Question & Answer - Oral Sensory-Motor, Myofunctional, Vocal Tract, & Airway Information
What are ten facts about tongue-tie?
Excerpt from article by Alison Hazelbaker, PhD, IBCLC, FILCA, CST, RCST (2015)
Fact 1: Tongue-tie does exist. It even has its own gene(s) that code(s) for it.
Fact 2: It manifests with various syndromes, which in and of themselves are relatively rare.
Fact 3: It is hereditary.
Fact 4: It has for a very long time had a clear definition: Tongue mobility restriction due to a tight and/or short lingual frenum.
Fact 5: It is a congenital anomaly. Regardless of whether tongue-tie is genetic or epigenetic, it occurs during development in the embryonic period.
Fact 6: Because tongue-tie, by definition, is impaired tongue mobility due to a congenital anomaly, it can cause deficits in all functions that require optimal tongue mobility, whether that is breastfeeding, bottle-feeding, chewing, protecting the airway, cleaning the teeth, or helping to form speech sounds. The degree to which this happens is somewhat known, but more research needs to be done before we have a firm grasp on this. Only then can we fine tune our treatment approach.
Fact 7: The incidence of tongue-tie was only hypothesized of late. A study out of Australia has shown that the incidence hovers around 5% of all people (Todd, 2014). More research needs to be done before we know an exact figure. The problem with incidence figures in the past was that no standardized assessment was being used. Dr. Todd, however, used a standardized, evidence-based screening tool for three years in a row in a large sample of infants. He was able to come up with what appears to be a very solid incidence statistic as a result. Please note here that Mother Nature does not create catastrophic increases in incidence of congenital anomalies unless some catastrophic epigenetic influence is at play. To claim that there is a rise in incidence to the tune of 20-50% is a clear misunderstanding of how epigenetic influences function epidemiologically.
Fact 8: Scissors frenotomy performed by trained practitioners has little to no risk. (No such data exists for laser, electrocautery or scalpel frenectomy.)
Fact 9: Breastfeeding improves post-frenotomy/frenectomy as long as tongue function is normalized as a result. Not all babies will show such improvement. (Dollberg, Marom, & Botzer, 2014) Anecdotally, many babies will need further therapy to restore proper tongue-function post-surgery.
Fact 10: Any connective tissue in the body (frena included) can be tight and impair optimal function. At what point that tightness can so severely impact function that no compensation can over-ride the restriction is an important question to put to the researchers.
Todd, D. (2014). Personal communication.
Dollberg, S., Marom, R., & Botzer, E. (2014). Lingual frenotomy for breastfeeding difficulties: A prospective follow-up study. Breastfeeding Medicine, 9 (6), 286-289.
Hazelbaker, A. (2015). Modern myths about tongue-tie: The unnecessary controversy continues. Retrieved from http://www.alisonhazelbaker.com/blog/.
ABOUT THE AUTHOR
Dr. Hazelbaker has been a therapist for nearly 30 years. She specializes in cross-disciplinary treatment and to that end has taken training in several modalities to best assist her clients. She is a certified Craniosacral Therapist, a Lymph Drainage Therapy practitioner, a Rhythmic Movement Training educator, a certified NOMAS assessor, and an International Board Certified Lactation Consultant. In 2010, she became a Fellow of the International Lactation Consultant Association (FILCA).
To LEARN MORE about and/or to contact Dr. Hazelbaker click on this link: http://www.alisonhazelbaker.com/alisonhazelbaker/
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Dr. Alison Hazelbaker granted permission for the posting of this excerpt from her original article.