The Rise of Tongue Ties: What's Behind the Increase?

In the 15th century when new mothers were struggling with breast feeding, the first place midwives would check was the newborns mouth. These skilled midwives would look for any restrictive tissue on the tongue, and if they spotted a problem, they'd perform a frenectomy (or tongue tie release) right then and there. In the absence of modern day tools like a laser, they would instead use one very long, very sharp fingernail.

Thankfully, we've come a long way since those renaissance days! Nowadays, new parents have a wealth of resources at their fingertips—no fingernail surgery required! We have lactation consultants, feeding specialist, newborn care specialist, occupational therapist, pediatricians and neonatologist ready to support our little ones. These professions are very needed and in may ways critical for supporting a newborn. However, most of these specialists often overlook the mouth.

In the late1990s, we turned a corner on a simple but significant oversight. Exciting new research started to reveal how a straightforward oral examination could lead to major improvements in quality of life. From 1997 to 2012, the number of diagnosed newborn tongue ties skyrocketed by ten times, and the numbers keep climbing! The healthcare community was really starting to gain perspective and raise awareness about this important issue.

The 90s really opened our eyes and helped spread the word, which is a big part of why we're seeing more diagnoses today. With more providers getting educated and really looking into these tissue attachments, it's made a difference! Plus, the 90s played a role in another reason for the rise in diagnoses too, folic acid.

Back in 1992, the United States Public Health Service started recommending folic acid for pregnant women. This was based on some important research that showed it could help lower the risk of neural tube defects. These defects happen when the protective structure around the brain and spinal cord doesn’t close as it should during early development. The good news is that folic acid plays a key role in helping our bodies promote fast cell growth and can help smooth out any hiccups during that process!

While folic acid has its benefits, one thing to keep in mind is that its effects on rapid cell growth aren’t limited to just the areas that need it. It gets distributed throughout the whole body. So, as we work to protect our little ones from serious health issues, we might also be increasing the chance of tongue-ties, lip-ties, and webbed digits. Personally, I think this risk is definitely worth taking! Plus, correcting things like a tongue-tie is usually pretty straightforward and can be done quickly in the office with the help of a myofunctional therapist.

To watch a posterior tongue tie surgery explanation click the link below

Rubin, G., Stewart, C., McGowan, L., Woodside, J. V., Barrett, G., Godfrey, K. M., & Hall, J. (2023). Maternal folic acid supplementation and the risk of ankyloglossia (tongue-tie) in infants; a systematic review. PLOS ONE, 18(11). https://doi.org/10.1371/journal.pone.0294042

Sato, K. (2020). Why is folate effective in preventing neural tube closure defects? Medical Hypotheses, 134, 109429. https://doi.org/10.1016/j.mehy.2019.109429

Smith, P. (2021, January 6). A Clinical Consensus on Tongue-Tie. Johns Hopkins Medicine. https://www.hopkinsmedicine.org/news/articles/2021/01/a-clinical-consensus-on-tongue-tie

Viswanathan, M., Urrutia, R. P., Hudson, K. N., Middleton, J. C., & Kahwati, L. C. (2024). Folic acid supplementation to prevent neural tube defects updated evidence report and systematic review for the US Preventive Services Task Force. Obstetric Anesthesia Digest, 44(2), 63–64. https://doi.org/10.1097/01.aoa.0001015916.41238.0c