Dentists say they've noticed a big increase in hotly debated tongue-tie surgery in babies and it's worrying.
Tongue-tie surgery involves cutting a thin piece of skin joining the underside of the tongue to the lower jaw. Photo: 123RF
Wellington anaesthetist Graham Sharpe is calling for urgent action over the surgery, saying it is massively over-diagnosed and treated, particularly by midwives.
The Dental Association told its members there was insufficient evidence to support the snip to help with breastfeeding, speech or orthodontic problems.
Its president elect, Katie Ayers, said dentists were worried about anecdotal evidence that tongue-tie surgery is on the rise.
"We're concerned that there may be more of these procedures being undertaken than are necessary and that this is putting some young children and infants at risk."
She can't give figures but said there was a strong interest from parents.
"A lot more inquiries coming through to general practices from parents that have been advised to have this done, and sometimes when they go for a second opinion the two opinions may not always be the same."
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Tongue-tie surgery involves cutting a thin piece of skin joining the underside of the tongue to the lower jaw.
It's done by midwives, dentists, GPs, and some surgeons, but there are no figures on how many each group does or the total number.
Latest figures from the Health Ministry reveal an average of about 700 are done a year - but that covers public hospitals only.
The aim is to improve breastfeeding, and it was a godsend to a Lower Hutt mother, Christine Nicholls, after first child Zoe was born four-and-a-half years ago.
"No matter what what I did ... she'd latch but my nipples were cracked and bleeding and ruined. She wasn't putting on enough weight. It was absolutely horrendous.
"I got to the point I didn't even want to hold her because if I did it meant she wanted to feed and the pain was worse than childbirth. A hundred times worse than having the baby in the first place."
But it can go wrong. The concern of anaesthetist Graham Sharpe was sparked by recommendations from the health watchdog, after an eight-day-old baby needed emergency care for bleeding following the procedure by a midwife in 2016.
Dr Ayers said she had heard of two or three other cases of babies or children needing hospital care after the tongue-tie cut.
"We have had case reports of post-operative bleeding, post-operative scarring and of course the pain and the stress of the procedure and some infants having an oral aversion after this."
A Wellington midwife and lactation specialist, Cheryl Ganly-Lewis, did the cut for 12 years until recently, and now works with two dentists who do it after an assessment with the baby and the parents.
"We don't do any releases here unless there's a clinical indicator, and by that I mean there'll be feeding issues, there may or may not be pain, there can be a lot of cholic going on."
Mrs Ganley-Lewis said so far this year a third of all of the babies brought to her have had the snip somewhere else first, but it hadn't solved the feeding problem.
"The mothers still cannot feed the baby. That's what brings women to me: It's 'I cannot feed my baby. If you can't help me today I'll have to give up because I can't keep going'."
College of Midwives midwifery adviser Jacqui Anderson said midwives only do the simplest tongue-tie surgery, but they were well-trained and able to do it safely.
"It's not really easy for us to tell at this point in time whether they're done unnecessarily, whether there's too many, whether there's too few because we haven't got some consistent processes and assessment tools that are being used throughout the country."
But both dentists and midwives are indicating they would back a team approach to the issue in future - along lines being used successfully in Canterbury for the past two years.
That may be welcome news to the Health Ministry, which wouldn't be interviewed but is considering whether guidelines are needed on the hot-button issue.