Treatment is completed with the newborn swaddled. This is to prevent any uncontrolled movements during the procedure and keep your child safe and comfortable. Your child will be provided with eye protection and topical anesthesia maybe utilized. Post-operative discomfort is minimal.
Most infants do not require any pain medications following a laser frenectomy. However every child is different and responds to this intervention differently. You may notice more irritability or fatigue in your infant, depending on the severity of treated ties or just some difference in sensitivity. If you feel that pain medication is appropriate, Tylenol should be sufficient. A single dose can be given every 6-8 hours. After the first 36-48 hours we would not expect pain medication to be necessary.
Often breastfeeding alone, more frequently than usual, will suffice. If breastfeeding is not possible for you, your IBCLC can instruct you on how to hand express or pump milk to feed your baby. Use of nipple shields may help if breastfeeding is still painful, but finger feeding will eliminate all risk of nipple confusion. The priority is to ensure your baby is hydrated and fed by ensuring correct breast drainage will prevent any risk of engorgement as well.
You may notice that the upper lip is now freed into a fuller position. This is due to the tension release of the previously underlying frenum. Swelling, if any will be slight and will be under the nose, where it meets the lip. This newfound lip and tongue mobility maybe confusing to your baby as he/she adjusts to the improved muscle freedom.
The day after treatment: You will notice a white diamond or triangle shape beginning to form in the area under the upper lip or a while line under the tongue (if the tongue tie has been released). The white color of this normal healing process is called an eschar is expected to last for 7-14 days. Soft tissue in the mouth does not form a dry scab.
It’s important to remember that you need to show your child that not everything that you are going to do to the mouth is associated with pain. Additionally, babies can have disorganized or weak sucking patterns that can benefit from exercises. Starting these exercises from the moment you make your appointment can speed up your recovery after the procedure. The following exercises are simple and can be done to improve suck quality. Aim for 4x/day leading up to the day of your procedure.
- Slowly rub the lower gumline from side to side and your baby’s tongue will follow your finger. This will help strengthen the lateral movements of the tongue.
- Let your child suck on your finger and do a tug-of-war, slowly trying to pull your finger out while they try to suck it back in. This strengthens the tongue itself. This can also be done with a pacifier.
- Let your child suck your finger and apply gentle pressure to the palate. Once the baby starts to suck on your finger, just press down with the back of your nail into the tongue. This usually interrupts the sucking motion while the baby pushes back against you. Listen for a seal break and then put your finger back up into the palate to re-stimulate sucking. Repeat as tolerated.
- With one index finger inside the baby’s cheek, use your thumb outside the cheek to massage the cheeks on either side to help lessen the tension.