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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52 Small Changes – by Brett Blumenthal
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We see a lot of books that exhort us to get a six-pack in a month, change our life in 7 days, learn Japanese in 24 hours. The reality is, things take time!
Brett Blumenthal is more realistic while being just as motivational:
The idea is simple… Make one small change per week for 52 weeks, and at the end of the year, you’ll be healthier and happier.
At 10almonds, we’re big fans of small changes that add up (or rather: compound!) to make big differences, so this one’s absolutely our style!
Best of all, she offers us not just “do this” advice, but also “and here’s the information and resources you’ll need to make this change work the best it can for you”
The advices range in topic from nutrition to exercise to sleep to mental wellness to interpersonal stuff and more. The biggest focus is on personal health, though, with small changes to exercise and nutrition making up the lion’s share of the changes.
Bottom line: this is a book you’ll want to grab once a week. Consider setting a reminder on your phone to check in with it each Sunday, for example!
Take the first step and order “52 Small Changes” from Amazon today!
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The No-Nonsense Meditation Book – by Dr. Steven Laureys
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We’ve reviewed books about meditation before, and when we review books, we try to pick ones that have something that make them stand out from the others. So, what stands out in this case?
The author is a medical doctor and neurologist, with decades of experience focusing on neuronal plasticity and multimodel neural imaging. So, a little beyond “think happy thoughts”-style woo.
The style of the book is pop-science in tone, but with a lot of hard clinical science underpinning it and referenced throughout, as one would expect of a scientist of Dr. Laurey’s stature (with hundreds of peer-reviewed papers in top-level journals).
You may be wondering: is this a “how-to” book or a “why-to” book or a “what-happens” book? It’s all three.
The “how-to” is also, as the title suggests, no-nonsense. We are talking maximum results for minimum mystery here.
Bottom line: if you’d like to be able to take up a meditative practice and know exactly what it’s doing to your brain (quietening these parts, stimulating and physically growing those parts, etc) then this is the book for you.
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The Tiniest Seeds With The Most Value
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If You’re Not Taking Chia, You’re Missing Out
Last Tuesday, we wrote about nutritional psychiatry, and the benefits of eating for one’s mental health.
You can check out Dr. Uma Naidoo’s to-dos, here:
The 6 Pillars Of Nutritional Psychiatry
In response, one of our subscribers wrote to mention:
❝Really interesting….just put chia seeds in my diet love them……taking the Drs advice.❞
~ Cindy, 10almonds subscriber
And then! On Friday, our tip at the top of the newsletter was:
Not sure how to incorporate chia seeds into your diet? It’s easier to want the benefits of their many brain-healthy (and otherwise-healthy, too) nutrients, than it is to know what to do with them necessarily, and not everyone enjoys seeds as a snack. So…
When you cook rice, throw in a tablespoon of chia seeds too. The cooking process will soften them and they won’t be texturally any different than the rice, but the nutrients will be all there.
They can also be thrown in with lentils, in the same fashion! Or oatmeal, when cooking it or making overnight oats.
We’ll be honest, it was Cindy’s comment that prompted us to suggest it. But wait! There was more to come in response:
❝You had a teaser ..on Chia seed.would of liked a article on the benefits . I’ve just discovered Chia seeds…❞
~ Cindy, 10almonds subscriber
So, Cindy, this one’s for you:
Nutritional powerhouse
First things first, these tiny seeds have a lot of nutrients. There are not many more nutrient-dense foods than this (there’s a kind of seaweed that might be a contender; we’ll have to do some research and get back to you).
Check them out:
USDA Nutritional Factsheet: Chia Seeds
So much protein and healthy fat, so many vitamins and minerals, and so many miscellaneous other micronutrients that we’d be here all day to list them (which is why we linked the above factsheet instead).
Antioxidants in abundance
These deserve a special mention, because they include quercetin which we’ve written about previously:
Fight Inflammation & Protect Your Brain, With Quercetin
…as well as quite a collection of others (including chlorogenic acid and caffeic acid, which may sound alarming but are great for lowering your blood pressure and against inflammation, respectively):
- The effect of chlorogenic acid on blood pressure: a systematic review and meta-analysis of randomized clinical trials
- Synthesis, preliminary bioevaluation and computational analysis of caffeic acid analogues
There are others too, with cardioprotective effects, liver-healthy effects, and anticancer properties:
Nutritional and therapeutic perspectives of Chia (Salvia hispanica L.): a review
Good for the heart and blood
Check it out:
- Chia flour supplementation reduces blood pressure in hypertensive subjects
- Chia seed (Salvia hispanica L.) supplementation to the diet of adults with type 2 diabetes improved systolic blood pressure: A randomized controlled trial
Oh, and about diabetes? There’s more, this time pertaining to reducing after-dinner blood sugars (or “postpranidial glycemia”, in sciencese):
- Reduction in postprandial glucose excursion and prolongation of satiety: possible explanation of the long-term effects of whole grain Salba (Salvia Hispanica L.)
- Effect of whole and ground Salba seeds (Salvia Hispanica L.) on postprandial glycemia in healthy volunteers: a randomized controlled, dose-response trial
Good for the brain
Regular 10almonds readers will know that “what’s good for the blood, is good for the brain” is a very good rule of thumb already, but their highomega-3 content makes them especially so:
What Omega-3 Fatty Acids Really Do For Us
Want some?
We don’t sell them, but you can probably find them in your local supermarket and/or health food store, and if you prefer getting things online, here for your convenience is an example product on Amazon
Enjoy!
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Peripheral Neuropathy: How To Avoid It, Manage It, Treat It
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Peripheral neuropathy (and what can be done about it)
Peripheral neuropathy is nerve damage, usually of the extremities. It can be caused by such things as:
- Diabetes
- Alcoholism
- Infection
- Injury
The manifestations can be different:
- In the case of diabetes, it’s also called diabetic neuropathy, and almost always affects the feet first.
- In the case of alcoholism, it is more generalized, but tends towards affecting the extremities first.
- In the case of infection, a lot depends on the nature of the infection and the body’s response.
- In the case of injury, it’ll naturally be the injured part, or a little “downstream” of the injured part.
- This could be the case of a single traumatic injury (e.g. hand got trapped in a slammed door)
This could be the case of a repetitive injury (carpal tunnel syndrome is a kind of peripheral neuropathy, and is usually caused by consistent misalignment of the carpal tunnel, the aperture through which a bundle of nerves make their way from the forearm to the hand)
Prevention is better than cure
If you already have peripheral neuropathy, don’t worry, we’ll get to that. But, if you can, prevention is better than cure. This means:
- Diabetes: if you can, avoid. This may seem like no-brainer advice, but it’s often something people don’t think about until hitting a pre-diabetic stage. Obviously, if you are Type 1 Diabetic, you don’t have this luxury. But in any case, whatever your current status, take care of your blood sugars as best you can, so that your blood can take care of you (and your nerves) in turn. You might want to check out our previous main feature about this:
- Alcoholism: obviously avoid, if you can. You might like this previous edition of 10almonds addressing this:
- Infection: this is so varied that one-liner advice is really just “try to look after your immune health”.
- We’ll do a main feature on this soon!
- Injury: obviously, try to be careful. But that goes for the more insidious version too! For example, if you spend a lot of time at your computer, consider an ergonomic mouse and keyboard.
- There are many kinds available, so read reviews, but here’s an example product on Amazon
Writer’s note: as you might guess, I spend a lot of time at my computer, and a lot of that time, writing. I additionally spend a lot of time reading. I also have assorted old injuries from my more exciting life long ago. Because of this, it’s been an investment in my health to have:
A standing desk
A vertical ergonomic mouse
An ergonomic split keyboard
A Kindle*
*Far lighter and more ergonomic than paper books. Don’t get me wrong, I’m writing to you from a room that also contains about a thousand paper books and I dearly love those too, but more often than not, I read on my e-reader for comfort and ease.
If you already have peripheral neuropathy
Most advice popular on the Internet is just about pain management, but what if we want to treat the cause rather than the symptom?
Let’s look at the things commonly suggested: try ice, try heat, try acupuncture, try spicy rubs (from brand names like Tiger Balm, to home-made chilli ointments), try meditation, try a warm bath, try massage.
And, all of these are good options; do you see what they have in common?
It’s about blood flow. And that’s why they can help even in the case of peripheral neuropathy that’s not painful (it can also manifest as numbness, and/or tingling sensations).
By getting the blood flowing nicely through the affected body part, the blood can nourish the nerves and help them function correctly. This is, in effect, the opposite of what the causes of peripheral neuropathy do.
But also don’t forget: rest
- Put your feet up (literally! But we’re talking horizontal here, not elevated past the height of your heart)
- Rest that weary wrist that has carpal tunnel syndrome (again, resting it flat, so your hand position is aligned with your forearm, so the nerves between are not kinked)
- Use a brace if necessary to help the affected part stay aligned correctly
- You can get made-for-purpose wrist and ankle braces—you can also get versions that are made for administering hot/cold therapy, too. That’s just an example product linked that we can recommend; by all means read reviews and choose for yourself, though. Try them and see what helps.
One more top tip
We did a feature not long back on lion’s mane mushroom, and it’s single most well-established, well-researched, well-evidenced, completely uncontested benefit is that it aids peripheral neurogenesis, that is to say, the regrowth and healing of the peripheral nervous system.
So you might want to check that out:
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How To Avoid Self-Hatred & Learn To Love Oneself More
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Alain de Botton gives a compassionate, but realistic, explanation in this video:
The enemy within
Or rather, the collaborator within. Because there’s usually first an enemy without—those who are critical of us, who consider that we are bad people in some fashion, and may indeed get quite colorful in their expressions of this.
Sometimes, their words will bounce straight off us; sometimes, their words will stick. So what’s the difference, and can we do anything about it?
The difference is: when their words stick, it’s usually because on some level we believe their words may be true. That doesn’t mean they necessarily are true!
They could be (and it would be a special kind of hubris to assume no detractor could ever find a valid criticism of us), but very often the reason we have that belief, or at least that fear/insecurity, is simply because it was taught to us at an early age, often by harsh words/actions of those around us; perhaps our parents, perhaps our schoolteachers, perhaps our classmates, and so forth.
The problem—and solution—is that we learn emotions much the same way that we learn language; only in part by reasoned thought, and rather for the most part, by immersion and repetition.
It can take a lot of conscious self-talk to undo the harm of decades of unconscious self-talk based on what was probably a few years of external criticisms when we were small and very impressionable… But, having missed the opportunity to start fixing this sooner, the next best time to do it is now.
We cannot, of course, simply do what a kind friend might do and expect any better results; if a kind friend tells us something nice that we do not believe is true, then however much they mean it, we’re not going to internalize it. So instead, we must simply chip away at those unhelpful longstanding counterproductive beliefs, and simply build up the habit of viewing ourselves in a kinder light.
For more on all this, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
- Escape From The Clutches Of Shame
- To Err Is Human; To Forgive, Healthy
- How To Get Your Brain On A More Positive Track (Without Toxic Positivity)
Take care!
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The Epigenetics Revolution – by Dr. Nessa Carey
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If you enjoyed the book “Inheritance” that we reviewed a couple of days ago, you might love this as a “next read” book. But you can also just dive straight in here, if you like!
This one, as the title suggests, focuses entirely on epigenetics—how our life events can shape our genetic expression, and that of our descendants. Or to look at it in the other direction, how our genetic expression can be shaped by the life experiences of, for example, our grandparents.
The style of this book is very much pop-science, but contains a lot of information from hard science throughout. We learn not just about longitudinal population studies as one might expect, but also about the intricacies of DNA methylation and histone modifications, for example.
Depending on your outlook, you may find some of this very bleak (“great, I am shackled by what my grandparents did”) or very optimism-inducing (“oh wow, I’m not nearly so constrained by genetics as I thought; this stuff is so malleable!”). This is also the same author who wrote “Hacking The Code of Life“, by the way, but we’ll review that another day.
Bottom line: this book is the best one-shot primer on epigenetics that this reviewer has read (you may be wondering how many that is, and the answer is… about seven or so? I’m not good at counting).
Click here to check out The Epigenetics Revolution, and learn how dynamic you really are!
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