A controversial procedure is back in the spotlight.

The New York Times on Monday released an investigation into tongue tie release surgeries, detailing the risks and questionable necessity for the surgery. The procedure has been promoted as a post-natal cure-all and a big business, according to the Times.

The practice has been considered since ancient Greece and performed by midwives in the Middle Ages.

Frenotomies, the formal name for a tongue tie surgery, performed in hospitals grew 800% between 1997 and 2012 and Google searches reached a high this year after years of growth.

Here's what you need to know about tongue tie release surgeries.

Why is tongue tie release surgery performed?

Tongue tie surgery is performed to remove a tendon that connects the tongue to the mouth. Ankyloglossia, the name for the condition, can affect any baby though it can be hereditary according to the Cleveland Clinic.

The surgery has been recommended to new mothers who experience pain when breastfeeding or when a child has difficulty latching on to feed.

A 2007 study in Can Fam Physician found that between 4% and 10% of babies are affected but researchers were limited by the lack of a single diagnostic standard.

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What are the risks of tongue tie release surgery?

According to the Cleveland Clinic, the risks of tongue tie release surgery include:

• Bleeding
• Poor feeding
• Airway obstruction
• Scarring
• Damage to the saliva ducts

What is the evidence for tongue tie release surgery?

A 2015 review of literature by researchers from Vanderbilt University found, "mother-reported improvements in breastfeeding, and potentially in nipple pain," after surgery.

A subsequent Cochrane Review in 2017 found that the surgery did reduce breastfeeding mother's pain but, "investigators did not find a consistent positive effect on infant breastfeeding."

The review also suggested that further randomized control trials were needed.

A 2022 systemic review in the International Journal of Pediatric Dentistry found that, "there was no clear connection between ankyloglossia and speech disorders."