New Patients
STEP 1
New Patient Forms
Please click to download and fill out the intake forms provided online prior to your consultation appointment
No Nursing 1 Hour Before
Please do not feed or nurse your baby 1 hour prior to the procedure. This is to minimize your baby spitting up during the procedure
STEP 2
Have These Items on Hand
We recommend having the following on hand prior to the procedure for pain management and exercises/stretching:
COCONUT OIL (FOOD GRADE)
Pain Medication
Infant Tylenol for children under 6 months of age
Ibuprofen (Motrin) for children over 6 months of age
Ibuprofen (Motrin) for children over 6 months of age
Homeopathic/ Holistic alternatives
Hylands Arnica Montana 30C: Dissolve 5 pellets in 1 oz dropper bottle of distilled water; give 5 drops every 2-3 hours as needed. Store chilled. This can be found at Sprouts, The Vitamin Shoppe, Whole Foods
Chamomilla (irritability and inflammation) – Boiron Camilia single doses (follow directions on box).
Breast milk ice chips – acts as a natural numbing agent for pain. Freeze milk flat in baggie and place tiny pieces under lips, tongue, cheek and let melt slowly.
Chamomilla (irritability and inflammation) – Boiron Camilia single doses (follow directions on box).
Breast milk ice chips – acts as a natural numbing agent for pain. Freeze milk flat in baggie and place tiny pieces under lips, tongue, cheek and let melt slowly.
STEP 3
What to expect at your appointment:
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.
IMPORTANT
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 is very helpful for all babies especially babies with feeding issues.
What to expect after the procedure
Days 1-3
Very sore
More fussy
Healing white patch forms
Difficulty with latch
Have back up feeding plan (pumped breastmilk)
Week 1
Not as sore
May still be fussy but less
Healing white pach still present
Baby relearning suck
Consult with LC and bodyworker recommended
1 week followup with Dr. Kristina
Weeks 2-4
Soreness should be gone
Healing patch shrinking
Pain meds not needed
New frenum forming
Continue LC and bodywork followup
Improvement in feeding
Weeks 4-6
Baby no longer sore, exercises no longer needed after 5 weeks
Healing patch gone, new frenum formed
Bodywork, LC, OT followup as needed
**Please note that this timeline varies with each baby
“White Diamond” Healing Patches
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.
Common Findings After Frenectomy and Tips:
Excess fussiness and crying
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.
Bleeding
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.
Difficulty with latching in the first week
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.
Increased saliva (drooling) and bubbles
This occurs because of healing and an increased movement of the tongue and is usually temporary.
Increased sleeping
This can occur because of medication and exhaustion from crying after the procedure. It also acts as a coping mechanism for discomfort.
When to Call Dr. Kristina
Uncontrolled bleeding
Fever greater than 101.5˚F
TIPS
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.
Stretching
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.
LIP STRETCHING
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
TONGUE STRETCHING
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
SUCKING EXCERCISES*
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
*Stretching Exercises Notes:
• 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.