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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This Is When Your Muscles Are Strongest
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Dr. Karyn Esser is a professor in the Department of Physiology and Aging at the University of Florida, where she’s also the co-director of the University of Florida Older Americans Independence Center, and she has insights to share on when it’s best to exercise:
It’s 4–5pm
Surprise, no clickbait or burying the lede!
This goes regardless of age or sex, but as we get older, it’s common for our circadian rhythm to weaken, which may result in a tendency to fluctuate a bit more.
However, since it’s healthy to keep one’s circadian rhythm as stable as reasonably possible, this is a good reason to try to keep our main exercise focused around that time of day, as it provides a sort of “anchor point” for the rest of our day to attach to, so that our body can know what time it is relative to that.
It’s also the most useful time of day to exercise, because most exercises give benefits proportional to progressive overloading, so training at our peak efficiency time will give the most efficient results. So much for those 5am runs!
On which note: while the title says “strongest” and the thumbnail has dumbbells, this does go for all different types of exercises that have been tested.
For more details on all of the above, enjoy:
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You might also like to read:
The Circadian Rhythm: Far More Than Most People Know
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The Reason You’re Alone
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If you are feeling lonely, then there are likely reasons why, as Kurtzgesagt explains:
Why it happens and how to fix it
Many people feel lonely and disconnected, often not knowing how to make new friends. And yet, social connection strongly predicts happiness, while lack of it is linked to diseases and a shorter life.
One mistake that people make is thinking it has to be about shared interests; that can help, but proximity and shared time are much more important.
Another stumbling block for many is that adult responsibilities and distractions (work, kids, technology) often take priority over friendships—but loneliness is surprisingly highest among young people, worsened by the pandemic’s impact on social interactions.
And even when friendships are made, they fade without attention, often accidentally, impacting both people involved. Other friendships can be lost following big life changes such as moving house or the end of a relationship. And for people above a certain advanced age, friendship groups can shrink due to death, if one’s friends are all in the same age group.
But, all is not lost. We can make friends with people of any age, and old friendships can be revived by a simple invitation. We can also take a “build it and they will come” approach, by organizing events and being the one who invites others.
It’s easy to fear rejection—most people do—but it’s worth overcoming for the potential rewards. That said, building friendships requires time, patience, caring about others, and being open about yourself, which can involve a degree of vulnerability too.
In short: be laid-back while still prioritizing friendships, show genuine interest, and stay open to social opportunities.
For more on all of this, enjoy:
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You might also like to read:
How To Beat Loneliness & Isolation
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The Wandering Mind – by Dr. Michael Corballis
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Our mind’s tendency to wander can be a disability, but could it also be a superpower? Dr. Corballis makes the case for such.
While many authors focus on, well, how to focus, Dr. Corballis argues in this book that our wandering imagination can be more effective at problem-solving and creative tasks, than a focused, blinkered mind.
The book’s a quick read (184 pages of quite light reading), and yet still quite dense with content. He takes us on a tour of the brain, theory of mind, the Default Mode Network (where a lot of the brain’s general ongoing organization occurs), learning, memory, forgetting, and creativity.
Furthermore, he cites (and explains) studies showing what kinds of “breaks” from mental work allow the wandering mind to do its thing at peak efficiency, and what kinds of breaks are counterproductive. Certainly this has practical applications for all of us!
Bottom line: if you’d like to be less frustrated by your mind’s tendency to wander, this is a fine book to show how to leverage that trait to your benefit.
Click here to check out The Wandering Mind, and set yours onto more useful tracks!
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Managing Major Chronic Diseases – by Alexis Dupree
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Our author, Alexis Dupree, is herself in her 70s, and writing with more than three decades of experience of surviving multiple chronic diseases (in her case, Multiple Sclerosis, and then a dozen comorbidities that came with such).
She is not a doctor or a scientist, but for more than 30 years she’s been actively working to accumulate knowledge not just on her own conditions, but on the whole medical system, and what it means to be a “forever patient” without giving up hope.
She talks lived-experience “life management” strategies for living with chronic disease, and she talks—again from lived experience—about navigating the complexities of medical care; not on a legalistic “State regulations say…” level, because that kind of thing changes by the minute, but on a human level.
Perhaps most practically: how to advocate strongly for yourself while still treating medical professionals with the respect and frankly compassion that they deserve while doing their best in turn.
But also: how to change your attitude to that of a survivor, and yet also redefine your dreams. How to make a new game plan of life—while working to make life easier for yourself. How to deal, psychologically, with the likelihood that not only will you probably not get better, but also, you will probably get worse, while still never, ever, giving up.
After all, many things are easily treatable today that mere decades ago were death sentences, and science is progressing all the time. We just have to stay alive, and in as good a condition as we reasonably can, to benefit from those advances!
Bottom line: if you have a chronic disease, or if a loved one does, then this is an immensely valuable book to read.
Click here to check out Managing Major Chronic Diseases, and make life easier!
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Human Connection In An All-Too-Busy World
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Many of us, in many ways, have more discretionary time than ever… On paper.
But rather than the 8-hour block of work of yesteryear, nowadays the things that take our time often come in a series of short bursts that punctuate our day.
This means that while in theory, we have n hours of “free” time per day, we actually have 9 minutes here, 23 minutes there, 1 hour 6 minutes somewhere else, and so on.
Social commitments, meanwhile, tend to require not only that we have time in a block, but also, that the time around that block also be sufficiently free, for travelling, preparation, etc.
The result? “We must do this again, and not leave it so long next time!” we say, sincerely, to the friend whom we will next see again in approximately 17 months’ time.
The problem is how our many theoretically-small obligations reduce the rest of our time to “time confetti”, and that happens on the large scale like we saw above, as well as on the small scale of “Ah, I have an hour to relax between these two things” and then suddenly the time is gone, once again reduced to time confetti:
Time Confetti and the Broken Promise of Leisure
So, how to maintain human connection with people beyond those with whom we live?
Some is infinitely better than none
Let’s say you want to call a friend or relative. There may be generational differences in how much one is expected to arrange this by text first, vs just calling, but either way, you don’t have to have an open-ended block of time, and sometimes, it’s better if you don’t.
Establish, at the start of the call, “Before we get into catching up, how are we for time, by the way? For my part, I’ll have to go by such-and-such a time”, and then work with that.
The benefit of doing this is that you’ll both know enough about the time constraints to use the time appropriately; you won’t run out the clock on smalltalk before getting to something big, and you’ll both come away feeling satisfied that you shared and were shared-with in a meaningful fashion.
In contrast, guessing at time constraints can leave big things clipped off, or else result in someone “looking for a way to politely end this conversation that stopped being interesting a while ago but it’ll seem rude if I say I have to go now”, of the kind that results in someone not being so open to a call next time.
Don’t rush to dismiss texts as a medium for meaningful connection
When text messages were first a thing, you’ll remember how we were all working within a very short character limit and a cost-per-message. It was telegrams for the modern age, basically.
Nowadays, that isn’t so; we can write as much or as little as we like, and this has two benefits:
- We can have longer, meaningful conversations around the other stuff in our life. We can reply in seconds, or after making a cup of tea and thinking about it, or after our grocery-chopping trip, or whenever suits us. Suddenly, time confetti isn’t such a barrier to human connection. Writer’s example: my prime social time in this manner is when I’m cooking dinner (which is often about an hour). There’s no way I could have a phonecall while doing that; my bad hearing notwithstanding, I just have my hands full too often with much else going on. But texting? I can do that in the several-minute gaps between assorted culinary tasks, while I’m waiting for the kettle to boil or the onions to brown or whatever.
- Sometimes, the brevity makes it easier. A quick text saying “Hey, just to let you know I’m thinking of you, and hope your day is going well!”, or “Unrelated to anything: I was just thinking about how I’m glad to have you in my life; you’re a good friend, and I appreciate that more than I often remember to say. Anyway, that’s all; it was just on my mind. I hope your day is going well!”
(The cheery closing words in those last two text message examples help signify: “don’t worry, I’m fine and am not looking for anything from you”, which will help the recipient to relax, and counterintuitively, more likely to reply with some kind words of their own, knowing that they’re not signing up for a potentially deep talk when they also have time confetti issues going on)
Seize the moment (and also let it go)
You probably have many small interactions with strangers, most days. In the store, walking the dog, at the doctor’s office, etc. So, two things:
- Make smalltalk. And if you’re not one for traditional smalltalk topics (weather etc), or even if you are, a level-up is:
- Compliment sincerely. Straight out of “How To Win Friends And Influence People”, of course, but it creates a moment of genuine connection; you say a thing, their day is improved, they smile, you complete your business with a smile of your own and go about your day.
(of course, do steer clear of anything that could be interpreted as flirting, if that is not your intent, and really it should never be your intent when it comes to the captive audience of someone who will get fired if they’re not nice to you)
But, with a little practice, these little moments add up to a lot more human connection than if we treat the strangers with whom we interact as though they were merely part of the scenery.
Want more than that?
Check out:
How To Beat Loneliness & Isolation
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Does Ginseng Increase Testosterone Levels?
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❓ Q&A With 10almonds Subscribers!
Q: You talked about spearmint as reducing testosterone levels, what about ginseng for increasing them?
A: Hormones are complicated and often it’s not a simple matter of higher or lower levels! It can also be a matter of…
- how your body converts one thing into another
- how your body responds (or not) to something according to how the relevant hormone’s receptors are doing
- …and whether there’s anything else blocking those receptors.
All this to say: spearmint categorically is an anti-androgen, but the mechanism of action remains uncertain.
Panax ginseng, meanwhile, is one of the most well-established mysteries in herbal medicine.
Paradoxically, it seems to improve both male and female hormonal regulation, despite being more commonly associated with the former.
- It doesn’t necessarily increase or decrease testosterone or estrogen levels (but it can, even if indirectly)
- It does improve sexual function
- …and alleviates symptoms associated with conditions as varied as:
- Late-onset hypogonadism (common for men during the andropause)
- Benign prostate hyperplasia (again common for men during the andropause)
- …and also counteracts unwanted side-effects of finasteride. Finasteride is often taken by men as a hair loss remedy or, less often but critically, in the case of an enlarged prostate.
But it also…
- Alleviates symptoms of PCOS (polycystic ovary syndrome, which effects around 20% of women)
- May even be an effective treatment for PCOS (rat model only so far)
- It also may improve female reproductive fertility more generally (the studies are down to fruit flies now though)
Bottom line: Panax ginseng is popularly taken to improve natural hormone function, a task at which it appears to excel.
Scientists are still working out exactly how it does the many things it appears to do.
Progress has been made, and it clearly is science rather than witchcraft, but there are still far more unanswered questions than resolved ones!
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