After your baby has had their tongue or upper lip tie release/ frenotomy, you will need to follow the following care instructions to ensure baby is as comfortable as possible and to ensure the best outcome and most feeding inmprovement for your baby.
Feeding: Offer your baby the breast as soon as possible after treatment and whenever baby shows interest in feeding. This may be much more frequent that usual. This will help the healing process, allow baby to get used to a new way of feeding with better function and provide pain relief for your baby. If baby refuses to feed offer expressed milk via a teaspoon as often as possible as well as continuing to offer the breast and keep baby skin to skin as much as possible if only a few weeks old.
Positioning: “Go back to basics” Ensure your latch and positioning are correct. Helpful positions you can try are:
Upright (face to breast)
Laid back feeding
Football hold
Transitional/ cradle hold
Remove teats and dummies if possible: Babies suck differently on teats than they do on a breast. These may only confuse baby more. The earlier baby can get back to the breast the better. Try using: a lactation aid or nipple shields if needed.
Be Patient: It may take time to notice a change and perseverance is needed, especially with Type 4 Ties. You should see an IBCLC for follow up at least twice following your procedure to ensure further suck training is not required and that your latching is correct.
Supply: If your supply is low, consider increasing it prior to treatment to ensure the best start back to the breast. The following can help to increase supply:
Breastfeed baby as often as they want to feed.
Use breast compressions while baby is feeding to empty breasts more.
Frequent expressing 1 hour after each feed at least 6 times per day.
Try Galactogogues, (milk boosters).
Switch feed, (both sides several times a feed) to empty breasts more and feed baby more.
What to watch for:
Pain– expect your baby to be a bit grizzly and unhappy for up to 48 hours. Use paracetamol as prescribed.
Swelling– You may notice some swelling under the lip or tongue for the first 24 hours which may make feeding difficult. The swelling will subside after 24 hours.
Bleeding– It is normal for the wound site to bleed briefly after the procedure and at the first exercise session.
Scarring– A diamond shaped scar will be present where the tie has been released. It may become white or yellow, similar to a mouth ulcer. This is normal. Post care exercises should continue until ALL scarring has changed to pink healed tissue.
Drooling/Dribbling– You may notice your baby dribble much more than usual, this normal and will resolve.
Infection- Signs of infection are excessive swelling of the tissue accompanied with an abnormal temperature.
If you are concerned about any of the above or anything else following the procedure you should contact your lactation consultant.