Baby tongue-tie surgery a concern

The health and disability commissioner (HDC) is recommending the Ministry of Health issues guidelines for midwives carrying out tongue-tie procedures performed on babies suffering feeding difficulties.

It followed an incident in 2016 where an eight-day-old baby was bleeding for hours after a tongue tie procedure was carried out by a midwife.

She did not provide the information pamphlets or explain nonsurgical alternatives to the frenotomy procedure that involves cutting the band of tissue connecting the bottom of the tongue’s tip to the floor of the mouth, the report said.

The mother was upset and called her mother to discuss the surgery, and asked to speak to her midwife, but the report says her request was ignored.

The midwife performed the surgery, cutting ‘‘deeply in to the floor of the mouth and the muscle underlying the tongue’’, the report says.

‘‘She did not perform the frenotomy with reasonable care and skill and, as a result, breached Right 4 (1) of the Code of Health and Disability Services Consumers’ Rights.’’

The baby’s wound started bleeding immediately, and after 15 minutes the midwife called an ambulance.

‘‘[She] could have advocated further for [the baby’s] transfer to hospital when the first ambulance was called. Adverse comment was made about her failure to do so,’’ the report said.

When the ambulance arrived, the consultant applied silver nitrate to the baby’s wound and the bleeding then stopped.

Later that day, the bleeding started again and another ambulance was called.

The baby was transferred to hospital, a journey that took over an hour, and the wound was repaired surgically.

The report said the consultant should provide a letter of apology.

It was also recommended the Ministry of Health consider formulating a position on the tongue-tie procedure, and consider developing guidelines for midwives.

Midwifery Council midwifery regulation and outreach deputy registrar Dr Susan Calvert said their first priority was safety.

Calvert said midwives were educated to look at a wide range of techniques and options to assist women to breastfeed.

The frenotomy required parental consent and parents to be informed of risks, benefits and alternatives, she said.

‘‘Because it is a surgical procedure, any midwives trained to perform frenotomy are required to undertake all the required processes as per the HDC’s act to ensure informed parental consent has been obtained prior to undertaking the procedure.’’

‘‘Midwives were educated to look at a wide range of techniques and options to assist women to breastfeed.’’ Dr Susan Calvert said of the procedure.