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Better Care For Babies With Tongue-tie

Babies born with tongue-tie will be assessed and treated consistently under new guidelines released by the Ministry of Health, Associate Minister of Health Dr Ayesha Verrall announced today.

Around 5% to 10% of babies are born with a tongue-tie, or ankyloglossia, in New Zealand each year. At least half can still breastfeed normally, but around 2% to 5% of babies may have difficulty breastfeeding.

“Tongue-tie is when normal movement of the tongue is restricted by a very short or tight band of tissue. In some tongue-tied babies, the tissue needs to be cut to allow more movement. However, this is not needed for all of them,” Dr Ayesha Verrall said.

“So far there has not been any national advice relating to tongue-tie, and there may also be an unnecessary focus on the condition which may delay the management of other feeding related issues in babies.

“We have heard the recent calls for urgent action in this area, with some health professional reporting an increase in the number of surgeries.

“The Ministry of Health held a meeting with health professionals on it in April last year to hear different viewpoints and develop consistent guidance.

"Several issues were identified including a lack of consistent information for consumers about the risks and benefits of surgical treatment for tongue-tie; inconsistent and inequitable access to treatment when indicated.

“While the surgery is minor, it’s not risk free. With the new guidance, parents can be reassured that no matter who is treating your baby or where you live, all health professionals are following the same advice to refer, assess and treat the condition.

“The guidelines also recommend that all practitioners performing the surgery continually audit their practice, and all referrals for breastfeeding issues related to tongue-tie are documented,” Dr Ayesha Verrall said.

Notes –

National Guidance for the Assessment, Diagnosis and Surgical Treatment of Tongue-tie in Breastfeeding Babies is available here.

Tongue-tie can only be surgically treated by a registered health professional who is trained in the procedure. This can include registered midwives, registered medical practitioners and dental surgeons.

The guidelines were agreed with input from organisations who are most involved in frenotomies including: New Zealand Dental Association, Plunket, La Leche League New Zealand, Royal New Zealand College of General Practitioners, New Zealand Lactation Consultants Association, New Zealand College of Midwives, Medical Council of New Zealand, Royal Australasian College of Physicians, Paediatric Society, New Zealand Breastfeeding Alliance, Midwifery Council New Zealand, Dental Council New Zealand and Medical Council New Zealand.

It is difficult to quantify the number of babies diagnosed with tongue tie and the number of frenotomies performed. This is because not all assessment, diagnosis and treatment of the condition is conducted within DHBs. There are a number of GPs, private lactation consultants and dental surgeons performing this service in the community and there is no obligation for them to provide data to the Ministry.

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