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Randomised controlled trial of early frenotomy in breastfed infants with mild–moderate tongue-tie
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  • Published on:
    Response to the two letters regarding tongue-tie, from Dr Essex and Mr Mercer

    Dr Essex and Mr Mercer highlight many of the reasons why we undertook the Bristol Tongue Tie trial. Ankloglossia is a spectrum condition, which overlaps with 'normal' variation in anatomy, and milder forms do not result in feeding impairment. There is very limited evidence of the need for frenotomy in mild-moderate degrees of tongue tie. However, it is also true that at the severe end of the spectrum infants can be limi...

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    Conflict of Interest:
    None declared.
  • Published on:
    The child has rights!


    The tongue remains with in the boundaries of the mandible during suckling and so it is difficult to see the anatomical or the physiological basis for how a frenulectomy works in reducing breast and nipple discomfort during feeding. This randomised trial does not seem to assess the potential, positive psychological impact of the mother being told their child has had a frenulectomy. That is the question that...

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    Conflict of Interest:
    None declared.
  • Published on:
    Most tongue tie is the medicalisation of childhood

    Lawson's editorial and Emond and colleagues' article exposes potentially bad medicine: lack of knowledge of normal and variations of normal; lack of knowledge of the natural history of a condition; a desire to do something - Ulysses syndrome (1); medicalising the child by giving the condition a name; and then ascribing any improvement to the intervention, forgetting that association does not mean causation.


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    Conflict of Interest:
    None declared.