Frenectomy Post Op Instructions

Child Lip and Tongue Frenectomy
Post-Operative Instructions

What to Expect – Following the procedure, your child may be fussy and irritable. There may also be a resistance to nursing as normal due to discomfort, lingering numbness, and the need to retrain how to breastfeed following the release. This is normal and will subside. In the 24 hours following the procedure, it’s possible for a slight fever and / or swelling to develop. This will usually resolve within two days. It’s also possible to see some slight bleeding following the procedure or when initially performing stretching exercises. If concerned, apply gentle pressure to the area to stop the bleeding. It is essential for you to follow up with your Lactation Consultant and other professionals after the procedure to ensure optimal results.

Pain Medication – You may use whatever works for your family, this includes Infant Tylenol, homeopathic remedies like Arnica or Rescue Remedy, or nothing at all. We will also provide you with a mixture of coconut oil and small amount of Clove oil to massage onto the area as it is healing.
*Infant Tylenol dosages:
*6-11 pounds – 1.25mL  *12-17 pounds – 2.5mL  *18-23 pounds – 3.75mL  *24-35 pounds – 5mL
*Arnica 30C – 2 pellets x 5-6 times a day. First day can give every two hours (Whole Foods)

Stretching – Post-procedure stretches are important to getting an optimal result and preventing reattachment. The mouth heals so quickly that it may prematurely reattach at either the tongue site or the lip site, causing a new limitation in mobility and the persistence or return of symptoms. These stretches are NOT meant to be forceful or prolonged. It’s best to be quick and precise with your movements. If your baby is inconsolable and in pain, stop the exercises and try again after waiting 30 minutes. Getting an affordable LED headlight (like a camping headlight) will allow you to better visualize the placement of your finger. The exercises described below are best done with the baby placed in your lap (or lying on a bed) with their feet going away from you. Perform these stretches 4 to 6 times per day for the first 2 weeks, and then taper from 4 to 3 to 2 to 1 per day before quitting completely at the end of the 3rd week.

Upper Lip – If you must stretch both sites, we recommend that you start with the lip. Typically, babies don’t like either of the stretches and may cry, so starting with the lip allows you to get under the tongue more easily once the baby starts to cry. For the upper lip, simply place your finger under the lip and move it up as high as it will go. Then gently sweep from side to side for several seconds. Remember, the main goal of this procedure is to insert your finger between the raw, opposing surfaces of the lip and the gum so they can’t reattach together.

Tongue – Insert both index fingers into the mouth (insert one in the mouth and go towards the cheek to stretch out the mouth, making room for your other index finger). Place both index fingers under the tongue and elevate it towards the roof of the mouth. The tongue needs three separate stretching motions:

1. Once you are under the tongue, lift it as high as it will go (towards the roof of the baby’s mouth). Hold it there for 1-2 seconds, relax and do it four more times. The goal is to completely unfold the diamond shaped wound so that it’s almost flat in orientation.
2. Next, with one finger propping up the tongue, place your other finger in the middle of the diamond shaped wound and do a gentle circular stretch for several seconds.
3. Then, turn your finger sideways and use a roller pin motion to stretch and depress the diamond. Make sure your finger starts within the diamond when doing this stretch. Once it’s done, repeat the motion on either side of the diamond (outside the diamond) to stretch the remainder of the floor of mouth.