occupational therapist, Michelle Emanuel, OTR/L, IBCLC, NBCR pediatric, occupational therapist specializing in newborn to precrawling babies and oral dysfunction restrictions. She’s also the person who told me not to rush into a tongue tie release with my last baby, a conservative choice that ended up being right. She formerly worked at the country’s #1 Children’s Hospital, Cincinnati Medical Center, for 17 years, as well. The NYT article ruffled some feathers in her network, but she remained unalarmed, and even a bit grateful that the concept of better oversight in the tongue tie release world was now a topic of conversation. She educates parents on the topic on her Instagram account @tonguetiebabies and is used to the questions.

“There is very little research and lots of issues with tongue tie releases such as wound care. Babies need optimal timing of release and therapeutic preparatory work before release. This isn’t being done except in select areas where therapists have training,” she says.

Basically, I’d gotten very lucky to be working with a provider who knew about how to properly prepare a baby for the procedure, and how to heal afterwards. Meeting with her in these sessions always felt like a mix of physical therapy, chiropractic care, and parenting education. They were a bit magically and exceptionally helpful in navigating before and after the tie release. And, based on the NYT’s assessments, far from what some people experience.

Then there’s the question of access — I struggled to pay for these procedures just weeks and months after unpaid leave. Many can’t pay for them at all. They aren’t covered by most insurances, and finding an experienced professional with availability can be difficult. Yet, as the NYT points out, the people performing the procedures are making bank. Whether they are exploiting parents in a desperate time, or helping them immensely, depends on one key distinction, according to Emanuel.

Emanuel estimates that less than half of lactation consultants know about optimal timing of research, and haven’t had the advanced education necessary to recommend it. She also says it’s one of the most vital questions a parent considering a tongue tie release should be asking their providers they are considering: “Do you recommend pre-frenectomy therapy? Do you use a team approach using therapists?” she says to ask.

Those questions gave me and my kids a gift of a year of successful breastfeeding and easier bottle feeding, and the reduced risk of tongue tie issues later as they develop into kids who could talk and eat real food as well. For that, I am grateful, and hope that the investigation the NYT did, and positive stories like my own as well, lead to more parents having safe access to this procedure.