The booming business of cutting out children’s tongues

Tess Merrell had breastfed three children and didn’t expect to have any problems with the fourth. But after a month of struggling with the newborn, she hired Melanie Henstrom to help her.

Henstrom, lactation consultantthe culprit identified: the child’s tongue was anchored to the ground from the mouth. It was a common problem, he said, that could be fixed with quick treatment at a dentist’s office.

“It was advertised as a miracle remedy“said Merrell, the Boise (Idaho) football coach.

Henstrom recommended a dentist, who in December 2017 he made a cut under the child’s tongue with a laser. A few days later, the little girl, Eleanor, He refused to eat and became dangerously dehydrated., medical records show. She spent her first Christmas connected to a probe.

For centuries, midwives and doctors they cut the lingual frenulum to facilitate breastfeeding. But the popularity of this procedure has skyrocketed over the past decade as more women undergo it increasing pressure to breastfeed.

According to a New York Times investigation, lactation consultants and dentists aggressively promote these interventionseven in children who show no signs of true tongue tie and despite the slight risk of serious complications.

A small part of the children They are born with a bundle of tissues which joins the tip of the tongue to the floor of the mouth. In some severe cases, doctors remove that tissue. However, many tongue ties are harmless and cutting them is proven to improve your diet They are scarce.

However, according to dozens of parents, dentists, doctors and counselors, some lactation consultants and dentists They offer laser surgery to anxious and exhausted mothers as a panacea that will improve breastfeeding and prevent a number of health problems.

An industry

Supporters of cutting tongue ties recommend apply the laser not only to the tissue under the tongue, but also to the mesh that connects the lips and cheeks to the gums. Diagnose and cut these “oral ligatures” – often via hundreds of dollars– has become a specialized industry.

A well-known New York dentist pocketing millions of dollars a year in your lingual frenulum cutting office. Lactation consultants referring patients and helping dentists They also charge. And the companies that produce lasers They too are adopting this trend.

It is difficult to estimate the volume of operations, as they are often not covered by health insurance. But everything indicates it The numbers are skyrocketing.

According to one study, lingual frenulum removals performed in hospitals – a small percentage of the total – they grew by more than 800% nationwide between 1997 and 2012, until it exceeded 12,000.

Otolaryngologists in 25 states reported a sharp increase in requests for consultations ankyloglossia, which sometimes fill their agenda. AND search for “anchored language” at Google hit a record in June, more than doubling over the past five years.

Many families rely on these procedures. But the boom in lingual frenulum cutting worries pediatricians across the country.

In 2020, a large New Jersey studio emailed families warning that children were “having their frenulums cut with clips, scissors, and lasers at an alarming rate.”

Last year, a Kentucky study issued a similar warning, citing children who refused to eat and they had “severe pain” after laser procedures. Dr. Charles Cavallo told the Times he sent that notice in response to what he considered a “profit motive” on the part of local dentists and lactation consultants.

The complications of cutting tongue ties

Serious complications They are rare. But doctors say they saw it The cuts cause so much pain that children refuse to eat, become dehydrated and malnourished. Some said that flaccid tongues blocked children’s airways.

Some parents said they felt guilty seeing their children suffer led them to depression. Others spent thousands of dollars on chiropractors and speech therapists who said their services were necessary for a successful recovery.

Unlike most medical specialties in the United States, the world of cutting of the lingual frenulum It works with little supervision. State dental boards accept complaints from the public, but rarely suspend dentists’ licenses. And only three states regulate lactation consultants.

Henstrom, for example, continues to serve as a consultant in Boisedespite the fact that healthcare workers and clients have made repeated complaints against her.

In a brief phone call, Henstrom said he pays close attention to each customer. “I literally did thousands of people who are happy with what I do” he said. He did not respond to a list of detailed questions.

Henstrom discovered the benefits of lingual frenulum cutting after undergoing the procedure herself at age 40. She stated that her scoliosis has improved and that she has stopped suffering from migraines and acid reflux. “I immediately felt a release of tension not only in my mouth, but throughout my body,” she wrote on her website.

After arriving in Boise in 2017, Henstrom got to work creating his own consulting firm, Baby Bonds, inviting midwives to lunch and offering free breastfeeding lessons. Always focused on undiagnosed anchored languages.

“If your baby is extremely picky, he or she most likely has an undetected tongue tie,” it says on its website.

In 2017, Merrell, fed up with trying to get Eleanor to breastfeed comfortably, contacted the local chapter of the La Leche League, a well-known organization that promotes breastfeeding. Henstrom, a volunteer with the group, responded in a Facebook message that Eleanor’s problem was “probably” a language problem.

Merrell countered that her pediatrician, a physical therapist and a previous lactation consultant had said so that wasn’t the problem.

“Trust me,” Henstrom said later in the exchange. “I’ve seen it hundreds of times and a review always solves the problem.”

“I hope so,” Merrell responded. “It would be nice to have a simple solution.”

After the operation, Eleanor seemed to improve. But then she stopped eating and became dehydrated. Her pediatrician sent her to the hospital. “We feel very stupid afterwards, because we paid to hurt our child“Merrell said.

“I feel horrible for what the Merrell family had to endure,” said Dr. Joel Whitt, the dentist who performed the procedure. He said This was the only negative result of the nearly 800 operations of this type that he had created. She referred the Times to two former patients, who confirmed that their children had benefited from the operation.

Whitt said he later dramatically reduced the volume of surgeries performed, in part because he was concerned that the benefits of releasing the labial frenulums were exaggerated.

As of early 2020, Henstrom was referring patients exclusively to another dentist, Dr. Samuel Zink. He also helped during the procedures, holding the children while Zink made cuts in their mouths with a laser after applying anesthesia, according to a recent podcast interview and interviews with his clients.

Henstrom’s clients said he charged $150 to attend the anchored tongue release session, with optional follow-up visits. Parents said Zink’s plots were usually around 600 dollars. Insurance rarely covered the expenses. (Zink did not respond to requests for comment.)

Most states, including Idaho, They do not regulate lactation consultants. But more than 19,000 consultants have credentials from the International Board of Examiners of Lactation Consultants. That group has received at least three complaints against Henstrom since 2020.

The breastfeeding board, which informs her disciplinary decisions, took no action against Henstrom.

Late last year, Henstrom recommended releasing the tongue, lips and cheeks of a baby named Vivi. A few days later, sitting in Zink’s waiting room, Vivi’s mother, Aubrey Nobili, She could hear her baby’s cries over the muffled hum. of a noise machine.

When Henstrom brought Vivi back to the living room, the girl couldn’t catch her breath. Nobili brought her daughter closer and smelled the charred meat.

Vivi never breastfed again.

Six months later, a specialist at St. Luke’s evaluated Vivi because she had difficulty swallowing and sometimes choked while feeding a bottle. The specialist wrote in his medical history that the problems were due “probably” to laser surgery.

Nobili and her husband Ryan say they have accumulated more than $5,000 in credit cards to pay for Vivi’s eating therapies.

Vivi turned one in November. Her family decorated the house with balloons and dressed her as a strawberry.

Only one thing was missing: a birthday cake. Vivi still can’t eat solid foods.