True condition is extremely rare

Tongue tie is often blamed when breastfeeding fails. Better support for mothers to help them to establish breastfeeding would be more helpful and a better use of resources than a tongue tie service. Despite the claims of various health professionals and voluntary groups to be experts committed to breastfeeding, the relatively poor breastfeeding rates in both the short term and the long term suggest that there is considerable room for improvement. The fact that tongue tie may have been diagnosed and treated by a variety of means and ‘got better’ does not mean the baby had tongue tie in the first place. There is a lack of understanding of normal babies by health professionals. True tongue tie is very rare. Many babies have an m-shaped tongue in the first few weeks of life. This is a normal variation which improves with time and does not indicate tongue tie. The hardest thing for those in the ‘caring professions’ is to do nothing and say nothing [or to say “I don’t know”]. Instead the temptation is to say something, no matter how specious, and do something, no matter how unnecessary. It is particularly true that if you pay them money they will intervene. The pressure for this service also reflects the spurious belief that “more must be better” – more diagnoses, more specialists, more treatment. The person who makes a diagnosis must be better than the one who doesn’t. The person who offers treatment must be better than the one who takes a hands-off-wait-and-see approach. I can see a growing empire of tongue tie specialist therapists, headed notepaper, a waiting list and a demand for more funds. It is a pity that in the current economic climate NHS money is going to be wasted in my opinion on a largely non-existent condition with treatments that are unnecessary and that potentially have side effects – albeit rare – of pain, bleeding and infection. Even non-surgical treatments can have the side effects of anxiety and guilt for parents.

Dr Charles Essex FRCPCH.

Consultant Neurodevelopmental Paediatrician, Trinity Street, Leamington