Debate over tongue tie procedures in babies continues. Here’s why it can be beneficial for some infants
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There is increasing media interest about surgical procedures on new babies for tongue tie. Some hail it as a miracle cure, others view it as barbaric treatment, though adverse outcomes are rare.
Tongue tie occurs when the tissue under the tongue is attached to the lower gum or floor of the mouth in a way that can restrict the movement or range of the tongue. This can impact early breastfeeding in babies. It affects an estimated 8% of children under one year of age.
While there has been an increase in tongue tie releases (also called division or frenotomy), it’s important to keep this in perspective relative to the increase in breastfeeding rates.
The World Health Organization recommends exclusive breastfeeding for the first six months of life, with breastfeeding recommended into the second year of life and beyond for the health of mother and baby as well as optimal growth. Global rates of breastfeeding infants for the first six months have increased from 38% to 48% over the past decade. So, it is not surprising there is also an increase in the number of babies being referred globally with breastfeeding challenges and potential tongue tie.
An Australian study published in 2023 showed that despite a 25% increase in referrals for tongue tie division between 2014 and 2018, there was no increase in the number of tongue tie divisions performed. Tongue tie surgery rates increased in Australia in the decade from 2006 to 2016 (from 1.22 per 1,000 population to 6.35) for 0 to 4 year olds. There is no data on surgery rates in Australia over the last eight years.
Tongue tie division isn’t always appropriate but it can make a big difference to the babies who need it. More referrals doesn’t necessarily mean more procedures are performed.
How tongue tie can affect babies
When tongue tie (ankyloglossia) restricts the movement of the tongue, it can make it more difficult for a baby to latch onto the mother’s breast and painlessly breastfeed.
Earlier this month, the International Consortium of oral Ankylofrenula Professionals released a tongue tie position statement and practice guideline. Written by a range of health professionals, the guidelines define tongue tie as a functional diagnosis that can impact breastfeeding, eating, drinking and speech. The guidelines provide health professionals and families with information on the assessment and management of tongue tie.
Tongue tie release has been shown to improve latch during breastfeeding, reduce nipple pain and improve breast and bottle feeding. Early assessment and treatment are important to help mothers breastfeed for longer and address any potential functional problems.
Where to get advice
If feeding isn’t going well, it may cause pain for the mother or there may be signs the baby isn’t attaching properly to the breast or not getting enough milk. Parents can seek skilled help and assessment from a certified lactation consultant or International Board-Certified Lactation Consultant who can be found via online registry.
Alternatively, a health professional with training and skills in tongue tie assessment and division can assist families. This may include a doctor, midwife, speech pathologist or dentist with extended skills, training and experience in treating babies with tongue tie.
When access to advice or treatment is delayed, it can lead to unnecessary supplementation with bottle feeds, early weaning from breastfeeding and increased parental anxiety.
Getting a tongue tie assessment
During assessment, a qualified health professional will collect a thorough case history, including pregnancy and birth details, do a structural and functional assessment, and conduct a comprehensive breastfeeding or feeding assessment.
They will view and thoroughly examine the mouth, including the tongue’s movement and lift. The appearance of where the tissue attaches to the underside of the tongue, the ability of the tongue to move and how the baby can suck also needs to be properly assessed.
Treatment decisions should focus on the concerns of the mother and baby and the impact of current feeding issues. Tongue tie division as a baby is not recommended for the sole purpose of avoiding speech problems in later life if there are no feeding concerns for the baby.
Treatment options
The Australian Dental Association’s 2020 guidelines provide a management pathway for babies diagnosed with tongue tie.
Once feeding issues are identified and if a tongue tie is diagnosed, non-surgical management to optimise positioning, latch and education for parents should be the first-line approach.
If feeding issues persist during follow-up assessment after non-surgical management, a tongue tie division may be considered. Tongue tie release may be one option to address functional challenges associated with breastfeeding problems in babies.
There are risks associated with any procedure, including tongue tie release, such as bleeding. These risks should be discussed with the treating practitioner before conducting any laser, scissor or scalpel tongue tie procedure.
Post-release support by a certified lactation consultant or feeding specialist is necessary after a tongue tie division. A post-release treatment plan should be developed by a team of health professionals including advice and support for breastfeeding to address both the mother and baby’s individual needs.
We would like to acknowledge the contribution of Raymond J. Tseng, DDS, PhD, (Paediatric Dentist) to the writing of this article.
Sharon Smart, Lecturer and Researcher (Speech Pathology) – School of Allied Health, Curtin University; David Todd, Associate Professor, Neonatology, ANU Medical School, Australian National University, and Monica J. Hogan, PhD student, ANU School of Medicine and Psychology, Australian National University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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How Much Can Hypnotherapy Really Do?
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Sit Back, Relax, And…
In Tuesday’s newsletter, we asked you for your opinions of hypnotherapy, and got the above-depicted, below-described, set of responses:
- About 58% said “It is a good, evidenced-based practice that can help alleviate many conditions”
- Exactly 25% said “It is a scam and sham and/or wishful thinking at best, and should be avoided by all”
- About 13% said “It works only for those who are particularly suggestible—but it does work for them”
- One (1) person said “It is useful only for brain-centric conditions e.g. addictions, anxiety, phobias, etc”
So what does the science say?
Hypnotherapy is all in the patient’s head: True or False?
True! But guess which part of your body controls much of the rest of it.
So while hypnotherapy may be “all in the head”, its effects are not.
Since placebo effect, nocebo effect, and psychosomatic effect in general are well-documented, it’s quite safe to say at the very least that hypnotherapy thus “may be useful”.
Which prompts the question…
Hypnotherapy is just placebo: True or False?
False, probably. At the very least, if it’s placebo, it’s an unusually effective placebo.
And yes, even though testing against placebo is considered a good method of doing randomized controlled trials, some placebos are definitely better than others. If a placebo starts giving results much better than other placebos, is it still a placebo? Possibly a philosophical question whose answer may be rooted in semantics, but happily we do have a more useful answer…
Here’s an interesting paper which: a) begins its abstract with the strong, unequivocal statement “Hypnosis has proven clinical utility”, and b) goes on to examine the changes in neural activity during hypnosis:
Brain Activity and Functional Connectivity Associated with Hypnosis
It works only for the very suggestible: True or False?
False, broadly. As with any medical and/or therapeutic procedure, a patient’s expectations can affect the treatment outcome.
And, especially worthy of note, a patient’s level of engagement will vastly affect it treatment that has patient involvement. So for example, if a doctor prescribes a patient pills, which the patient does not think will work, so the patient takes them intermittently, because they’re slow to get the prescription refilled, etc, then surprise, the pills won’t get as good results (since they’re often not being taken).
How this plays out in hypnotherapy: because hypnotherapy is a guided process, part of its efficacy relies on the patient following instructions. If the hypnotherapist guides the patient’s mind, and internally the patient is just going “nope nope nope, what a lot of rubbish” then of course it will not work, just like if you ask for directions in the street and then ignore them, you won’t get to where you want to be.
For those who didn’t click on the above link by the way, you might want to go back and have a look at it, because it included groups of individuals with “high/low hypnotizability” per several ways of scoring such.
It works only for brain-centric things, e.g. addictions, anxieties, phobias, etc: True or False?
False—but it is better at those. Here for example is the UK’s Royal College of Psychiatrists’ information page, and if you go to “What conditions can hypnotherapy help to treat”, you’ll see two broad categories; the first is almost entirely brain-stuff; the second is more varied, and includes pain relief of various kinds, burn care, cancer treatment side effects, and even menopause symptoms. Finally, warts and other various skin conditions get their own (positive) mention, per “this is possible through the positive effects hypnosis has on the immune system”:
RCPsych | Hypnosis And Hypnotherapy
Wondering how much psychosomatic effect can do?
You might like this previous article; it’s not about hypnotherapy, but it is about the difference the mind can make on physical markers of aging:
Aging, Counterclockwise: When Age Is A Flexible Number
Take care!
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War in Ukraine affected wellbeing worldwide, but people’s speed of recovery depended on their personality
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The war in Ukraine has had impacts around the world. Supply chains have been disrupted, the cost of living has soared and we’ve seen the fastest-growing refugee crisis since World War II. All of these are in addition to the devastating humanitarian and economic impacts within Ukraine.
Our international team was conducting a global study on wellbeing in the lead up to and after the Russian invasion. This provided a unique opportunity to examine the psychological impact of the outbreak of war.
As we explain in a new study published in Nature Communications, we learned the toll on people’s wellbeing was evident across nations, not just in Ukraine. These effects appear to have been temporary – at least for the average person.
But people with certain psychological vulnerabilities struggled to recover from the shock of the war.
Tracking wellbeing during the outbreak of war
People who took part in our study completed a rigorous “experience-sampling” protocol. Specifically, we asked them to report their momentary wellbeing four times per day for a whole month.
Data collection began in October 2021 and continued throughout 2022. So we had been tracking wellbeing around the world during the weeks surrounding the outbreak of war in February 2022.
We also collected measures of personality, along with various sociodemographic variables (including age, gender, political views). This enabled us to assess whether different people responded differently to the crisis. We could also compare these effects across countries.
Our analyses focused primarily on 1,341 participants living in 17 European countries, excluding Ukraine itself (44,894 experience-sampling reports in total). We also expanded these analyses to capture the experiences of 1,735 people living in 43 countries around the world (54,851 experience-sampling reports) – including in Australia.
A global dip in wellbeing
On February 24 2022, the day Russia invaded Ukraine, there was a sharp decline in wellbeing around the world. There was no decline in the month leading up to the outbreak of war, suggesting the change in wellbeing was not already occurring for some other reason.
However, there was a gradual increase in wellbeing during the month after the Russian invasion, suggestive of a “return to baseline” effect. Such effects are commonly reported in psychological research: situations and events that impact our wellbeing often (though not always) do so temporarily.
Unsurprisingly, people in Europe experienced a sharper dip in wellbeing compared to people living elsewhere around the world. Presumably the war was much more salient for those closest to the conflict, compared to those living on an entirely different continent.
Interestingly, day-to-day fluctuations in wellbeing mirrored the salience of the war on social media as events unfolded. Specifically, wellbeing was lower on days when there were more tweets mentioning Ukraine on Twitter/X.
Our results indicate that, on average, it took around two months for people to return to their baseline levels of wellbeing after the invasion.
Different people, different recoveries
There are strong links between our wellbeing and our individual personalities.
However, the dip in wellbeing following the Russian invasion was fairly uniform across individuals. None of the individual factors assessed in our study, including personality and sociodemographic factors, predicted people’s response to the outbreak of war.
On the other hand, personality did play a role in how quickly people recovered. Individual differences in people’s recovery were linked to a personality trait called “stability”. Stability is a broad dimension of personality that combines low neuroticism with high agreeableness and conscientiousness (three traits from the Big Five personality framework).
Stability is so named because it reflects the stability of one’s overall psychological functioning. This can be illustrated by breaking stability down into its three components:
- low neuroticism describes emotional stability. People low in this trait experience less intense negative emotions such as anxiety, fear or anger, in response to negative events
- high agreeableness describes social stability. People high in this trait are generally more cooperative, kind, and motivated to maintain social harmony
- high conscientiousness describes motivational stability. People high in this trait show more effective patterns of goal-directed self-regulation.
So, our data show that people with less stable personalities fared worse in terms of recovering from the impact the war in Ukraine had on wellbeing.
In a supplementary analysis, we found the effect of stability was driven specifically by neuroticism and agreeableness. The fact that people higher in neuroticism recovered more slowly accords with a wealth of research linking this trait with coping difficulties and poor mental health.
These effects of personality on recovery were stronger than those of sociodemographic factors, such as age, gender or political views, which were not statistically significant.
Overall, our findings suggest that people with certain psychological vulnerabilities will often struggle to recover from the shock of global events such as the outbreak of war in Ukraine.
Luke Smillie, Professor in Personality Psychology, The University of Melbourne
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Marrakesh Sorghum Salad
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As the name suggests, it’s a Maghreb dish today! Using sorghum, a naturally gluten-free whole grain with a stack of vitamins and minerals. This salad also comes with fruit and nuts (apricots and almonds; a heavenly combination for both taste and nutrients) as well as greens, herbs, and spices.
Note: to keep things simple today, we’ve listed ras el-hanout as one ingredient. If you’re unfamiliar, it’s a spice blend; you can probably buy a version locally, but you might as well know how to make it yourself—so here’s our recipe for that!
You will need
- 1½ cups sorghum, soaked overnight in water (if you can’t find it locally, you can order it online (here’s an example product on Amazon), or substitute quinoa) and if you have time, soaked overnight and then kept in a jar with just a little moisture for a few days until they begin to sprout—this will be best of all. But if you don’t have time, don’t worry about it; overnight soaking is sufficient already.
- 1 carrot, grated
- ½ cup chopped parsley
- 1 tbsp apple cider vinegar
- ½ tbsp chopped chives
- 2 tbsp ras el-hanout
- 3 cloves garlic, crushed
- 2 tbsp almond butter
- 1 tbsp lemon juice
- 1 tsp white miso paste
- ½ cup sliced almonds
- 4 fresh apricots, pitted and cut into wedges
- 1 cup mint leaves, chopped
- To serve: your choice of salad greens; we suggest chopped romaine lettuce and rocket
Method
(we suggest you read everything at least once before doing anything)
1) Cook the sorghum, which means boiling it for about 45 minutes, or 30 in a pressure cooker. If unsure, err on the side of cooking longer—even up to an hour will be totally fine. You have a lot of wiggle room, and will soon get used to how long it takes with your device/setup. Drain the cooked sorghum, and set it aside to cool. If you’re entertaining, we recommend doing this part the day before and keeping it in the fridge.
2) When it’s cool, add the carrot, the parsley, the chives, the vinegar, and 1 tbsp of the ras el-hanout. Toss gently but thoroughly to combine.
3) Make the dressing, which means putting ¼ cup water into a blender with the other 1 tbsp of the ras el-hanout, the garlic, the almond butter, the lemon juice, and the miso paste. Blend until smooth.
4) Assemble the salad, which means adding the dressing to sorghum-and-ingredients bowl, along with the almonds, apricots, and mint leaves. Toss gently, but sufficiently that everything is coated.
5) Serve on a bed of salad greens.
Enjoy!
Want to learn more?
For those interested in some of the science of what we have going on today:
- Four Ways To Upgrade The Mediterranean Diet ← including an anti-inflammatory version, which is functionally what we’re doing today. As an aside when people hear “Mediterranean” they often think “Italy and Greece”. Which, sure, but N. Africa (and thus Maghreb cuisine) is also very much Mediterranean, and it shows!
- Our Top 5 Spices: How Much Is Enough For Benefits?
- Why You Should Diversify Your Nuts!
- Brain Food? The Eyes Have It!
Take care!
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Stop Overthinking – by Nick Trenton
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This book is exactly what it says on the tin. We are given twenty-three techniques to relieve stress, stop negative spirals, declutter your mind, and focus on the present, in the calm pursuit of good mental health and productivity.
The techniques are things like the RAIN technique above, so if you liked that, you’ll love this. Being a book rather than a newsletter, it also takes the liberty of going into much more detail—hence the 200 pages for 23 techniques. Unlike many books, it’s not packed in fluff either. It’s that perfect combination of “to the point” and “very readable”.
If you’ve read this far into the review and you’re of two minds about whether or not this book could be useful to you, then you just might be overthinking it
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Skin Care Down There (Incl. Butt Acne, Hyperpigmentation, & More)
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Dr. Sam Ellis, dermatologist, gives us the low-down:
Where the sun don’t shine
Common complaints and remedies that Dr. Ellis covers in this video include:
- Butt acne/folliculitis: most butt breakouts are actually folliculitis, not traditional acne. Folliculitis is caused by friction, sitting for long periods, or wearing tight clothes. Solutions include antimicrobial washes like benzoyl peroxide and changing sitting habits (i.e. to sit less)
- Keratosis pilaris: rough bumps around hair follicles can appear on the butt, often confused with acne.
- Boils and abscesses: painful, large lumps; these need medical attention for drainage.
- Hidradenitis suppurativa: recurrent painful cysts and boils in skin creases, often in the groin and buttocks. These require medical intervention and treatment.
- Ingrown hairs: are common in people who shave or wax. Treat with warm compresses and gentle exfoliants.
- Hyperpigmentation: is often caused by hormonal changes, friction, or other irritation. Laser hair removal and gentle chemical exfoliants can help.
In the event that the sun does, in fact, shine on your genitals (for example you sunbathe nude and have little or no pubic hair), then sun protection is essential to prevent further darkening (and also, incidentally, reduce the risk of cancer).
For more on all of this, plus a general introduction to skincare in the bikini zone (i.e. if everything’s fine there right now and you’d like to keep it that way), enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
The Evidence-Based Skincare That Beats Product-Specific Hype
Take care!
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The Rise Of The Machines
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In this week’s health science news, several pieces of technology caught our eye. Let’s hope these things roll out widely!
When it comes to UTIs, antimicrobial resistance is taking the p—
This has implications far beyond UTIs—though UTIs can be a bit of a “canary in the coal mine” for antimicrobial resistance. The more people are using antibiotics (intentionally, or because they are in the food chain), the more killer bugs are proliferating instead of dying when we give them something to kill them. And yes: they do proliferate sometimes when given antibiotics, not because the antibiotics did anything directly good for them, but because they killed their (often friendly bacteria) competition. Thus making for a double-whammy of woe.
This development tackles that, by using AI modelling to crunch the numbers of a real-time data-driven personalized approach to give much more accurate treatment options, in a way that a human couldn’t (or at least, couldn’t at anything like the same speed, and most family physicians don’t have a mathematician locked in the back room to spend the night working on a patient’s data).
Read in full: AI can help tackle urinary tract infections and antimicrobial resistance
Related: AI: The Doctor That Never Tires?
When it comes to CPR and women, people are feint of heart
When CPR is needed, time is very much of the essence. And yet, bystanders are much less likely to give CPR to a woman than to a man. Not only that, but CPR-training is part of what leads to this reluctance when it comes to women: the mannequins used are very homogenous, being male (94%) and lean (99%). They’re also usually white (88%) even in countries where the populations are not, but that is less critical. After all, a racist person is less likely to give CPR to a person of color regardless of what color the training mannequin was.
However, the mannequins being male and lean is an issue, because it means people suddenly lack confidence when faced with breasts and/or abundant body fat. Both can prompt the bystander to wonder if some different technique is needed (it isn’t), and breasts can also prompt the bystander to fear doing something potentially “improper” (the proper course of action is: save a person’s life; do not get distracted by breasts).
Read in full: Women are less likely to receive CPR than men. Training on manikins with breasts could help ← there are also CPR instructions (and a video demonstration) there, for anyone who wants a refresher, if perhaps your last first-aid course was a while ago!
Related: Heart Attack: His & Hers (Be Prepared!)
When technology is a breath of fresh air
A woman with COPD and COVID has had her very damaged lungs replaced using a da Vinci X robot to perform a minimally-invasive surgery (which is quite a statement, when it comes to replacing someone’s lungs).
Not without human oversight though—surgeon Dr. Stephanie Chang was directing the transplant. Surgery is rarely fun for the person being operated on, but advances like this make things go a lot more smoothly, so this kind of progress is good to see.
Read in full: Woman receives world’s first robotic double-lung transplant
Related: Why Chronic Obstructive Pulmonary Disease (COPD) Is More Likely Than You Think
Take care!
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