Why is treating tongue-tie in breastfed babies an underground movement in Ireland?
It is not news to anyone I’m sure that Ireland has the lowest breastfeeding rates in Europe. Public health campaigns and two active Government policies to improve rates in recent years have failed to have any impact at all. A slight increase has been attributed directly to the increase of foreign nationals in the country and the fact that our population of older mothers is growing. Research indicates that older mothers are more likely to breastfeed their children.
So all that money and time on trying to improve our breastfeeding rates and we have nothing to show for it. There’s a very strong argument to be made that rather than waste it on PR and ineffective policy, it should all have been ploughed into post-natal support where new mothers have immediate and regular access to qualified experienced lactation consultants when they need it. Watch the rates soar then…
A lack of breastfeeding knowledge in our professional healthcare providers is one of the significant barriers to improving breastfeeding rates here. A second barrier is not prioritising establishing breastfeeding as a matter of policy in our healthcare system. Take, for example, the issue of tongue-tie in newborn babies.
A tongue-tie is where the piece of tissue that attaches the tongue to the floor of the mouth – called the frenulum – is tight or restricted. Medically, it’s called ankyloglossia. Lots of babies with a tongue-tie can successfully breastfeed without any problems for the mother or baby but in some cases it can cause problems with latching, an unsettled baby, poor weight gain, sore nipples, a poor milk supply and mastitis. These are all problems that can easily derail a mother’s plan to breastfeed if they aren’t addressed. Studies have demonstrated that treating a tongue-tie by dividing the frenulum, a procedure called a frenuloplasty, can have a positive affect on breastfeeding in the majority of cases. In fact, the NICE guidelines in the UK support it once the procedure is carried out by a trained professional and the carers understand the procedure. You can read more about it here.
Although the procedure sounds awful, if it is done when a baby is less than three months old, no anesthesia is necessary, in most cases there is very little bleeding and the baby can be fed straight away. After six months, a general anaesthetic is required and it becomes a serious operation.
Treating tongue-tie when it’s causing problems for breastfeeding does not happen in maternity hospitals in Ireland. Which makes no sense whatsoever when your baby is still under their care up to six weeks after their birth. Surely if a staff lactation consultant diagnoses that a frenuloplasty will likely improve existing breastfeeding problems then this simple procedure should be done as a matter of course in the same hospital? Instead, parents are told that it might be considered in a few years time if it presents speech development problems and often they are encouraged to switch to formula. Once again a woman’s breastfeeding journey stops much sooner than she planned.
So here’s what happens instead: a good lactation consultant, or a word-of-mouth recommendation from a friend or an online parenting forum sees you making an appointment with a doctor who performs frenuloplasties in his own surgery. It’s like an underground movement. I am constantly hearing of people travelling across the country to one of these doctors – of which there are very few (I know of only two but there may be others) – so that they can fix the problem and continue on to successfully breastfeed their newborn baby.
Why is this happening when it’s being performed routinely internationally? The HSE has an information page about tongue-tie on its website basically supporting it as a treatment for improving breastfeeding outcomes but providing no information whatsoever on where to go to get it done. Can any readers shed any light on this? I have a few specific questions – maybe they’re cynical, I don’t know:
- Is it because a consultant will get paid more if they wait until a child is old enough to require a general anaesthetic?
- Is it because the HSE and the medical community talk a lot about the importance of breastfeeding but really they don’t give a flying eff?
- Is it because they don’t really believe it is an effective treatment to improve breastfeeding rates?
I have a feeling it’s questions one and two but I’d love to be proved wrong. Do you know?
DECEMBER 2013 UPDATE: I will continue to maintain and up to date list of practitioners offering tongue-tie treatments around the country. Please do let me know if you have any new information. Thanks a million!
Information on tongue tie:
Tongue tie procedures contact details:
Dr Justin Roche, paediatrician, South Tipperary General Hospital by referral only. Telephone: 052 617 7033
Dr Rachel Quigley, GP, Blackrock, Cork. Telephone: 021 4358031
Prof. John Fenton, Barrington’s Hospital, Dooradoyle, Co Limerick. Telephone: 061 307540
Prof. Prem Puri, Paediatric Surgeon, Beacon Hospital, Sandyford Industrial Estate, Dublin 16. Telephone: 01 292 0530
Inchicore Family Doctors, Primary Care Centre, St Michaels Estate, Dublin 8. Referral from a lactation consultant only. Tel: 4166011.
Dr Siun Murphy, Consultant Plastic Surgeon, Blackrock Clinic is now dividing tongue ties in babies up to 1 year (breastfed and formula fed babies). Referrals accepted from IBCLCs, GPs, PHNs, Paediatricans. Nicola O’Byrne IBCLC is working with Dr. Murphy in the clinic, so will be assisting breastfeeding mums and babies post procedure with latching, positioning and general breastfeeding concerns. Referrals should be sent to firstname.lastname@example.org.