Please show up with your forms already completed online. We will spend the consultation reviewing the completed forms and performing an oral examination. In kids and adults, the consultation will also include a functional assessment. if treatment is recommended and if time allows, it can be done at the same time as the consultation. The procedure is a quick, in office treatment and no general anesthesia is recommended. Due to laser safety regulation, parents are not allowed to be in the treatment room. A topical anesthetic is used for all patients. For kids older than 1 or 2 a local anesthetic is also applied in the treating areas.
Please note that for the first 24-48 hours, your baby will be very sore. Staying ahead of the pain at this time is extremely important. You may also notice some feeding difficulties during this time. It is important to consult with your IBCLC within the first week of healing to ensure the best outcome of the frenectomies. Feeding improvement can take up to 2-4 weeks to be seen. Additional bodywork by a chiropractor may also be needed.
The term “white diamond” is commonly used when talking about lip and tongue tie healing. The diamond is the shape of the wound created by the laser. The area will form a set, soft scab after the first day. This is natures “band-aid” and can be white or yellow. In jaundiced babies the scab can even be a neon yellow color.
The first few days or even the first week – this is why it is so important to stay ahead of the pain to avoid any discomfort. When children are in pain and uncomfortable it makes exercises more difficult to do.
Some patients may bleed a little after the procedure, especially after the first few stretches. This is normal and when mixed with saliva looks like a lot of blood.
This is common and why it is so important to follow up with your IBCLC after the procedure ideally in the first week. Your baby may also need bodywork as well.
This occurs because of healing and an increased movement of the tongue and is usually temporary.
This can occur because of medication and exhaustion from crying after the procedure. It also acts as a coping mechanism for discomfort.
Fever greater than 101.5˚F
If your baby moves a lot and is squirmy during the stretches, you can use a swaddle and place baby’s head in your lap or get the help of a second person to hold baby.
Use nitrile (non latex gloves) and use an LED head lamp for better visibility.
Frozen breast milk chips to be placed in frenectomy areas to help with pain and temporarily numb areas.
In my personal experience, I have found that it is easier to do stretches prior to feeding baby but you can do what works best for you and your baby.
Stretches ensure that the lasered frenum does not reattach. Use nitrile gloves if possible or clean, washed hands. Start the first stretch 4 hours after the procedure.
Start with the lip stretch first. If you start with the lip stretch and baby cries, it will be easier to get access to the tongue afterwards to do that stretch.
Place your index finger under the lip and move it up until you reach the bone (this is the vestibule)
Run finger left to right three times
Lift lip up towards nose and hold for 3 seconds
Place both index fingers under the tongue and lip tongue upwards and backwards like a forklift
The goal is to visual the diamond
Use middle finger to push the chin down – hold stretch for 3 seconds
With index finger and rolling pin motion rub wound up and down three times
Rub lower gumline from side to side so babies tongue can follow. This motion strengthens lateral or side to side tongue movements.
Let baby suck on your finger. Slowly pull your finger out while letting baby try to suck it back in. This will strengthen the tongue
• Please note that these stretches are extremely important to try to avoid reattachment and to obtain the best possible result.
• Lighting is important. You need to be able to see the wound. Purchase an affordable LED headlight like a camping headlight.
• Your baby will not be happy with the stretches at the beginning but it will get better.