Inside the Booming Business of Cutting Babies' Tongues | Hacker News Reader

Inside the Booming Business of Cutting Babies' Tongues

nytimes.com

23 pointspseudolus27 comments

Ah, the business of extracting money from naive new parents by charging them for unnecessary operations that often end up usually doing no significant good and risking major harm. The report of the "Tequila and Tongue Ties" event is just classic. It's circumcision all over again.

They do the same with sex-affirming surgery on babies when they are born with two or "undetermined" sexual organs (intersex). In many cases the "subject" (because that's how they are treated) ends with non-functional and painful mutilation which would not have happened if left alone. Instead, they could have then decided what to do later, on their own and with a lot less negative effects later in life. Edit: a link to what I am talking about https://www.hrw.org/report/2017/07/25/i-want-be-nature-made-...

The first person mentioned in the article was a mother of 4 who had breastfed 3 babies before without trouble.

These are not all rubes. The world is complicated and people seek advice from experts when they have trouble. Sometimes bad things happen, especially in areas that are poorly researched and rife with differing opinions.

When health is an industry driven by profit, the incentives don't lean towards better health for the public - they lean towards more profit for the ones who can charge for it.

https://archive.ph/t0WOy

This was recommended to my son last year when he was 4, no longer breast feeding. I can’t remember if it was the dentist or pediatrician who recommended it. Didn’t do the procedure; I have the same connective tissue in my tongue and never had any problems in life except I have a lot of belly gas…

LOL, it’s a real symptom apparently:

“Tongue-Ties and the Surprising Link to Constipation & Reflux”

https://tonguetieal.com/tongue-and-lip-ties-and-the-surprisi...

Is that link offered ironically? That source is clearly not objective.

yes

I am confused, so people who do not do research and work in a given field should be the only ones to talk about it?... sounds like a recipe for conjecture and assumption and opinion IMHO. If I read a study, I generally like to know that the authors are actively engaged and well informed and educated, experienced in the subject matter they are talking/writing about. This really has become a ..."damned if you do, damned if you don't, you can and you can't you will and you won't" (ala Mark Twain)...situation. The problem that absolutely DOES exist is that there is not ENOUGH research, which is why, presumably, so many are now working on research to fill in those knowledge gaps, and refine clinical understandings, and provide better care, better breathing, better feeding, better sleeping to babies and families globally. So long as the studies are being performed in accordance with the best practices in the field, and are in absolute alignment with the hippocratic oath. Are there cases being misdiagnosed? Yes, are there cases being mistreated? Also yes. BUT is a hard stop on studying, and learning more a good idea if we want things to improve?

I can't read the article, but if one has a tongue tie there can be serious life-long consequences. Basically if one is tongue tied, one's tongue will rest on the bottom of one's mouth. The mouth does not develop normally. The nasal passage way will be narrow. One will likely breath through one's mouth instead of the nose. This will lead to problems of the nasal passage not developing as it should. For one's health it is import to breath through the nose and not the mouth; read James Nestors book Breath. One will have breathing issues and likely sleep apnea. The tongue is supposed to rest on the root of the mouth and not on the floor of the mouth for it to develop properly. The sleep apnea normally gets worse; likely during midlife the sleep problem will effect job performance... Just from a speech impediment problem, it is worth it. I had a tongue tie release surgery (lingual frenectomy) as an adult. I had a release as a baby, but it only release the very front part so that it was barely enough to breast feed and I had speech problems because it was not fully released. After the surgery as an adult my pronounciation improved according to friends. It feels like my tongue can move as it should move. My mouth and nasal passage way did not develop as it should as a child and I am considering major surgery (MMA, EASE procedure, functional rhinoplasy) to correct; not something that one wants to do if one can correct it early with a lingual frenectomy and oral myofunctional Therapy. That being said, one should have it done by somebody that is competent is airway focused and not somebody trying to make extra money. It is normally paired with myofunctional therapy for about 6 weeks before and after the surgery. On another note, I have tuned into myofunctional podcast run by dental hygenist; they said that the can usually determine whether one is a mouth breather or a nasal breather by the hygene of the mouth...

Forgot to mention that a sign of underdevelopment is the need for braces. I was borderline needing braces as a kid and I will be getting them as an adult to help fit my tongue in my mouth better. Much better to not need braces (at any age) or major surgery as an adult.

It shocks me to see the end game of a culture where the ONLY incentive is financial gain. Doctors performing unnecessary surgery making 90k per week. Shameless.

And everyone is making money, laser makers etc, everyone else doesn't dismiss these people as unethical, but jump on the band wagon: if there's a market, it's fulfilling a want, right? Who am I to judge and I can make money too, right? It's harmless, right?

Late stage capitalism at its worst. Everyone profiting from everyone else to the bottom of the chain: the baby that didn't ask to be part of this trainwreck of a system.

The only way around it is less barriers to entry but that's a hard bridge to cross.

Why the rush to blame capitalism when simple human cultural memeing is at play? Medicine has fads. They are often stopped or started by one or two individuals. Various theories have been held out about various facets of medicine, and doctors often split into camps until they reconvene / one is proven wrong, etc. There is no need to even involve money yet as simple professional recognition and the desire for human popularity is at play. For example, basic research reveals that even in countries with socialized systems, tongue ties seem to be a thing that people now have

For example, the NHS has a whole page on it, with a link to an industry association to help you find a practitioner. Now, it would make sense that the doctors themselves wanted the procedure done (they get paid), but why would the NHS, who loses money, put this information out there unless certain doctors actually believed it?

I hadn't come across this "tongue ties" until now.

The article mentions that it is a condition that does exist even though is pretty rare. The fact that it is a recognised health condition should be enough for the NHS to put the information out there.

The other side of it is doctors who diagnose and operate.

Firstly, do you have any evidence that spurious diagnostics and operations are actually happening on the NHS at a rate that could be construed as either malice or rampant incompetence vs simple error? The article describes a situation where one of those (or both) is likely at play.

Secondly, if doctors are paid per procedure, how is that any different than a purely private system? The doctors's incentives go towards doing more of the procedures. Top that with the fact that the patients/parents have no financial incentive to avoid the operation, and you get a double whammy. The worst incentives of privatised health care topped with no (financial) incentive to stop the malpractice from happening.

> Late stage capitalism at its worst.

Any evidence that ignorance, greed, and opportunism is unique to "capitalism" or "late stage capitalism"?

Seems to me you are just making an observation about human nature, which manifests itself in any and all economic systems.

I think the argument that humans are naturally willing to harm infants for personal gain is not at all true. Generally, harming other humans, especially young humans, is deeply traumatic to most of the species. Harming children for personal gain, particularly economic gain, stands to ask why people stand at all to gain economically when committing harm.

Never attribute to malice what is better explained by stupidity. Often doctors just take wild guesses and use their positions of authority to make it seeem as if they know what they're doing. This is a historically problematic part of the profession and has led to all kinds of known harms. For example, the deaths of laboring women in early maternity wards by doctors who 'knew best'.

> I think the argument that humans are naturally willing to harm infants for personal gain is not at all true.

Who is making that argument? There isn't even agreement on the assertion of "harm" in the particular context of the original article. The road to hell is paved with good intentions, as they say.

I guess you're being downvoted by the people who don't realize that greed was recognized as one of the major human failures long before capitalism was invented...

> "Late stage capitalism at its worst."

You're literally posting on a site paid for by a venture capital fund who's audience is startup hackers and other venture capital people. Why are you here on HN if you dislike capitalism?

I think it's fine to invest in say battery technology.

In Europe IIRC, for example, doctors are not allowed to advertise. Not considered ethical.

In this article, the for profit medical system has placed ethics so far behind money. It's not just one outlier doctor , it's a whole system.

Maybe I overreacted. But to me something is wrong when basic human decency comes in second in the helping professions.

Well, for us it was a blessing. My daughter destroyed my wife nipples, to the point she was unable to breastfeed due to pain. After the surgery my wife noticed immediate relief and it went pain free after another week. She proceeded to breastfeed her for 2 years.

I do believe medicine driven by money is really really bad, just reporting our experience.

We had this problem too, it wasn't a tongue tie, he just had trouble latching. A doctor looked under his lip and said its "borderline" whatever that means and set us up with a ENT specialist. We missed the appointment and I'm glad we did. Inflicting pain on your infant and modifying their body is not something to be taken lightly. I looked in there, it all looked pretty normal to me.

She pumps and feeds him the milk from a bottle. It was a workable solution. He breastfeeds directly sometimes, he's used to the bottle so it's a little harder for him but it's fine, just a mild inconvenience.

The positive out of this is that he never became a pacifier addict, he couldn't keep it in his mouth without assistance. I think probably it will have no impact on his life as he grows at all.

It was really heavy from the point of view of pain indeed.

In our case our daughter was identified as both having a tongue tie and a lip tie.

I can't tell if it's true or not, but I can tell the surgery did save my wife connection with my child, after that they spent a lot of time together.

The horrible part is having to rub on the wound for the next 2 weeks to prevent healing. I had to do that and it was devastating.

Still worth though, both the my daughter and my wife were heaving serious problems due to this.

It was suggested to my wife to get our daughter's tongue tie taken care of when she had trouble with breastfeeding. I said it sounded like bullshit with no scientific basis, but we were desperate parents with little recourse and lactation consultants were unhelpful with suggestions like suffocate your baby with your breast until they latch. So I said if she felt like it would help she could do it, because sometimes science doesn't have all the answers. It didn't help, and our child still struggled with breastfeeding. I felt really angry at the medical establishment after that, and my feelings towards the medical establishment have not improved. This is just the first incident in which the medical establishment failed my daughter, and I think that pediatric care in this country is in absolute shambles. The only thing I can figure is that the doctors who go on to become pediatricians must not have been good at any other specialties so they decided to work with children because they couldn't screw it up too badly. Remember, this is still the same field where doctor's claimed babies couldn't feel pain until the 90s.

The medical establishment will fail you every step of the way if you put faith in it. If you use it as a tool to inform your judgment, take any form of body modification very seriously you can utilize it. If you just trust and listen it will always fail you. From thalidomide to ritalin to this, the truth is that it's not much different from alchemy or blood letting, it's a little more advanced but nowhere near as much as we think. We think of medical science as some infallible science and our time as some future where we know the answers now and we have almost figured it all out, that is not true. Inform your judgment, take things seriously and medicine can be useful to you.

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