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  • Making Sense of Studies That Claim Benefits of Frenotomy in the Absence of Classic Tongue-Tie

    Author(s)
    Douglas, Pamela
    Griffith University Author(s)
    Douglas, Pamela S.
    Year published
    2017
    Metadata
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    Abstract
    By performing an in-depth analysis of one high profile example, this article aims to help breastfeeding support professionals understand the methodological flaws that characterize recent studies claiming to show the efficacy of frenotomy for the diagnoses of posterior tongue-tie and upper lip-tie. The example study does not address definitional confusion or control for the effects of the passage of time. It does not consider the effects of caring attention, validation, and lactation consultant support. It also does not consider the extensive research over the past three decades that has established that reflux in the first ...
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    By performing an in-depth analysis of one high profile example, this article aims to help breastfeeding support professionals understand the methodological flaws that characterize recent studies claiming to show the efficacy of frenotomy for the diagnoses of posterior tongue-tie and upper lip-tie. The example study does not address definitional confusion or control for the effects of the passage of time. It does not consider the effects of caring attention, validation, and lactation consultant support. It also does not consider the extensive research over the past three decades that has established that reflux in the first 6 months of life is benign, even though increased reflux frequency may correlate with unsettled infant behavior. The study authors relied on the hypothesis that reflux is caused by excessive air swallowing in infants with poor latch due to posterior tongue-tie and upper lip-tie, which lacks credible physiological mechanisms or supporting evidence. The authors’ claim that conducting a randomized controlled trial to investigate the efficacy of frenotomy would be unethical contradicts the basic principles of good science. This article argues that our breastfeeding women and their babies deserve the most rigorous scientific methods available, and acknowledgment of the biases inherent in less rigorous research, if we are to make appropriate decisions concerning intervention with frenotomy and to prevent unnecessary oral surgery.
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    Journal Title
    Journal of Human Lactation
    Volume
    33
    Issue
    3
    DOI
    https://doi.org/10.1177/0890334417706694
    Subject
    Nursing not elsewhere classified
    Clinical Sciences
    Nursing
    Public Health and Health Services
    Publication URI
    http://hdl.handle.net/10072/352436
    Collection
    • Journal articles

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