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What is the tongue brake?
The tongue frenulum is a small bridle that connects the tongue to the floor of the mouth. We all have one, its length and appearance may vary. “It happens that this frenum is abnormally short, sometimes thick, it can restrict the mobility of the tongue”, explains Dr. Gisèle Gremmo-Féger.
What are the consequences of a too short tongue frenum?
A frenulum that is too short can make sucking more difficult, make it difficult for the infant to latch on, and cause pain in the mother due to lesions on the nipples.
When is the tongue frenum judged to be too short?
The diagnosis is made in the maternity ward or during the first weeks. And is regulated by an incision, with scissors, of the brake. A general practitioner, a pediatrician or an ENT doctor performs this frenotomy, a rapid operation without anesthesia, the frenum being poorly innervated and vascularized.
Tongue frenulum operations, or frenotomies, on the rise
Does frenotomy affect many babies? “It concerns 4 to 5% of babies. However, in recent years we have witnessed an overdiagnosis of anomalies of the tongue frenulum. It’s an aberration, says Dr Gremmo-Féger. The pediatrician does not hide her annoyance at this “epidemic” of unnecessary operations. How then to explain the increase in too short brake diagnoses observed by perinatal pros? These incisions seem to have become a response as rapid as mechanical to various difficulties related to breastfeeding.
In France, if the figures are lacking, this trend is quite clear abroad. In the United States, for example, a study carried out on hospitalized infants showed that the number of frenotomies increased fivefold between 2003 and 2012.
The testimony ofAnaïs *, mother of Lenny, 9, Logan, 3, and Anya, 1.
“I canceled the operation at the last moment. “
“On the advice of an osteopath, we consulted an ENT for Logan. At 1 month, he had colic linked, according to him, to a problem with the frenulum of the tongue. The ENT programmed the intervention without telling us more. I did some research. On D-Day, I was not confident, I had a lot of questions. Faced with our hesitation, the ENT got angry. We canceled the operation at the last minute. I did well to listen to myself: I breastfed my son for two and a half years, without problem, without pain. “
* His blog: mafamilleauvegetal.com
Tongue frenulum surgery: does it make breastfeeding easier?
“Faced with breastfeeding problems, I plead to avoid surgery as much as possible,” says Carole Hervé, IBCLC certified lactation consultant, for whom this question of the too short tongue frenulum comes up more and more during consultations about problems breastfeeding. Indeed, the multiplication of blog articles and discussions on forums has the effect of increasing the frequency of interventions which have until then remained fairly anecdotal. In fact, “many breastfeeding difficulties are linked to malposition, which is a source of pain and discomfort for the mother, and for the baby results in difficulty in breastfeeding. “
Before examining the baby’s tongue frenulum, the lactation consultant observes the reflexes and positions adopted by the mother with her baby. Most of the time, the difficulties are resolved once the duo has found their position! Without the length of the tongue frenulum necessarily being at stake …
Once the tongue frenulum has been cut, if the child is to have rehabilitation sessions, we have to face the facts: the frenulum was not the cause of the problem.
Osteopathy, to take care of a short tongue frenulum
If breastfeeding difficulties and pain persist, look for “mechanical problems” from which the newborn may be suffering. Thierry Leboursier, pediatric osteopath, explains that he receives more and more mothers evoking a problem of tongue frenulum or whose baby has had a frenotomy, without the breastfeeding concern being resolved: “I will look for residual tensions intrauterine life and childbirth in the skull and cervical level. I gently handle the baby to release these tensions and help him open his jaw better, turn his head better, suck better and feel better. “
Tongue frenulum surgery, or frenotomy: as a last resort
And if nothing helps, the lactation consultant, ENT doctor or pediatrician will examine the mobility of the tongue and this famous brake to establish the clinical diagnosis: when the baby really has a restrictive brake that prevents him from sucking, there is no alternative to the operation. But it is quite rare!