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Restricted infant oral connective tissue: how this diagnosis became so common + who has (and hasn't) benefited. Dr Pamela Douglas February 2024

Dr Pamela Douglas18th of Mar 202419th of Dec 2024

This ia a 15 minute video on a complicated topic, on which I hoped to give you some context.

It's hard for parents to believe that so many conferences, research papers, and health professional and bodywork therapy businesses (not to mention social media discussions) could be getting things wrong. That so many references stuck at the bottom of articles could be misinterpreted. But this is what happens.

It's happened with other popular waves of diagnoses in breastfeeding babies in my life-time, and it's happened again with the over-use of tongue-tie diagnoses. It can only happen because clinical breastfeeding support remains a research frontier, because as health professionals we aren't really trained to critically analyse research and research methodologies, and because businesses in health become heavily invested in particular diagnoses and treatments, so that independent thinking is difficult (or to be frank, sometimes outrightly 'cancelled').

My article in Breastfeeding Medicine in 2013 was, as far as I am aware, the first publication in a medical journal to analyse the rise in the diagnosis of posterior tongue-tie. The ACIOR team that Professor Laurie Walsh and myself had brought together was the first to publish , in 2018, a consensus statement which specifically addressed the inappropriate application of diagnoses and treatments of lip-tie and buccal ties.

Selected references

Douglas PS. Re-thinking 'posterior' tongue-tie. Breastfeeding Medicine. 2013;8(6):1-4.

Douglas PS. Deep cuts under babies' tongues are unlikely to solve breastfeeding problems 2016. Available from: https://theconversation.com/deep-cuts-under-babies-tongues-are-unlikely-to-solve-breastfeeding-problems-54040.

Douglas PS. Tongues tied about tongue-tie. Griffith Review Online. 2016.

Douglas PS. Conclusions of Ghaheri’s study that laser surgery for posterior tongue and lip ties improve breastfeeding are not substantiated. Breastfeeding Medicine. 2017;12(3):180-181.

Douglas PS. Making sense of studies which claim benefits of frenotomy in the absence of classic tongue-tie Journal of Human Lactation. 2017;33(3):519–523.

Douglas PS. Special Edition: Tongue-tie Expert Roundtable. Clinical Lactation. 2017;8(3):87-131.

Douglas PS. Untangling the tongue-tie epidemic. Medical Republic. 2017;1 September:http://medicalrepublic.com.au/untangling-tongue-tie-epidemic/10813.

Douglas PS, Cameron A, Cichero J, Geddes DT, Hill PS, Kapoor V, et al. Australian Collaboration for Infant Oral Research (ACIOR) Position Statement 1: Upper lip-tie, buccal ties, and the role of frenotomy in infants Australasian Dental Practice. 2018;Jan/Feb 144-146.

LeForte Y, Evans A, Livingstone V, Douglas PS, Dahlquist N, Donnelly B, et al. Academy of Breastfeeding Medicine Position Statement on ankyloglossia in breastfeeding dyads. Breastfeeding Medicine. 2021;16(4):278-281.

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