Care after Frenotomy

What should I expect after the procedure?

This procedure is typically done on newborn infants in the first week or so of life. At this age, they rarely have any prolonged discomfort, beyond the brief time that the procedure actually takes. While babies in general have fussy periods, crying during the week after frenotomy is generally no more frequent than without the procedure. Pain medication is generally not necessary, and doesn’t seem to make any difference in their overall mood. Of course, if there is any concern, I am always happy to see your child at any time.

When can I feed my baby after the procedure?

Nursing or bottle feeding may be done immediately after frenotomy. It helps soothe the baby, and will help stop any minor bleeding that may occur.

What do I need to do after the procedure?

The following is very important to ensure good healing and to prevent recurrence of the tongue tie. Any wound in the body (like the cut in the floor of the mouth) will eventually heal, but if left alone, it will heal by “contracture”, pulling the edges of the wound tightly together. Our goal is to mold the tissues of the floor of the mouth so that it heals flatter with better tongue extension. There will always be a small band under the tongue where the lining of the mouth heals, but by doing this massage for two weeks after frenotomy you will get a much better result.

Gloves aren’t necessary for this massage, although if you prefer, you can use them. Just wash your hands before and after. Some people use a small amount of coconut oil on their fingers to make the process easier.

If you look under the tongue, you will see a diamond shaped opening where the tongue tie was cut. This is the area that has to heal. Over the healing period you will see some yellow or white material in this area. This is the scab, it is a normal part of the healing process. It is NOT an infection or thrush, it does not require antibiotics or any other medication. Feel free to contact me if you have any questions.

The massage is done by touching the tips of your index fingers together, and pushing firmly on the diamond area. You then lift the tongue by pushing your fingers up toward the roof of the mouth. It’s important to keep your fingertips together so that you stretch the area (don’t let them slip to the sides). You won’t hurt the baby by doing this, so don’t be afraid to apply some pressure to get a good stretch. Take a look at the video at the bottom of this page to get a better idea of how to do this maneuver.

This photo shows the diamond drawn onto the image. It also shows the finger tips slightly apart for clarity, but remember to keep your fingertips touching when you are doing the massage.

This massage should be done 3 times a day for about 10 seconds each time, pausing at the end of the stretch with the tongue lifted up. Don’t worry if you don’t follow that schedule exactly, but do your best to do this during the healing process over the first two weeks.

You can also help your baby improve their sucking by having them do exercises during this healing period. Place your finger in their mouth and let them suck on it. Then slowly pull it out, letting them pull against you (like a tug of war game!). This strengthens the tongue and lips, and will improve feeding in general.

What about follow up?

The follow up visit is in three weeks, please call my office for an appointment.

Massaging the frenotomy site to promote healing.