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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What is retinol? And will it make my acne flare? 3 experts unpack this trendy skincare ingredient
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Retinol skincare products suddenly seem to be everywhere, promising clear, radiant and “youthful” skin.
But what’s the science behind these claims? And are there any risks?
You may have also heard retinol can increase your risk of sunburn and even make acne worse.
For some people, retinol may help reduce the appearance of fine lines. But it won’t be suitable for everyone. Here’s what you need to know.
Irina Kvyatkovskaya/Shutterstock What is retinol?
Retinol is part of a family of chemical compounds called retinoids. These are derived from or related to Vitamin A, a nutrient essential for healthy skin, vision and immune function.
All retinoids work because enzymes in our skin convert them into their “active” form, retinoic acid.
You can buy retinol in creams and other topical products over the counter.
These are often promoted as “anti-ageing” because retinol can help reduce the appearance of fine lines, wrinkles and even out skin tone (for example, sun spots or acne scars).
It also has an exfoliating effect, meaning it can help unclog pores.
Stronger retinoid treatments that target acne will require a prescription because they contain retinoic acid, which is regulated as a drug in the United States, European Union, United Kingdom and Australia.
How is retinol used in skincare?
One of the most common claims about retinol is that it helps to reduce visible signs of ageing.
How does this work?
With age, the skin’s barrier becomes weaker, making it more prone to dryness, injury and irritation.
Retinol can help counteract this natural thinning by stimulating the proliferation of keratinocytes – cells that form the outer skin layer and protect against damage and water loss.
Retinol also stimulates the production of collagen (a key protein that creates a scaffolding that keeps skin firm and elastic) and fibroblasts (cells that produce collagen and support skin structure).
It also increases how fast the skin sheds old cells and replaces them with new ones.
Over time, these processes help reduce fine lines, fade dark spots and even out skin tone. It can also make skin appear clearer.
While effective, this doesn’t happen overnight.
You may have also heard about a “retinol purge” – a temporary flare of acne when you first start using topical retinoids.
Studies have found the skin may become irritated and acne temporarily worsen in some cases. But more research needs to be done to understand this link.
The idea of a retinol purge is popular on social media. TikTok, CC BY-NC-ND So, is retinol safe?
At typical skincare concentrations (0.1–0.3%), side effects tend to be mild.
Most people who experience irritation (such as redness, dryness, or peeling) when starting retinol are able to build tolerance over time. This process is often called “retinisation”.
However, retinol increases the skin’s sensitivity to UV radiation (known as photosensitivity). This heightened reactivity can lead to sunburn, irritation and an increased risk of hyperpigmentation (spots or patches of darker colour).
For this reason, daily use of broad-spectrum sunscreen (SPF30 or higher) is strongly recommended while using retinol products.
Who should avoid retinol?
Teenagers and children generally don’t need retinol unless specifically prescribed by a doctor, for example, for acne treatment.
People with sensitive skin or conditions such as eczema (dry, itchy and inflamed skin) and rosacea (chronic redness and sensitivity) may find retinol too irritating.
Using retinol products alongside other skincare treatments, such as alpha-hydroxy acids, can over-exfoliate your skin and damage it.
Importantly, the active form of retinol, retinoic acid, is teratogenic (meaning it can cause birth defects). Over-the-counter retinol products are also not recommended during pregnancy or breastfeeding.
Choose and store retinol products wisely
Since retinol is classified as a cosmetic ingredient, companies are not required to disclose its concentration in their products.
The European Union is expected to introduce new regulations that will cap the concentration of retinol in cosmetic facial products to 0.3%.
These are precautionary measures aimed to limit exposure for vulnerable groups, such as pregnant women, given the risk of birth defects.
It’s therefore recommended to use products that clearly state the retinol concentration is between 0.1% and 0.3%.
Retinol is also a notoriously unstable molecule that degrades with exposure to air, light or heat.
Choosing a product with airtight, light-protective packaging will help with potential degradation problems that could lead to inactivity or harm.
What’s the safest way to try retinol?
The key is to go low and slow: a pea-sized amount of a low-concentration product (0.1%) once or twice a week, preferably at night (to avoid UV exposure), and then the frequency and concentration can be increased (to a maximum of 0.3%) as the skin adjusts.
Using a moisturiser after retinol helps to reduce dryness and irritation.
Wearing sunscreen every day is a must when using retinol to avoid the photosensitivity.
If you experience persistent redness, burning, or peeling, it’s better to stop using the product and consult your doctor or a dermatologist for personalised advice.
Laurence Orlando, Senior Lecturer, Product Formulation and Development, Analytical Methods, Monash University; Zanfina Ademi, Professor of Health Economics, Monash University, and Zoe Porter, Lecturer, Pharmacy and Pharmaceutical Science, Monash University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Why We Remember – by Dr. Charan Ranganath
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As we get older, forgetfulness can become more of a spectre; the threat that one day it could be less “where did I put my sunglasses?” and more “who is this person claiming to be my spouse?”.
Dr. Ranganath explores in this work the science of memory, from a position of neurobiology, but also in application. How and why we remember, and how and why we forget, and how and why both are important.
There is a practical element to the book too; we read about things that increase our tendency to remember (and things that increase our tendency to forget), and how we can leverage that information to curate our memory in an active, ongoing basis.
The style of the book is quite casual in tone for such a serious topic, but there’s plenty of hard science too; indeed there are 74 pages of bibliography cited.
Bottom line: while filled with a lot of science, this is also a very human book, and a helpful guide to building and preserving our memory.
Click here to check out “Why We Remember”, and learn how to hold on to what matters the most!
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Celeriac vs Zucchini – Which is Healthier?
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Our Verdict
When comparing celeriac to zucchini, we picked the celeriac.
Why?
Both have their merits! But…
In terms of macros, the celeriac has nearly 2x the fiber, more than 2x the carbs, and slightly more protein, winning in this category.
In the category of vitamins, celeriac has more of vitamins B1, B3, B5, B7, E, and K, while zucchini has more of vitamins B2, B9, and C, yielding a 6:3 win to celeriac here.
Looking at minerals, celeriac has more calcium, copper, iron, magnesium, phosphorus, potassium, selenium, and zinc, while zucchini has a tiny bit more manganese, making this round another compelling win for celeriac.
In other considerations, celeriac also has slightly more polyphenols (most notably quercetin), but it’s a tiny difference. Realistically, we could call this last round a tie.
Adding up the sections makes for a clear overall win for celeriac, but by all means do enjoy either or both, as diversity is best!
Want to learn more?
You might like:
What’s Your Plant Diversity Score?
Enjoy!
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Ginkgo Biloba, For Memory And, Uh, What Else Again?
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Ginkgo biloba, for memory and, uh, what else again?
Ginkgo biloba extract has enjoyed use for thousands of years for an assortment of uses, and has made its way from Traditional Chinese Medicine, to the world supplement market at large. See:
Ginkgo biloba: A Treasure of Functional Phytochemicals with Multimedicinal Applications
But what does the science say about the specific claims?
Antioxidant & anti-inflammatory
We’re going to lump these two qualities together for examination, since one invariably leads to the other.
A quick note: things that have antioxidant and anti-inflammatory properties, often also help guard against cancer and aging. However, in this case, there are few good studies pertaining to anti-aging, and none that we could find pertaining to anti-cancer potential.
So, does it have antioxidant and anti-inflammatory properties, first?
Yes, it has potent antioxidants that do fight inflammation; this is clear, from an abundance of in vitro and in vivo studies, including with human patients:
- Properties of Ginkgo biloba L.: incl. Antioxidant Characterization
- Anti-inflammatory effects of Ginkgo biloba extract against hippocampal neuronal injury
- Gingko biloba-derived lactone prevents osteoarthritis by activating anti-inflammatory signaling pathway
- The anti-inflammatory properties of Ginkgo biloba for the treatment of pulmonary diseases
In short: it helps, and there’s plenty of science for it.
What about anti-aging effects?
For this, there is science, but a lot of the science is not great. As one team of researchers concluded while doing a research review of their own:
❝Based on the reviewed information regarding EGb’s effects in vitro and in vivo, most have reported very positive outcomes with strong statistical analyses, indicating that EGb must have some sort of beneficial effect.
However, information from the reported clinical trials involving EGb are hardly conclusive since many do not include information such as the participant’s age and physical condition, drug doses administered, duration of drug administered as well as suitable control groups for comparison.
We therefore call on clinicians and clinician-scientists to establish a set of standard and reliable standard operating procedure for future clinical studies to properly evaluate EGb’s effects in the healthy and diseased person since it is highly possible it possesses beneficial effects.❞
Translation from sciencese: “These results are great, but come on, please, we are begging you to use more robust methodology”
If you’d like to read the review in question, here it is:
Advances in the Studies of Ginkgo Biloba Leaves Extract on Aging-Related Diseases
Does it have cognitive enhancement effects?
The claims here are generally that it helps:
- improve memory
- improve focus
- reduce cognitive decline
- reduce anxiety and depression
Let’s break these down:
Does it improve memory and cognition?
Ginkgo biloba was quite popular for memory 20+ years ago, and perhaps had an uptick in popularity in the wake of the 1999 movie “Analyze This” in which the protagonist psychiatrist mentions taking ginkgo biloba, because “it helps my memory, and I forget what else”.
Here are a couple of studies from not long after that:
- A double-blind, placebo-controlled, randomized trial of Ginkgo biloba in cognitively intact older adults: neuropsychological findings
- Effects of Ginkgo biloba on mental functioning in healthy volunteers
In short:
- in the first study, it helped in standardized tests of memory and cognition (quite convincing)
- In the second study, it helped in subjective self-reports of mental wellness (also placebo-controlled)
On the other hand, here’s a more recent research review ten years later, that provides measures of memory, executive function and attention in 1132, 534 and 910 participants, respectively. That’s quite a few times more than the individual studies we cited above, by the way. They concluded:
❝We report that G. biloba had no ascertainable positive effects on a range of targeted cognitive functions in healthy individuals❞
Read: Is Ginkgo biloba a cognitive enhancer in healthy individuals? A meta-analysis
Our (10almonds) conclusion: we can’t say either way, on this one.
Does it have neuroprotective effects (i.e., against cognitive decline)?
Yes—probably by the same mechanism will discuss shortly.
- Ginkgo Biloba for Mild Cognitive Impairment and Alzheimer’s Disease: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
- Treatment effects of Ginkgo biloba extract on symptoms of dementia: meta-analysis of randomized controlled trials
Can it help against depression and anxiety?
Yes—but probably indirectly by the mechanism we’ll get to in a moment:
- Role of Ginkgo biloba extract as an adjunctive treatment of elderly patients with depression
- Ginkgo biloba in generalized anxiety disorder and adjustment disorder with anxious mood
Likely this helps by improving blood flow, as illustrated better per:
Efficacy of ginkgo biloba extract as augmentation of venlafaxine in treating post-stroke depression
Which means…
Bonus: improved blood flow
This mechanism may support the other beneficial effects.
See: Ginkgo biloba extract improves coronary blood flow in healthy elderly adults
Is it safe?
Ginkgo biloba extract* is generally recognized as safe.
- However, as it improves blood flow, please don’t take it if you have a bleeding disorder.
- Additionally, it may interact badly with SSRIs, so you might want to avoid it if you’re taking such (despite it having been tested and found beneficial as an adjuvant to citalopram, an SSRI, in one of the studies above).
- No list of possible contraindications can be exhaustive, so please consult your own doctor/pharmacist before taking something new.
*Extract, specifically. The seeds and leaves of this plant are poisonous. Sometimes “all natural” is not better.
Where can I get it?
As ever, we don’t sell it (or anything else), but here’s an example product on Amazon
Enjoy!
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Fermenting Everything – by Andy Hamilton
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This is not justanother pickling book! This is, instead, what it says on the front cover, “fermenting everything”.
Ok, maybe not literally everything, but every kind of thing that can reasonably be fermented, and it’s probably a lot more things than you might think.
From habanero chutney to lacto-lemonade, aioli to kombucha, Ukrainian fermented tomatoes to kvass. We could go on, but we’d soon run out of space. You get the idea. If it’s a fermented product (food, drink, condiment) and you’ve heard of it, there’s probably a recipe in here.
All in all, this is a great way to get in your gut-healthy daily dose of fermented products!
He does also talk safety, and troubleshooting too. And so long as you have a collection of big jars and a fairly normally-furnished kitchen, you shouldn’t need any more special equipment than that, unless you decide to you your fermentation skills for making beer (which does need some extra equipment, and he offers advice on that—our advice as a health science publication is “don’t drink beer”, though).
Bottom line: with this in hand, you can create a lot of amazing foods/drinks/condiments that are not only delicious, but also great for gut health.
Click here to check out Fermenting Everything, and widen your culinary horizons!
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Bird flu has been detected in a pig in the US. Why does that matter?
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The United States Department of Agriculture last week reported that a pig on a backyard farm in Oregon was infected with bird flu.
As the bird flu situation has evolved, we’ve heard about the A/H5N1 strain of the virus infecting a range of animals, including a variety of birds, wild animals and dairy cattle.
Fortunately, we haven’t seen any sustained spread between humans at this stage. But the detection of the virus in a pig marks a worrying development in the trajectory of this virus.
David MG/Shutterstock How did we get here?
The most concerning type of bird flu currently circulating is clade 2.3.4.4b of A/H5N1, a strain of influenza A.
Since 2020, A/H5N1 2.3.4.4b has spread to a vast range of birds, wild animals and farm animals that have never been infected with bird flu before.
While Europe is a hotspot for A/H5N1, attention is currently focused on the US. Dairy cattle were infected for the first time in 2024, with more than 400 herds affected across at least 14 US states.
Bird flu has enormous impacts on farming and commercial food production, because infected poultry flocks have to be culled, and infected cows can result in contaminated diary products. That said, pasteurisation should make milk safe to drink.
While farmers have suffered major losses due to H5N1 bird flu, it also has the potential to mutate to cause a human pandemic.
Birds and humans have different types of receptors in their respiratory tract that flu viruses attach to, like a lock (receptors) and key (virus). The attachment of the virus allows it to invade a cell and the body and cause illness. Avian flu viruses are adapted to birds, and spread easily among birds, but not in humans.
So far, human cases have mainly occurred in people who have been in close contact with infected farm animals or birds. In the US, most have been farm workers.
The concern is that the virus will mutate and adapt to humans. One of the key steps for this to happen would be a shift in the virus’ affinity from the bird receptors to those found in the human respiratory tract. In other words, if the virus’ “key” mutated to better fit with the human “lock”.
A recent study of a sample of A/H5N1 2.3.4.4b from an infected human had worrying findings, identifying mutations in the virus with the potential to increase transmission between human hosts.
Why are pigs a problem?
A human pandemic strain of influenza can arise in several ways. One involves close contact between humans and animals infected with their own specific flu viruses, creating opportunities for genetic mixing between avian and human viruses.
Pigs are the ideal genetic mixing vessel to generate a human pandemic influenza strain, because they have receptors in their respiratory tracts which both avian and human flu viruses can bind to.
This means pigs can be infected with a bird flu virus and a human flu virus at the same time. These viruses can exchange genetic material to mutate and become easily transmissible in humans.
The Conversation, CC BY-SA Interestingly, in the past pigs were less susceptible to A/H5N1 viruses. However, the virus has recently mutated to infect pigs more readily.
In the recent case in Oregon, A/H5N1 was detected in a pig on a non-commercial farm after an outbreak occurred among the poultry housed on the same farm. This strain of A/H5N1 was from wild birds, not the one that is widespread in US dairy cows.
The infection of a pig is a warning. If the virus enters commercial piggeries, it would create a far greater level of risk of a pandemic, especially as the US goes into winter, when human seasonal flu starts to rise.
How can we mitigate the risk?
Surveillance is key to early detection of a possible pandemic. This includes comprehensive testing and reporting of infections in birds and animals, alongside financial compensation and support measures for farmers to encourage timely reporting.
Strengthening global influenza surveillance is crucial, as unusual spikes in pneumonia and severe respiratory illnesses could signal a human pandemic. Our EPIWATCH system looks for early warnings of such activity, which can speed up vaccine development.
If a cluster of human cases occurs, and influenza A is detected, further testing (called subtyping) is essential to ascertain whether it’s a seasonal strain, an avian strain from a spillover event, or a novel pandemic strain.
Early identification can prevent a pandemic. Any delay in identifying an emerging pandemic strain enables the virus to spread widely across international borders.
Australia’s first human case of A/H5N1 occurred in a child who acquired the infection while travelling in India, and was hospitalised with illness in March 2024. At the time, testing revealed Influenza A (which could be seasonal flu or avian flu), but subtyping to identify A/H5N1 was delayed.
This kind of delay can be costly if a human-transmissible A/H5N1 arises and is assumed to be seasonal flu because the test is positive for influenza A. Only about 5% of tests positive for influenza A are subtyped further in Australia and most countries.
In light of the current situation, there should be a low threshold for subtyping influenza A strains in humans. Rapid tests which can distinguish between seasonal and H5 influenza A are emerging, and should form part of governments’ pandemic preparedness.
A higher risk than ever before
The US Centers for Disease Control and Prevention states that the current risk posed by H5N1 to the general public remains low.
But with H5N1 now able to infect pigs, and showing worrying mutations for human adaptation, the level of risk has increased. Given the virus is so widespread in animals and birds, the statistical probability of a pandemic arising is higher than ever before.
The good news is, we are better prepared for an influenza pandemic than other pandemics, because vaccines can be made in the same way as seasonal flu vaccines. As soon as the genome of a pandemic influenza virus is known, the vaccines can be updated to match it.
Partially matched vaccines are already available, and some countries such as Finland are vaccinating high-risk farm workers.
C Raina MacIntyre, Professor of Global Biosecurity, NHMRC L3 Research Fellow, Head, Biosecurity Program, Kirby Institute, UNSW Sydney and Haley Stone, Research Associate, Biosecurity Program, Kirby Institute & CRUISE lab, Computer Science and Engineering, UNSW Sydney
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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