"One can only wonder in the face of the spectacular increase, in France and in the world, of lingual frenotomy" in infants, regretted at the end of April in a press release the Academy of Medicine, the body which carries the consensus of the medical knowledge in France.

What does this technical term mean?

To the fact of giving a scalpel or laser blow under the tongue to give it more freedom by incising the frenulum which connects it to the bottom of the mouth.

It is "an aggressive and potentially dangerous gesture for newborns or infants", insists the Academy of Medicine, while many caregivers - pediatricians, ENT, speech therapists ... - had already worried at the start of the year in a joint press release.

All agree on one observation: more and more parents have such an operation performed on their child, despite its lack of interest in most cases.

"It probably started in the United States and Canada and then it spread," says AFP Virginie Rigourd, pediatrician at the Paris Necker hospital.

A sign of its popularity in the English-speaking world, the number of frenotomies has quintupled over the past ten years in Australia.

Without being able to give such precise figures, the French doctors note that the movement also wins the parents whom they see in consultation.

A simplistic answer

"It's not something new, it's been several years since there is this craze," says Dr. Rigourd.

Where does this idea come from to parents?

According to the pediatrician, two types of actors, both outside the medical sphere, are generally involved: osteopaths and lactation consultants.

Most often, in fact, it is to facilitate breastfeeding that parents request this operation, even if other considerations are sometimes at work: avoiding pronunciation defects, digestive problems...

The fashion for frenotomy is part of a resurgence in breastfeeding popularity in recent years ANDREJ ISAKOVIC AFP/Archives

The frenotomy trend is part of a resurgence in the popularity of breastfeeding in recent years, encouraged by public health institutions such as the World Health Organization (WHO).

"There is a return to breastfeeding (but) there is a lack of well-trained staff to be able to inform mothers, so there is an upsurge in problems", notes Virginie Rigourd, citing for example pain in the mother .

But frenotomy is a simplistic answer to problems that are often complex to treat, contrary to what many breastfeeding counselors claim.

"To miss out on a restrictive brake is to jeopardize breastfeeding and the health of babies and mothers alike", thus assures a lactation consultant on her website, offering online training on the subject for a hundred euros.

However, this is far from being the case, according to a study carried out by Cochrane, an organization highly respected in the scientific world and which compiles numerous works on the same subject by regularly updating its conclusions.

"Always better to cut"

"No study has been able to prove that frenotomy allows successful long-term breastfeeding", concludes this work, which also underlines the low quality of the studies carried out on the subject.

The interest of this operation is therefore far from proven in the event of a breastfeeding problem.

However, even more aberrant, some parents are offered to have it carried out when they have not reported any concern.

This is the case of Léa, who saw a Parisian osteopath when her son was born in 2018 for a simple check-up.

His interlocutor suggested that he incise a tongue brake considered "too thick" in the child.

"It was kind of preventive: + We don't really know why, but it's always better to have it cut +", reports Léa, who did not follow up on this suggestion but understands that other young parents there yield.

"You need everything that is best for your child: if you are told that having your child's brake cut is the best, even for no obvious reason, you go for it".

© 2022 AFP

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