The Booming Business of Cutting Babies’ Tongues

from The New York Times I'm Sabrina. tavernes and this is the. [Music]. daily a times investigation has found. that doctors are increasingly performing. unnecessary medical procedures that. generate huge profits while often. harming. patients today my colleague Katie Thomas. on the forces is driving this emerging.

and troubling Trend in American. Healthcare and the story of one family. caught in the middle of. it it's Monday February. 19th so Katie tell me about this. investigation so I am a healthc care. reporter who writes about the kind of. intersection of healthc care and money. and I was working with two other. colleagues Sarah cliff and Jessica. silver Greenberg and together the three.

of us had long been interested in are. the medical procedures and the tests and. other things that we get when we go to. the doctor or into a hospital are they. always necessary but what we were really. interested in exploring was not just are. these procedures and are these tests Etc. are they necessary but in some. situations could they actually be. harmful to patients and so that's what. we decided to to try and take a look at. and so we had gotten started in our.

reporting when we got a tip and it was. from a mom in boisey Idaho and her name. was Lauren lavel hello gosh nice to meet. you Hi how are you and my colleague. Jessica silver Greenberg and I went to. her house to meet with her and where. does her story start I am a mom of two I. live in boisee my daughter June is four. and I have a a 17-month-old Flora her.

story starts when Lauren gets pregnant. with her daughter June so by the time we. got pregnant with June November of 2018. about eight months after we had the. miscarriage I think I was just more. hesitant and nervous than anything. Lauren and her husband had had trouble. conceiving and so they were so happy. when they learned that they were going. to have June and like both firsttime. parents they were also a little bit. nervous but being Tae and super prepared. I did all my homework we hired a.

doua I wanted an. epidural having an actal Tri birth. absolutely was not for me and you Lauren. is very organized she's always on top of. everything and she makes all sorts of. plans and she gets a lot of different. providers lined up ahead of time I. didn't know anything about breastfeeding. like zero things including one that she. has hired to help her with breastfeeding. where did you find out about her so I. asked ulla for a list of recommendations.

and she gave me a very short list at the. time there were very few lactation. consultants in the valley and Melanie. was one of them she ended up deciding to. work with Melanie henstrom who is a. local lactation consultant in Boise she. sold this package at the time I don't. know if she still did but it was like. prenatal visit breastfeeding. class and then she'll come to the. hospital and help you latch and then. she'll come to the house a couple times. after and I thought oh this sounds. perfect great you know I'm covered there. so one week after her due date she gives. bir.

and it was a difficult labor it took 24. hours Lauren was completely exhausted. but once June arrived the family was. very very excited to have her and I. remember June coming out and that. surreal feeling you have when you see. your first baby for the first time like. oh my God like there's a baby in the. room and June was a healthy baby but she. was having trouble breastfeeding she. would not latch like she wouldn't even. attempt she would scream it was the only. time she ever cried would if you tried.

to make her to. breastfeed so as her pediatrician was. making the rounds they noticed that June. was having trouble she and said that. June's tongue is really tight we can. clip it if You' like and that they could. clip it and what does that mean exactly. Katie clipping her tongue what it means. is that there's a small percentage of. babies whose tongue is very tightly. Tethered to the bottom of their mouth. and for a very small percentage of. babies their tongue is almost tied so.

tightly down that they can't nurse well. so it makes breastfeeding very difficult. if a baby has a tongue like this exactly. if you bottle feed your baby the baby. can basically adjust and make do but if. you want to breastfeed some babies have. trouble basically latching on to their. mother when they don't have that tongue. motion and so some version of clipping. these tongue ties has been done for. centuries midwives have been doing it. pediatrician s do it and traditionally.

what it's been is a very quick snip. right underneath the tongue just to. loosen up the tongue and traditionally. that procedure is extremely. straightforward there's little to no. follow-up care and basically the baby. naturally heals as it learns to. breastfeed and so we said okay you know. they explained that it was completely. painless they do it with scissors she. wouldn't even feel it and all of that. was true they clipped it I don't even. think she woke up but in June's case it. didn't seem to help much and she and.

Lauren were still having problems. breastfeeding. afterwards so while she's still in the. hospital she calls up the lactation. consultant that she had hired Melanie. henstrom just to let her know what was. going on and from talking to her on the. phone Melanie said that the situation. was actually much worse than Lauren had. thought and that Lauren's baby needed. another tongue tie procedure a deeper. cut under the tongue how did she make. this diagnosis Katie was it over the. phone how did she know this yes Lauren.

told us that it was it was from a phone. conversation and in addition to that she. also warned her that basically you know. Lauren and her husband should really. take this seriously and consider getting. it done because if she doesn't get it. fixed it could lead to a whole host of. problems Beyond just problems. breastfeeding she'll have scoliosis and. she'll suffer from migraines and she'll. never eat and she'll have a speech. impediment she won't sleep I mean just. like the long list of things over the.

phone and Lauren starts panicking I mean. first of all I felt I've never felt more. terrible in my life than that first day. or so after giving birth like the come. down from the hormones the drugs all of. it the sleep. deprivation and then you know here was. this baby we' wanted we were told we. probably would never have after one. miscarriage and she's so perfect like. the most beautiful baby i' ever seen and. you think that she has some deformity. that's going to ruin her but Melanie. says it's okay you know she has a. solution and she tells Lauren that.

there's a dentist in town who can handle. cases that are as severe as Junes a. dentist why a dentist well there's a. procedure that's done in a dentist's. office that's a laser surgery and. dentists use this high-powered laser. machine that can quickly cut the flesh. that connects the lips and the cheeks to. the gums so according to Lauren Melanie. tells her that by chance this dentist. has an opening.

because she said a family coming in from. Oregon had just canell their Saturday. appointment so I thought okay wow you. know people are coming in from Oregon to. see him so we talked about. it we both felt unsure but we said well. let's at least take the appointment and. then we can at least meet with the. dentist and also someone can look at our. mouth and assess and go from there. Lauren agrees to go in and and meet the. dentist like I think some people when. they hear the story think like like why.

would you believe that like it just. sounds so. scammy but to me there's a lot of things. that you hear in the hospital that sound. insane like it's no different than. someone saying like your baby's orange. because their Billy Rubin their levers. are too high so we got to go put them. under these lights like that sounds. insane that sounds more insane than you. know your baby's having a hard time. eating CU their tongue is too tight and. it needs to be cut like that seems. rational actually um and all of this. seemed really weird to Lauren at the. time but you know in the context of the.

hospital and having a baby lots of. things about Healthcare are weird so one. day after they got back home from the. hospital Laura and her husband pack up. the car and go to the office early in. the morning you know I was wearing my. Hospital diaper and an ice pack took the. elevator up to his office and it's and. what happen so Melanie greets them at. the door they sign some paperwork and. pretty soon the dentist Dr Samuel zinc. arrives and and then he like very.

briefly you know very briefly looks in. her mouth and is like yeah she's got you. know whatever however he classified it. grade four whatever he says class 4 and. she has a lip tie which you know that. had never been mentioned to us before so. it's very much like on the spot like. this new piece of. information you know pretty quickly the. dentist diagnosed June is having a. couple of ties he confirmed that she had. a tongue tie and he said it was severe. he also said that she had tightness. under her top lip called a lip tie and.

so the baby actually needed to get two. cuts and again Lauren said that the. dentist and the consultant told her how. important it was for her to do this for. her baby one of us says like you know. what happens if we don't do the. procedure like what are our Alternatives. and it was like basically like there's. no alternative like you have to do this. otherwise like again long La so Lauren. and her husband decided to do. it but before the proed procedure starts.

Melanie actually stopped Lauren from. coming into the room Melanie turned. around and put a hand on my shoulder and. said oh no and I said oh am I not going. with you she goes well we can't tell you. no but you know if you hear her. cry it'll impact your milk supply like. adversely what do I know so I said oh. okay and she pulled out the white noise. machine and said what do you want to. listen to and I had no idea what she was. talking about had no idea what it was.

and so then she just turned it on white. noise and left what happens next is. Melanie turns on a white noise machine. in the room and that was the moment that. I was. like get your baby and get out of here. and I didn't listen to it it was like. all of my mom intuition firing being. like this isn't right you know it's like. I don't know how to describe it but like. a full body you have to get your baby. and get out of here and I just ignored.

it she said her maternal instincts. really kicked in and she just had this. instinctive fear about the procedure and. whether June would be. okay but the procedure itself was very. quick within just a couple of minutes. Melanie returns with June and she was. screaming like. screaming and so worked up this was like. hysterical inconsolable. and she was also choking on something.

like gagging and June was so worked up. Lauren had only had her for a couple of. days but she said that this was on a. different level than any other way she. had ever seen June crying and June just. wouldn't stop crying and she looked over. to Melanie and Lauren said that she. remembered Melanie saying this was very. typical and so they pay the dentist they. pay $600 for the procedure and then they.

go home and what happens over the next. several days June did not get better you. know as Melanie had assured them you. know she was basically inconsolable. Lauren said just crying hysterically and. Lauren and her husband you know they. don't know how to comfort her they're. they're new parents they've only had a. baby a couple of days and you know. they're they're almost beside themselves. there was nothing we could do and I. remember finally I said like this is not.

normal we're going to the emergency room. and they decided to go to the emergency. room where a doctor looks inside jun's. mouth and finds a large sore in in her. mouth that he says is probably causing. her so much pain and so he said you know. it breaks my heart to see a sore that. big in a baby this small it was like the. floodgates opened and like there was. nothing but guilt and shame like.

unmanageable guilt and shame like what. have we done who are these people what. have I done to my baby will she ever be. the same like what did I do so at this. point Lauren is really understanding. that her intuition about this surgery. was probably right and that she and her. husband may have really made a mistake. with this what does June's recovery look. like so June never did end up feeding. successfully which was the main reason.

why Lauren and her husband had decided. to do this procedure that was the whole. point right that was the whole point. right and over the next couple of years. June had a number of issues that you. know there's no official medical. diagnosis for but Lauren has attributed. a lot of her behaviors to what had. happened to her when she was just a few. days old I mean you couldn't close the. fridge door too loud or else it would. like set her off or you know we would. attempt to take her for a stroller walk.

on the Green Belt which is the walking. path and she'd be asleep in her car seat. you know stroller and someone would try. to pass us on their bike and like ring. their Bell and it would startle her and. it would just like set her off so she. just was very very very. fragile so Lauren just wanted to get. answers and she really wanted to hold. Melanie in the dentist accountable so. she gathered all of the paperwork that. she had text emails other.

correspondents and she went to the Idaho. Board of Dentistry where she filed a. complaint against the dentist and then. she also went to a professional. organization that certifies lactation. consultants and filed a complaint with. them as well and did she get anywhere. with either of them at first no the. Idaho Dentistry board didn't want to. investigate and Lauren appealed and she. lost her appeal and she didn't initially. hear back at all from the lactation. board no one wanted to take. responsibility that's the thing no one.

wanted to stick their neck out there. what's the. alternative the story never gets told. and that's when she decided to reach out. to us and after our story came out the. lactation board finally told Lauren that. they were investigating Melanie and. Katie you guys were reporting the story. I'm assuming you reached out to both the. dentist and to Melanie what did they say. Beyond a very brief phone conversation. that I had with melie. in which you know she defended her work.

and she said that she had a number of. very satisfied customers she didn't. respond to detailed questions about. Lauren's story or the stories of her. former clients and Dr zinc did not. respond to our request for comment but. he did tell the Dentistry board that. Lauren's baby's procedure was uneventful. and that an extremely small percentage. of patients do not respond well to the. procedure and how big of an issue is. this Katie I mean how common is it for.

mothers to have an experience like. Lauren's so after we got the tip from. Lauren and we dug deeper into her story. we found ourselves really surprised by. how big this industry was for tongue Tai. releases and in part it's been driven by. this movement for breastfeeding and the. the breast is best campaign and a. growing number of parents who are. choosing to breastfeed their children in. turn that has sparked this big boom in. tongue Tai releases one study that we.

found showed that these procedures have. grown 800% in in recent years wow yeah. and also as we started talking to other. parents around the country we learned. that some of them had similar stories to. what Lauren had told us there's plenty. of instances where there's no harm done. to the baby at all when they get these. procedures but we also found cases where. babies were harmed you know where they. developed oral aversions which basically.

means that they don't want to eat. because they fear having anything put in. their mouth including a bottle we found. cases where babies became. malnourished uh had to be. hospitalized we found more than one. instance in which babies had to be given. a feeding tube just weeks after the. procedure so these sound so painful and. awful for a newborn these problems but I. guess you know there's always a risk. Katie in any medical procedure right I.

mean how much of this is just the risk. you sign up for when you agree that your. baby should have a surgery well that's. true I mean there's always a risk but. what you're supposed to do is weigh the. risks against what the potential. benefits of a procedure are and when we. really started drilling down into what. those benefits were and into the medical. research we found there just wasn't a. lot of potential benefit for these. procedures you know if if at all in many.

cases really so the procedures don't. have a medical reason to. exist that's right we reviewed all of. the best quality medical research on. this and you know other than that. old-fashioned snip under the tongue. which does show that in some cases it. can reduce pain for breastfeeding. mothers but otherwise all of this growth. and all of these other more invasive. procedures we found there just wasn't. good evidence that they help babies and.

the more we looked into tongue ties and. started to connect it to the other. reporting we were doing we started to. realize that it was driven by some. really big forces in our Health Care. system that really had the potential to. harm. [Music]. patients we'll be right. back so Katie we talked about the this. new surge in a procedure that surgically.

unties infants tongues from the bottom. of their mouths often needlessly. sometimes even harmfully and you said. your reporting found that this surgery. was actually part of a broader Trend. tell me about this trend and what's. driving it so that's what this. investigation was really about to find. the procedures that are doing. unnecessary harm to patients and to. really kind of understand why this is. happening you know like what's driving. the prevalence of these procedures and.

you know there's just a lot of. unnecessary surgeries out there but we. decided to Center our reporting on three. particular surgeries that had the. potential to harm patients in addition. to tongue ties we focused on a. particular Heria surgery a bariatric. surgery which can be overdone and cause. harm and a vascular surgery done on. patients legs to help us understand the. forces that were at work that were. driving all of this and what did you. find when you dug deeper into those.

surgeries well it's very complex but we. ultimately found three main drivers that. were underlying all of these first. there's a financial incentive for the. doctors to perform these surgeries. there's also a real push from the. medical device companies that make these. surgeries possible and last there's a. huge information void for solid medical. advice that a lot of these doctors and. companies take advantage of in order to. push the surgeries okay so let's start. with the money Katie how exactly is that.

incentivizing doctors to perform a lot. more of these procedures like what are. the mechanics of that so the reality of. our healthcare industry today is that in. many places you know even in places like. nonprofit hospitals the doctors who work. there are not getting a salary a. straight salary that's just kind of you. get paid for showing up to work that day. instead they're actually getting paid. based on the procedures that they're. doing how complex those procedures are.

possibly how. lucrative and it's not every doctor. there are still doctors that get paid. salaries but it's increasingly the case. that doctors have at least a part of. their pay is tied to the procedures that. they're doing interesting so the. procedure is growing in importance in. terms of actual compensation for doctors. right I mean in part it's kind of baked. into the Health Care system that we've. always had. you can even think about it as the small.

town Doctor Who operated his own. independent practice or her own. independent practice it's essentially a. small business and and they would get. paid based on the patients that they saw. it but like increasingly even in for. example large Hospital Systems where you. might think that a doctor is is just. getting paid a salary to work in a. hospital in fact you know a chunk of. their bonus for example can sometimes be. tied to the procedures that they're. doing and that is increasingly the case.

interesting and so one particularly. egregious example of this was at a. hospital that's in New York Belleview. hospital and basically what my. colleagues found there was that they had. basically turned their surgery. Department into an assembly line for. bariatric surgery which makes your. stomach smaller and can lead to weight. loss but what we found was that they. were greenlighting patients that. basically didn't meet the qualific. ations for this surgery which is a.

serious surgery and what they found was. that there were several situations where. people had very serious outcomes as a. result of getting the bariatric surgery. there okay so this is an extreme case of. a hospital turning to a particular. surgery to drive profits and it wasn't. uncommon in your reporting it sounds. like no it wasn't the only example but. it was the most striking and when we. reached out to bellev they defended. their work and they said that their. practices were helping patients who. would otherwise get care but you know.

our reporting was pretty conclusive that. the program was turning through a record. number of surgeries so what else was. driving this increase in harmful. surgeries that you guys found so we. found it wasn't just the hospitals who. were benefiting the other major player. that benefits are these companies that. are making the tools and the products. that doctors are using during the. procedures and in order for them to sell. more of their products a lot of time. what they end up doing is promoting the. procedures themselves. so like medical device makers like the.

company that made the laser in June. surgery right and you know they do this. in a number of ways they're giving them. loans to help them buy the equipment and. in some cases they're even lending them. money to help set up those clinics where. the procedures are performed so they're. really underwriting these doctors so. that they can perform more surgeries and. ultimately sell more machines yes and. the other things that they do is you. know the the laser companies for example. they will host webinars where they will.

have dentists who who frequently perform. these procedures show other dentists how. to do the procedures we even discovered. this conference that was created by one. of the laser companies and it had kind. of a wild name the name of the. conference was tongue ties and Tequilas. oh God right it brought in dentists to. talk about how to make money off the. procedures you know how to promote. themselves on social media how to. actually per formform the procedure and. you know of course when they were all.

done they they got to celebrate with an. open tequila bar okay so a lot of this. really amounts to these companies trying. to popularize these procedures basically. like to get the word out even if the. procedures don't really work or in some. cases cause harm right but they also. play a big role in the other Factor. that's driving a lot of this which is. the information that they put out there. about the surgeries these companies. often sponsor research which doctors. often rely on to guide their practices.

and you know part of what we found is. that it can kind of create this Echo. chamber where doctors feel more. comfortable and justified in doing these. procedures when they have kind of this. whole alternate universe that is telling. them that it's okay to do these. procedures and in fact it's beneficial. to. patients so tell me about this Echo. chamber effect the best example of this. we found was a doctor in Michigan named. Dr Jihad Mustafa he calls himself the.

leg saver and what we found was that he. and several other doctors do these. procedures called. atherectomy which is basically like. inserting a tiny rotor rer inside an. artery to get the blood flowing and Dr. Mustafa in particular was not only a. very prolific performer of these. procedures but he actually founded his. own medical conference and even helped. start a medical journal that was devoted. to using these procedures. and you know like tongue ties there's. really no good evidence that these are.

actually beneficial to patients and in. fact despite his nickname as the legs. saer One Insurance Company told Michigan. authorities that 45 people had lost. their limbs after getting treated at Dr. mustafa's Clinic over a 4-year period 45. people lost their limbs yes I mean that. is the ultimate version of harm right. right now he he did speak to us and he.

defended his work and said that he. treats very sick people and despite his. best efforts some of these patients are. you know already so sick that they. sometimes lose their limbs and how much. did he receive for each procedure. doctors like him typically receive about. $3,000 for each of these atherectomy. procedures wow but we found that that. misinformation or poor information also.

applied when doctors were learning new. types of surgeries really like how so. one of the areas we looked at was the. area of hernia surgery that I mentioned. and there's a particular type of surgery. it's a very complex version of a hernia. surgery called component separation and. the expert surgeons that we spoke to. said that it's difficult to learn and. you have to practice it over and over.

and over again to get it right but one. recent survey of hernia surgeons said. that one out of the four surgeons had. taught themselves how to perform that. operation really yeah not by learning it. from an experienced surgeon but by. watching videos on Facebook and YouTube. I mean how unusual is that I guess to me. it strikes me as very unusual I mean I. think of you know learning of about how. to take my kitchen faucet apart on. YouTube but but I do not think of a. doctor learning about how to perform a.

surgery on YouTube right and you know it. has actually become increasingly popular. in recent years and there's not good. vetting of the quality of the. instruction we even found videos on a. website run by a medical device company. that was intended to be a how-to for how. to do these surgeries but the video. contained serious mistakes wow and Katie. all of these videos some of them with.

serious mistakes I mean is this. something that would be subject to. Medical Regulators like is there any. kind of rules of the road for this stuff. you know there's less than you would. expect sometimes hospitals have rules. about what sort of Education their. doctors need before performing a surgery. but we were surprised that there was a. lot less regulation than we thought. there would be and much less vetting of. these videos than we anticipated so. essentially what you found was this.

complex often times interconnected group. of forces device companies pushing their. products hospitals bolstering their. bottom line and rampant misinformation. that as you said all really Trace back. to the same motivating factor which is. money but wouldn't the fear of being. sued for medical malpractice prevent a. lot of this Behavior you know this kept. popping up during the course of our. reporting I do think we have this idea. that anytime a doctor does anything.

wrong they're going to get sued but that. just wasn't always the case in our. reporting you know there's a lot of. statutes of limitations time limits on. when somebody can file a lawsuit in. other ways that make it somewhat hard to. really like hold a doctor accountable. one example is the regulatory. organizations that oversee doctors um. the one doctor that I mentioned earlier. Dr Mustafa. State investigators had found that his.

overuse of procedures had led people to. lose their legs and yet he ultimately. settled with the state and he was F. $25,000 that actually adds up to about. two of these atherectomy procedures so. it sounds like malpractice is not. necessarily going to be the root to. rectifying a lot of this but I guess I'm. wondering if the federal government. could actually rein some of this in you. know before the patients are har. you know it's possible but this is just.

a very difficult issue some of the. themes that we explored in this. reporting are really just firmly. embedded in our Health Care system and. the way that it works the fact is that. we have a for-profit health care System. right so everyone from doctors to. hospitals to the device companies. benefit when more procedures are done. all of the incentives are pointing in. the same direction right and so trying. to find one or two Simple Solutions will. probably not easily fix the issue as. much as we all hope that it could so is.

the lesson here be much more. discriminating and Vigilant as a patient. I mean to get a second opinion when. you're standing in front of a doctor or. a dentist who's telling you that you or. your baby needs a procedure yes I think. that is one of the. takeaways but look we understood that. even reporting on all of this was risky. because people could hear about these. harmful surgeries and start wondering if. everything that their doctors tells them. is a scam and of course while some of.

these procedures are harmful a lot of. procedures are. life-saving but ultimately for now. patients are kind of left on their own. to navigate which a pretty complex and. opaque Health Care system when you have. somebody standing in front of you saying. you should do this it can be very. confusing. right and this is something that Lauren. talked a lot about just how confusing. all of this was for her there's a lot of. information that you're getting that is. truly like someone is speaking a foreign.

language and because they do it all day. long it's not user friendly like it. isn't design for the comfort or. understanding of the person receiving. the. information there is so much blind trust. and faith that you have in the system in. the providers who are giving you this. information you trust like this is what. they do all day long so there is no real. reason to question that is the system. that we have in this. [Music].

country Katie thank you thank. [Music]. you we'll be right. [Music]. back. here's what else you should know.

today on Friday the Russian authorities. announced that opposition leader alexay. navali died in prison he was 47 navali a. charismatic anti-corruption activist led. the opposition to Vladimir Putin for. more than a decade his popularity was. broad extending far outside the realm of. liberal Moscow and that proved. threatening to the Russian authorities. who attempted to poison him in 2020. navali survived and later extracted a.

confession from his wouldbe assassin on. tape navali believed that Russia could. be a free society and he had the. extraordinary ability through sheer. force of his personality Charisma and. confidence to get others to believe it. too though he had been in prison since. 2021 his death still came as a. shock.

his wife Julia Nal made a surprise. appearance at a security conference in. Munich shortly after the Russian. authorities announced her husband's. death she received an emotional Standing. Ovation in Moscow my colleague Valerie. Hopkins spoke to Russians who were play. in flowers in his.

honor and expressing disbelief that he. was gone and I asked them if they. believe in the beautiful Rush of the. future that Naval talked about and they. said yes but they don't we don't think. we will survive to see. it at least 400 people have been. detained since his death including a. priest who had been scheduled to hold a. memorial service in St.

[Music]. Petersburg today's episode was produced. by ASA chatra Diana win will Reed and. Alex Stern with help from Michael Simon. Johnson it was edited by Michael benois. with help from Brendan clink Berg. contains original music by Diane Wong. and Dan Powell and was engineered by. Alyssa Moxley our music is by Jim. brunberg and Ben Lanser of.

[Music]. wonderly that's it for the daily I'm. Sabrina Tavern see you. [Music]. tomorrow.