Tongue Tie Revisions: The Different Methods Explained

By Kate Macdonald

March 20, 2019

It hasn’t been easy- maybe breastfeeding has been painful, latching baby is difficult and you have struggled with milk supply.  Your baby has been assessed and you have been told your baby has a tongue tie and needs a revision. You are probably feeling emotional about it and wondering how it will help you and your baby.  It is important to know what a revision is, how the procedure is performed and how to take care of it after.

What is a Frenotomy?

The procedure of revising a tongue tie is called a frenotomy. Is a simple procedure that releases of the membrane (lingual frenulum) from the floor of the mouth (tongue tie) or from the upper lip to the upper gum (lip tie). It is a quick procedure that does NOT require your baby to be put to sleep. Treatment of tongue ties can be performed by Nurse Practitioners, Doctors, Midwives, as well as Dentists.  This procedure is usually performed in a clinic or dentist office. There are 2 methods that are commonly used for this procedure which are either using scissors or a laser to release the frenulum.

What to expect?

A topical numbing cream will be placed on the gums prior to the procedure which will help minimize any pain. During the procedure they will hold your baby’s tongue upward to the roof of the mouth in order to make the frenulum taut. A quick cut of the tissue will be done with sterile scissors or a laser.  The procedure usually causes minimal bleeding.

If the procedure is performed with scissors you will be able to be present in the treatment room. Usually you will sit opposite the health care provider with your knees in contact and your baby will lie on your knees. Babies often fuss or cry during the positioning of the procedure and the actual release of the membrane takes seconds. If the procedure is done with laser, for safety reasons you will not be allowed in the treatment room until after the procedure is done. If the lingual frenulum is too thick a more extensive procedure called a Frenuloplasty may be recommended. This procedure is done under general anesthesia and the wound is closed with dissolvable sutures.

Before

After

 

(Photo Credit: Standford Medicine)

 

 

After the procedure is over, mom will be able to feed baby immediately.  Often some mothers will notice improvements with breastfeeding immediately.  Tongue mobility will improve and some babies need practice to learn how to use their tongue in an effective manner. You may notice that your baby’s upper lip is slightly puffy. This is normal as the lip had to be help up to complete the procedure.  

Aftercare: What do I do?

Instructions will be provided from the care provider that completed the procedure and will need to be followed for 3- 4 weeks ideally.  It is possible to for a tongue tie to reattach so these exercises are important. Exercises should be preformed regularly first 2-3 weeks and then will taper off in the 4th week.

Prior to doing the exercises ensure that you wash your hands and your fingernails are short.

Some babies are a little sore in the first 24-48 hours and will likely be fussier than normal.  Your Health Care Provider may recommend infant Tylenol/Acetaminophen, refer to the instructions on the package or check with your pharmacy or health care provider for the correct dosage based on your baby’s age and weight.  

Within the first 2 days after the procedure you will notice a grayish-white patch form where the cut was made. This is normal and is not a sign of infection.  It will return to its normal appearance in about 2 weeks.

Follow up

Make sure that you have a follow up visit after the tongue tie revision. It is important to continue get the help you need to work on feeding and/or teaching your baby how to latch now that they have more movement with their tongue. Please feel free to reach out to a Mama Coach in your area if you need some support with feeding. We are here for you and will come to you and give you the support and guidance that you need in the comfort of your home.

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