Restricted infant oral connective tissue: how this diagnosis became so common + who has (and hasn't) benefited. Dr Pamela Douglas February 2024
This ia a 15 minute video on a complicated topic, on which I hoped to offer you some context.
It's hard for parents to believe that so many conferences, research papers, professional organisations, and health professional and bodywork therapy businesses (not to mention social media discussions) could be getting things wrong. That so many references stuck at the bottom of articles could be misinterpreted. But this is what happens.
It's happened with other popular waves of diagnoses in breastfeeding babies in my life-time, and it's happened again with the over-use of tongue-tie diagnoses. It can only happen because clinical breastfeeding support remains a research frontier, because we as health professionals we aren't really trained to critically analyse research and research methodologies, and because businesses in health become heavily invested in particular diagnoses and treatments, so that independent thinking is difficult (or to be frank, sometimes outrightly 'cancelled').
My article in Breastfeeding Medicine in 2013 was, as far as I am aware, the first publication in a medical journal to analyse the rise in the diagnosis of posterior tongue-tie. The ACIOR team that Professor Laurie Walsh and myself had brought together was the first to publish, in 2018, a consensus statement which specifically addressed the inappropriate application of diagnoses and treatments of lip-tie and buccal ties. Since then there have been multiple systematic reviews which carefully analyse all existing research, and which find widespread overdiagnosis of restricted oral connective tissues in infants and overuse of frenotomies.
But if it's not restricted fascia, tight oral connective tissues, and disrupted neuromotor suck pathways causing the breastfeeding problems, then what's going on?
Now, with Possums Breastfeeding & Lactation, we offer a whole different way of making sense of breastfeeding problems, oral connective tissue restrictions, and what helps - for both parents and health professionals.
Selected references
Douglas PS. Re-thinking 'posterior' tongue-tie. Breastfeeding Medicine. 2013;8(6):1-4.
Douglas PS. Deep cuts under babies' tongues are unlikely to solve breastfeeding problems 2016. Available from: https://theconversation.com/deep-cuts-under-babies-tongues-are-unlikely-to-solve-breastfeeding-problems-54040.
Douglas PS. Tongues tied about tongue-tie. Griffith Review Online. 2016.
Douglas PS. Special Edition: Tongue-tie Expert Roundtable. Clinical Lactation. 2017;8(3):87-131.
Douglas PS. Untangling the tongue-tie epidemic. Medical Republic. 2017;1 September:http://medicalrepublic.com.au/untangling-tongue-tie-epidemic/10813.