Tongue tie and lipe tie revisions – or frenectomies – are common procedures preformed on infants, primarily to assist with breastfeeding success. However, the after care is essential to proper healing and future success. Here are the best tips for success along with free printables for suck training and post revision exercises.
Tongue-tie and lip tie revisions can be a lifesaver when it comes to breastfeeding.
Unfortunately, many parents go home after their child has had a frenectomy and wonder why things haven’t improved more.
The answer is often this – they weren’t given the proper instructions for follow-up care.
The truth is, the frenectomy is the first step in the process for more successful breastfeeding. While many new parents DO see immediate relief of the symptoms they or their baby was experiencing, it takes time and a little more work to get your baby to where you want them to be.
Tongue Tie Post Surgery Care
Below are two printables that you are welcome to download – one contains post frenectomy stretches and the other is for suck training. These are talked about more below. Make sure to talk with your care provider first!
How long until I see results from a frenectomy?
As mentioned, some babies have immediate improvement – I experienced this myself with my third baby after his frenectomy. I teared up as I immediately had no more pain.
However, the general rule is that it can take as long as old as your baby is to see total resolution and improvement. So the younger your baby is, the quicker you will see results. This is simply because the older your baby is, the more habits they have that are set in place, and it can be harder for them to relearn how to breastfeed.
Tongue Tie Recovery Time
A baby is considered fully recovered from a tongue tie about 6-8 weeks after the procedure. They should be examined at this time by the provider to ensure no reattachment has occured.
Right after the procedure
Babies and infants can suffer from irritability and may cry a lot between 24-48 hours after surgery. Doctors often prescribe pain-relieving medications such as Infant Tylenol (or Ibuprofen if they are over six months). The pain often subsides following the healing of the wound.
Nursing can also be very soothing for a baby, though some may be more resistant to nurse because of the trauma to their mouth. I would definitely recommend doing lots of skin to skin and babywearing.
It is not common practice for an infant to have general anesthesia for a tongue tie procedure (and if someone suggests it, I would strongly recommend finding another provider). However, if this does happen to you, be aware that your baby may be extra drowsy.
Regardless, your baby might be extra sleepy after the procedure, as that is often the baby’s response to pain.
Ideally, you will meet with a lactation consultant immediately following or within 24 hours of having the procedure done to do an exam, asses how baby is eating, and come up with a care plan. If your baby has had trouble with weight gain, this will need to be closely monitored as well.
You may continue to breastfeed after the procedure. In fact, you should ideally be offered a place to nurse immediately following the procedure.
The newfound movements of the tongue may make it difficult for the baby to latch on the breast and can make the baby more irritable as they relearn to nurse. It does take time to overcome the past eating habits.
Getting a deep latch is essential. Try different positions and latching techniques in order to have the greatest success.
If your baby has been getting a bottle and you’d like to try them back at the breast, it is a great time to start reintroducing the breast. Remember, though, that if either of you are feeling frustrated or overwhelmed, it is OKAY to stop and try again later.
Keep your baby close and make sure you and your infant have many skin-skin contacts to enable your baby to search for the breasts and start his natural latching and sucking process. Compress your breasts to ease the flow of the milk once your baby has latched on. If your baby finds it difficult to suck on the breasts, you can feed him your expressed milk with the help of a syringe or a spoon. If still, your baby is facing difficulty, you can contact a lactation consultant.
While you may have already initiated breastfeeding, I strongly recommend taking my class, “The Complete Online Breastfeeding Class“. I teach you everything about latching, troubleshooting breastfeeding, milk supply, pumping, and more – all from the comfort from your home.
One of the BEST things I did after Andrew got his revision was visit with a Cranial Sacral Therapist and have her do manual work on Andrew’s mouth. She did gentle techniques to help loosen the tension in his mouth, and it was incredible to see how much more relaxed he was after nursing.
The tongue tie helped with the pain, but the body work we got done just made it seem like he was more comfortable, too.
I would seek out the help of an infant Chiropractor who is familiar with tongue ties or a Cranial Sacral Therapist. You can ask your IBCLC or the office you got the procedure done at for recommendations, as it’s important to go to someone who has experience working with infants after frenectomies.
Exercises after tongue tie revision
Your baby needs to perform different movements with the newly freed tongue. The exercises must be carried out between 6-8 times a day and each session must last for a minimum of 15 to 30 seconds.
This may seem like a lot – and it kind of is – but they are essential for helping reattachment and helping your baby’s wounds heal correctly.
Your provider should provide you with specific instructions on this.
However, if they didn’t, here are the exercises – along with videos – from Dr. Ghaheri. He is the leading expert on tongue and ip ties.
A few tips –
- Do the exercises whenever you change your baby’s diaper. This tends to be 6-8 times a day, anyways, and it’s a good way to remind yourself.
- Lay your baby’s head in your lap, with their feet facing away from you.
- Many baby’s do not like these exercises, but they can be done fairly quickly. Do not skip them!
- You may want to swaddle your baby to ensure they don’t swat you away or wiggle too much
- You have to use enough pressure – I made this mistake, and I paid for it when my son’s tongue reattached. I was so worried about hurting him, that I didn’t do them effectively enough.
I cannot emphasize the importance of these. It was really disheartening when I realized a week or so after the initial procedure that the pain had come back – and it was because his tongue had reattached. The dentist we saw told me I really needed to apply more pressure, and once I started doing that, it made the biggest difference, and we had no reattachment.
Suck Training and Massage Techniques
Many babies who have tongue ties often need help with learning to suck more efficiently. An IBCLC or other lactation professional can provide you with suck exercises that you can easily do at home in addition to the stretches. These tend to be more fun and soothing for a baby than the stretches.
Here are some basic ones you can try:
Always use a clean or gloved finger, tickle above your baby’s lip or directly on their lip. Wait for them to open their mouth and “invite” you before placing a finger in their mouth.
- When your baby opens their mouth, starting on the bottom gums midline, gently massage with one finger from front to back.
- Repeat on the other side and then on the upper gums.
Tug of War and Pressure
- Insert your finger, nail pointed down, into the baby’s mouth and wait for them to “latch” on and start to suckle
- Once your baby is actively suckling, gentle try to pull your finger out. Don’t do it so harshly that you pull it out but enough that they have the desire to pull it back in. Keep playing tug of war as long as they seem interested.
- If your baby won’t draw your finger in, you can slowly push it in. Make sure you don’t go back to far.
- You can add in a little pressure by gently pressing your finger (nail side down) on the back of their tongue. This adds a bit of weight and helps them learn to better lift their tongue.
- At the end of adding the pressure, flip your finger over so your nail bed is pointed up, and gently pull your finger out to encourage them to bring their tongue down and cup your finger like they would your nipple.
- Place one index finger on the inside of the baby’s cheek.
- Use thumb on the outside of the cheek to massage the cheek
- Tickle the edges of your baby’s mouth, going back and forth between each corner.
- Place your finger tip on the tip center of your baby’s tongue
- Gently (with no pressure) slide about half way back on your baby’s tongue.
- Lift up your finger, put it back at the front of your baby’s tongue, and continue
Bottom Lip Tickling
- Gently tickle the center of your baby’s bottom lip
- This will encourage them to stick their tongue out of their mouth and learn to extend their tongue more effectively
- Place your finger tip in the center of your baby’s tongue
- Apply gentle, downward pressure and move forward to the tip of their tongue
- Do this one time, and then lift your finger up and place it back in the center of the tongue and repeat.
- Do not drag your finger back to the center at any point.
You should be instructed to follow-up with the provider who did the revision around two weeks post revision and six weeks post revision. These visits are important to ensure healing is going well and that no reattachment has occured.
With these tongue-tie aftercare tips, your baby’s tongue will heal in no time, and he will eventually learn to bring the newfound movements of the tongue under conscious control. Make sure you continue breastfeeding throughout the entire aftercare procedure to help the baby learn the natural sucking action.
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- Is Your Breastfeeding Baby Biting? Here’s What You Should Do.
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Katie Clark is an International Board Certified Lactation Consultant (IBCLC). She has helped thousands of mothers and families around the globe navigate breastfeeding challenges and questions since 2015. She has a passion for creating research-based, helpful breastfeeding education and helping parents find a way to make breastfeeding work for them. Katie is a mom of three little boys and lives in the great state of Colorado. She also has a degree in Communications with an emphasis in print journalism.