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Risk Learning Certified Faculty is a global collective of brilliant, experienced professionals with a passion for helping others understand, manage and mitigate risk exposure for individuals and organisations

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The Controversy Over Tongue Surgery for Infants

To the Editor:

Re “A Booming Industry of Cutting Babies’ Tongues” (front page, Dec. 21):

This article describes a surgery performed on babies who are born with their tongues attached too tightly to the bottom of their mouths. One needs only to note that there is not a single substantive profile in the article of a family that had a positive experience with the procedure — a statistical majority — to understand that the reporters are fearmongering.

Their article poisons the well against not only a procedure that can provide relief to breastfeeding parents and babies who are having difficulty feeding, but also against lactation consultants, pediatric dentists and medical professionals described as part of this “booming industry.”

As an internationally board-certified lactation consultant, I am glad to clarify that in my experience, laser tongue-tie surgery is never the first attempt at resolving feeding issues in infants. We work diligently to create feeding plans and strategies that work for both parents and babies, often providing support in cases where families have been ignored by their primary-care team.

The only “kickbacks” most of us receive when we refer a client to a pediatric dentist are holiday cards and the testimonials of grateful parents.

Heather ONealMorgantown, W.Va.The writer is an advanced-practice registered nurse and a certified nurse-midwife.

To the Editor:

The article on cutting babies’ tongues overlooks a major issue contributing to the rise in tongue-tie diagnoses: a general lack of education and awareness about breastfeeding’s significant challenges.

It is a common myth that breastfeeding is seamless. In fact, it is often a very long, painful, complicated and exhausting process. Many first-time parents, myself included, are shocked to discover this. It is especially true for those of us already struggling with postpartum depression. We will do almost anything a health care professional recommends to help us and our babies.

Incorporating lactation consultations into obstetric visits is one solution, but medical institutions and practitioners need to do much more to prepare new parents. With the right resources and support, we will be empowered to make informed decisions about this procedure.

Sara KoenigSilver Spring, Md.

To the Editor:

Your exact article on the dramatic uptick in procedures to cut tongue-ties is disturbing and disheartening.

I’m grateful that the article highlights what can happen when a medical business model benefits from overdiagnosing. It’s unfortunate and infuriating that this procedure has caused unnecessary harm.

But I also worry that the pendulum will swing so far in the other direction that families will be scared to even explore the possibility of a tongue release. There are many mother-baby duos who have benefited from this procedure when — and this is key — it is indicated and performed by an experienced ear, nose and throat doctor, preferably one who is educated on breastfeeding.

My son and I are among those duos, and when I directed my 2014 documentary, “Breastmilk,” about families’ experiences with breastfeeding, I made sure to include a nonlaser tongue-tie release. Since then, I’ve been heartened to see that resources around nursing have become much more accessible.

Now, however, I am concerned that practitioners like the “evangelists” in your piece will undo that progress. For years, those who want to help mothers nurse have been similarly derided as crusaders. Such advocates can seem difficult because breastfeeding does not easily fit into our contemporary lifestyles.

Dana Ben-AriNew York

To the Editor:

While this is a very valuable article, detailing the forces driving surgical tongue-tie releases, it fails to include an important perspective.

I chose to clip my 10-month-old’s tongue-tie, even though she had no issues with breastfeeding. Tongue-ties can have an impact on sound production, as babies start babbling, and toddlers start saying words. This, in turn, can affect how they hear the sounds, which then influences how they learn to read and spell.

As a longtime educator and learning specialist, I’ve seen this many, many times. If a true tongue-tie is present, it is better to prevent these issues than have to remediate them.

Tara MallonSouth Orange, N.J.The writer is a certified learning-disabilities teacher consultant.

To the Editor:

As a pediatric occupational therapist and the mother of a child who had his tongue-tie released by Dr. Scott Siegel, the Manhattan oral surgeon mentioned in the article, I want to express my sincere disappointment and frustration with the content and tone of the piece.

I am not dismissing the pain and discomfort experienced by the families mentioned, but I find that is absolutely not the norm for a tongue-tie release. By highlighting these experiences, you are discouraging families from seeking a procedure that could dramatically Improve breastfeeding outcomes, not to mention later speech development.

I was able to breastfeed my son for 10 months, thanks to a procedure that lasted five seconds and healed within a couple of weeks. I couldn’t be happier with our decision to work with Dr. Siegel, and the children I’ve treated who have been his patients have also had overwhelmingly positive outcomes.

I would encourage the reporters to do a follow-up and speak to a variety of board-certified lactation consultants, speech-language pathologists and occupational therapists. The information presented in this article does not line up with the clinical opinions of many of these professionals, myself included.

Emma KlassenNew York

To the Editor:

Re “Homes Are Still Built by Hand. No Wonder They’re So Costly,” by Binyamin Appelbaum (Opinion, Dec. 19):

There is a longstanding tradition of factory housing in America. Thumbing through the beautiful reprints of Sears, Roebuck housing catalogs of the 1920s and ’30s provides a good cross-section of what was available and at what price a hundred years ago. Driving through many towns and cities, we can observe these structures all over the place. They have stood the test of time.

All components, down to the last nail, were usually brought to their locations in railroad boxcars and assembled on site. In those days, the railroad tracks formed a latticework over the American terrain so that housing could be brought to many places. The Sears housing is aggregated close to train stations.

This railroad system is greatly diminished today, so getting housing to its desired location is now more difficult and costly. Sometimes we see part of a house being hauled on the interstate, but this is infrequent, expensive and mighty awkward.

Anne VohlReno, Nev.

To the Editor:

Binyamin Appelbaum’s article brought to mind a memory from 40 years ago. At that time, I worked in a building across from a small vacant lot. Those on my shift worked through Thursday, were off on Friday and returned on Saturday morning.

One of my co-workers arrived one Saturday morning wearing a puzzled expression. Sidling over to me, she asked, “Was there a house across the street when we left on Thursday?” No, in fact, there hadn’t been, but two days later, there was one. And it still stands in the same location.

Mr. Appelbaum makes some great points about why we should take manufactured housing more seriously.

Ellen LodwickSilver Spring, Md.


 




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Educación

¿Qué es un Seguro Educativo? La Comisión Nacional para la Protección y Defensa de los Usuarios de Servicios Financieros (Condusef) define al seguro educativo como un instrumento financiero, de supervivencia del menor, en el que durante determinado tiempo el padre, madre o tutor paga una prima (cantidad mensual, trimestral, semestral o anual) y el beneficiario recibirá al cumplir 15, 18 o 22 años, una suma asegurada para continuar sus estudios.

Seguro Educativo

Es un plan a través del cual garantiza un capital que ayudará a pagar la educación universitaria o de posgrado de sus hijos además de brindarle protección por Fallecimiento o Invalidez. Puede asegurar a otra persona que tenga como interés común la educación del menor asegurado mediante la opción mancomunada. Tiene la opción de elegir la edad en la que el menor recibir el beneficio, ya sea a los 18 - 22 años además del tipo de moneda a contratar: nacional, dólares americanos o udis, entre otros beneficios. Contiene básicamente tres componentes: Ahorro. Son las aportaciones periódicas denominadas primas para alcanzar la suma asegurada. Seguro. Cubre el riesgo contra invalidez o fallecimiento de los padres o tutores, el cual podría afectar el cumplimiento de la meta. Inversión. El ahorro acumulado crece con el tiempo para que no

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© ARM Seguros 2017

Educación

¿Qué es un Seguro Educativo? La Comisión Nacional para la Protección y Defensa de los Usuarios de Servicios Financieros (Condusef) define al seguro educativo como un instrumento financiero, de supervivencia del menor, en el que durante determinado tiempo el padre, madre o tutor paga una prima (cantidad mensual, trimestral, semestral o anual) y el beneficiario recibirá al cumplir 15, 18 o 22 años, una suma asegurada para continuar sus estudios.

Seguro Educativo

Es un plan a través del cual garantiza un capital que ayudará a pagar la educación universitaria o de posgrado de sus hijos además de brindarle protección por Fallecimiento o Invalidez. Puede asegurar a otra persona que tenga como interés común la educación del menor asegurado mediante la opción mancomunada. Tiene la opción de elegir la edad en la que el menor recibir el beneficio, ya sea a los 18 - 22 años además del tipo de moneda a contratar: nacional, dólares americanos o udis, entre otros beneficios. Contiene básicamente tres componentes: Ahorro. Son las aportaciones periódicas denominadas primas para alcanzar la suma asegurada. Seguro. Cubre el riesgo contra invalidez o fallecimiento de los padres o tutores, el cual podría afectar el cumplimiento de la meta. Inversión. El ahorro acumulado crece con el tiempo para que no pierda su poder adquisitivo