Shira Johnson, IBCLC
After frenectomy - what to expect
What to expect after baby’s tongue tie release
Shira Johnson, IBCLC Shira Johnson Lactation LLC
o Realistic Expectations:
· Baby may nurse immediately after the procedure. Latch may or may not initially feel different. Although some do, it’s very normal not to notice a difference immediately. Improvement can take several weeks (best results seen if taking a team approach to aftercare, see below).
· Baby may cry, be very fussy and/or sleepy for ~24 hours after release.
· Baby may refuse nursing/feeding for part of the first day after release. Don’t worry.
They typically return to normal within 24-48 hours. If you’re concerned, watch for signs of dehydration and contact your release provider, pediatrician or ER with any major concerns.
· The wounds resulting from tongue or lip release should be diamond-shaped; You should be able to visualize this.
· As the wounds heal, a white/yellow scab will appear. This is normal; doesn’t indicate infection.
· If often takes 3-6 weeks to see significant improvement after a release.
Progress usually doesn’t happen overnight! It can feel discouraging, but progress might be slow. Progress can seem like a roller coaster - this is normal as baby learns new skills, and experiences various types of soreness and fatigue due to using new muscles, etc.
Proper aftercare within the weeks following release are critical to optimal results (see below).
o Pain management:
Some babies require no pain relief, but many need more active support for discomfort anywhere from 1-10 days following release:
· Skin to Skin, lots of snuggling, baby wearing
· Homeopathic Arnica Montana (pellets dissolved in water and administered to baby with a dropper), can be combined with other homeopathic remedies as well, some favorites include Aconitum, Hypericum, Bryonia.
· Bach's Rescue Remedy or Five Flower Formula flower essences for calming
· Frozen Breastmilk chips under tongue
· Tylenol- Many providers still recommend Acetominophen, but please be aware of potential dangers & negative side effects from Tylenol when making your decision:
o Team Approach to Aftercare:
You should receive instructions from your IBCLC and/or Dentist/release provider for:
· Active wound care; “stretches/lifts” of release sites to prevent wound from healing too quickly or reattaching. These should be done 4-6x/day for 2-3 weeks.
· Oral exercises & games to strengthen & achieve optimal mobility (IBCLC or other feeding therapist should teach these). To be done 3-5x/day for several weeks, or as instructed. Follow up with IBCLC/therapist as function improves/changes, as recommended exercises may change.
· Bodywork – Bodywork (for example, with craniosacral therapist, chiropractor, PT, etc.) done before and after frenectomy is an integral part of this process. Habitual compensations or tension in baby’s body influence how the mouth moves, and even how digestion works, etc. Therefore, release (frenectomy) alone may not result in any improvement without this complementary team approach. The release alone is just one part of the process to achieve good oral function.
Note: After release, a new frenulum eventually grows. This is normal. The above steps ensure that there is adequate mobility & space for a new frenum to grow long enough to allow for full range of motion and coordination for optimal comfort and efficacy!