New Zealand is witnessing a surge in demand for tongue-tie (ankyloglossia) surgeries among newborns, driven by consumer interest and anecdotal evidence that the procedures can resolve breastfeeding difficulties. However, experts and health officials are raising concerns about the lack of robust data on the efficacy of these surgeries, the potential for overdiagnosis, and the absence of standardized training for the professionals performing them. ### A Growing Trend with Uncertain Benefits The article highlights that while some babies do benefit from frenotomy procedures, there is no consensus on the effectiveness of these surgeries. The Ministry of Health released its first national guidance on treating tongue-tie in 2020, acknowledging the need for better data collection and an audit to assess long-term effects. Despite this, data collection remains fragmented, and no national database exists to track the number of procedures or their outcomes. ### The Role of Midwives and Other Professionals Midwives, who are not traditionally trained in frenotomy, are increasingly performing the procedure after completing additional courses. Dr. Graham Sharpe humorously notes that the list of professionals performing the surgery is 'growing,' including blacksmiths and airline pilots, though this is likely an exaggeration for effect. Midwives are observing a 'consumer-driven demand' for these procedures, with parents seeking quick fixes for breastfeeding challenges. ### Concerns Over Training and Safety Dr. Yvonne LeFort, a specialist in breastfeeding medicine, emphasizes the importance of proper training and the risks associated with the procedure, including bleeding, infection, and oral aversion. She notes that while the procedure is often referred to as a 'snip,' it is a surgical intervention that requires careful execution and informed consent. ### The Need for National Data and Regulation The New Zealand College of Midwives (NZCOM) is calling for a national dataset to track the number of babies diagnosed with tongue-tie and the outcomes of interventions. Currently, there is no comprehensive data on the long-term effects of frenotomy, making it difficult to assess its true efficacy. The NZCOM also advocates for a specialized, multidisciplinary approach to diagnosis and treatment, similar to the model in Canterbury, which includes thorough assessments and follow-up. ### Government Response and Future Steps The Ministry of Health has acknowledged the need for better data and has seen a reduction in the number of frenotomy procedures since the release of the 2020 guidelines. However, it has not mandated private providers to collect or share data with the ministry. The article questions whether this reduction is due to improved training or simply a decrease in consumer demand. ### Conclusion The article underscores the need for a balanced approach to addressing tongue-tie in newborns. While some babies may benefit from the procedure, the lack of standardized training, fragmented data, and potential for overdiagnosis pose significant challenges. Experts and health officials are calling for a national dataset, better regulation, and a multidisciplinary approach to ensure that procedures are performed safely and effectively, with the best interests of the child and family in mind.