Frenectomy (Under 2 Post-Op Care)
What to Expect
In general, the procedure is very well tolerated by infants. We take every measure to ensure that discomfort and stress are minimized during the procedure.
1. General anesthesia and oral sedation are not utilized in our office for a frenectomy.
2. Crying and fussiness are common during the procedure and initially after. Some infants bounce right back into their routines and others may remain fussy for a day or two.
3. We provide a private room to soothe and/or feed your baby after the procedure is completed.
4. Remember, all babies are different and some may need a little extra time adjusting to the new sensations of movement.
What About Discomfort?
Most babies experience only minimal discomfort for the first 24-48 hours after the procedure. Breastfeeding and skin-to-skin contact provide natural pain relief. If your baby seems uncomfortable, Tylenol (Acetaminophen) can be given.
Dosage: Using the dropper in the manufacturer’s packaging:
• 6-11 pounds 1.25 ml
• 12-17 pounds 2.5 ml
• 18-23 pounds 3.75 ml
• 24-35 pounds 5ml
For infants under the age of 2 months, please consult your pediatrician. Please note that Ibuprofen (Motrin or Advil) should NOT be used for babies under the age of 6 months.
Please consult a qualified medical provider for homeopathic remedies. Products containing Benzocaine (i.e. Baby Orajel) should not be used due to health risks in young children.
One of the many benefits of using the diode laser for this procedure is that minimal bleeding occurs. However, the area treated by the laser causes an ulcer-like wound that will need time to heal. This is why you may see a white-colored area where the laser was used. Cold breast milk in a dropper, placed on the wound, every hour for the first day or two can be very soothing and cooling. We also encourage skin-to-skin contact with your infant.
Important Concepts to Understand
1. Any open oral wound likes to contract towards the center of that wound as it is healing. Separate the wound to guide healing and avoid reattachment.
2. If you have two open raw surfaces in the mouth in close proximity, they will want to reattach.
We feel that post-procedure lifts are essential in achieving an optimal result. These lifts are NOT meant to be forceful or prolonged. Your baby may be upset or uncomfortable during lifts; however, it is important to complete the lifts properly and as instructed.
The main complication of releasing a tie is the mouth heals so quickly that it may prematurely reattach at either the tongue site or lip site, causing a new limitation in mobility and the persistence or return of symptoms.
A small amount of spotting or bleeding is common after the procedure as the site heals, especially in the first few days; However, in using a diode laser, the bleeding is minimized.
Wash your hands well prior to your lifts. Avoid having long nails or gloves.
The following strategies are recommended for the lifts below:
• Sit on the floor or bed and place your child’s head in your lap with their feet pointed away from you.
• If you have a partner, form a knee-to-knee position with your child’s head in the lap of the person doing the lifts.
Recommended Lifting Schedule
Day of Procedure: Only do ONE set of lifts before going down for the
night. Don’t wake up your infant in the night this first night, let them sleep.
Next Day: Start your lifting routine. We recommend lifts be done 6 times
in a 24 hour period. You do not have to do overnight lifts unless your baby is awake. You will continue doing your daily lifts until your lactation consultant, body worker, speech or feeding therapist graduates you or until the white/open wound has fully healed.
The Upper Lip is the easier of the two sites to lift so we recommend that you start with the lip. For the upper lip, lift the lip up to cover nostrils and hold for 5 seconds. You will do this lift 6 times during a 24 hour period.
The Tongue should be your next area to lift. Place fingers in the upper outer edges of the “diamond” (not in the wound bed). Use both index fingers to lift under the tongue like a forklift. Hold it there for up to 5 seconds. The goal is to completely unfold the diamond so that it’s almost flat in orientation.
The Buccal is the last area to lift if your child had them released. Lift cheeks up and outward away from the midline like a fishhook and hold for 5 seconds.
It is essential that you follow up with your lactation consultant, body worker, SLP, myofunctional therapist, or feeding specialist after the procedure to ensure optimal results.