What parents should know after report suggests tongue-tie may be over-diagnosed

A new report from the American Academy of Pediatrics suggests health care providers may be diagnosing too many cases of tongue-tie in babies and children, leading to unnecessary surgeries.

Also called ankyloglossia, tongue-tie is a condition where the lingual frenulum or the membrane fold near the tongue affects the tongue's motion and function. It can impact breastfeeding, causing a baby to have difficulty latching while nursing or pain for a nursing mother, among other difficulties.

One of the challenges with tongue-tie, according to the AAP report published Monday, is that there is no standard for diagnosing and treating the condition. But with more awareness, which the report claims has been driven in part by doctors, dentists, surgeons and social media, tongue-tie diagnoses and treatments, including a surgical procedure called frenotomy, have increased significantly from under 5,000 cases in 1997 to 70,000 cases in 2016.

Experts disagree, however, whether treatments like frenotomy, which involves cutting the lingual frenulum with scissors or lasers, or post-surgery stretching exercises can improve breastfeeding or offer other benefits like better speech articulation or even prevent sleep apnea. Even though a frenotomy is generally considered a safe procedure, like any surgery, it can still carry risks, such as bleeding or infection.

Dr. Maya Bunik, the chair of the AAP section on breastfeeding, shared her tips for parents on what they should consider if they suspect their baby has tongue-tie or their child has received a tongue-tie diagnosis.

What parents should know about tongue-tie

Bunik told "Good Morning America" parents should ask questions and seek the advice of a baby's pediatrician or family medicine doctor if they notice a problem breastfeeding, such as when a baby is having trouble latching during nursing or a nursing mom is experiencing pain while trying to breastfeed.

"There are a lot of other things that could be going on with the baby," said Bunik, who is also a professor of pediatrics at the University of Colorado School of Medicine. "Sometimes babies are sleepy. Sometimes babies have had other conditions. Sometimes, it's because the mom's milk supply has been affected by her medical conditions … so there's lots of reasons why the baby may not be able to get enough milk."

If a baby or child does get diagnosed with tongue-tie, a provider may suggest surgery as a treatment option, but Bunik encouraged parents to consider a second opinion early on as well.

"[The frenulum is] a very thin tissue. With time, we know that stretches," Bunik said. "And so what we've come to learn is that even though it may be diagnosed, about 50% of them don't actually need to be treated, either cut with scissors or have laser done."

Bunik, who has been practicing for over 25 years, said she has personally seen mothers and babies who have been able to navigate breastfeeding when a child has tongue-tie, without having to opt for surgery.

Bunik also pointed out that some providers may push surgery and other treatments for possible financial gain.

"I suspect that social media in the last 10 years, along with the dental profession, having laser use be more ubiquitous in practices has really made this sort of an explosion," said Bunik. "It's hard to believe, if you charge $800 cash, that there's not some other motivation that you have to make this diagnosis, and that's what we're worried about."

Overall, Bunik said parents facing breastfeeding difficulties should seek support sooner than later and follow-up with multiple providers if they feel they're being recommended costly treatment options as a quick fix.

"I think that we have made it into a bigger thing than it probably is and that we should probably be supporting mom and baby pairs and breastfeeding parents holistically, rather than jumping to a quick fix that may not be the fix," Bunik added.