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After-care

Home Care Information for Post-Op Frenectomy
(Newborn to 1 year)

Thank you for choosing us! We truly wish you and your baby an easy & fast recovery and successful bonding experience. This packet includes information that will help you and your little one recover as best as possible. Improvements with feedings are usually gradual and may take anywhere from 2-4 weeks. In most cases, a frenectomy alone will not cure all of the feeding problems and additional therapies may be needed. Therefore, it is critical to work with an IBCLC who has extra training in suck dysfunction in order to achieve optimal end goal. Outcomes may vary from baby to baby. If you have any questions or concerns, feel free to call us at 914-440-3211.

Immediately following the laser release in office and the baby is comfortably resting in your arms, we suggest either breast or bottle feeding to soothe the baby and aide in the training the muscles’ new function.

You will receive a post-operative take home packet with all of the details and instructions you need to ensure proper recovery.

What You May Expect After the Procedure

Days 1-3

  • Most babies will be very sore for the first 24-48 hours
  • Expect baby to be fussier than usual Healing "white patch" forms
  • Pain meds given as indicated
  • Difficulty with latch may occur
  • Have "backup" feeding plan and comfort measures prepared

First Week

  • Baby's soreness starts to taper off 7-10 days
  • Baby may be fussy
  • Healing white patch continues to form
  • Pains meds given as needed
  • Baby is re-learning how to suck
  • Feedings may be inconsistent
  • LC follow up is highly recommended to evaluate breastfeeding and suck training

Weeks 2-4

  • Baby should not be sore but exercises are mildy irritating
  • Healing white patch shrinking
  • Pain meds not necessary
  • New frenulum forming
  • Bodywork and LC follow up as needed
  • Improved progress with feeding

Weeks 4-6

  • Baby is not sore and stretching exercises are not necessary after 4 weeks
  • Healing patch gone and new frenulum takes final shape and position
  • Bodywork, OT, PT or LC follow ups as needed
  • Continual progress with feeding

Stretching Exercises

  • The purpose of the stretching exercises is to ensure that a new frenulum heals with increased flexibility. We highly encourage you to approach these exercises in a positive manner. Your technique AND positive demeanor are EQUALLY important.
  • Please do one round of exercises before bed on the day of the procedure. On the following day you may start stretching protocols listed below. Consistency is key. Do NOT exceed more than 6 hours in between stretches.

Stretching Protocol

Stretch and massage each area 6 times a day for 3 weeks

Please take note of the "white diamond patches." The released area will form a wet scab after the first day. This is nature's "band aid." It is not always white and in some cases it can be yellow, bright yellow, green or grey. The diamond will usually peak in size by day 7 and the shrink from day 7-21. Make sure you are gently rubbing into this scab because the healing is occurring underneath it. After one week, the white area will get smaller each day, but HEALING IS STILL HAPPENING! So even though the scab will heal you MUST continue the stretching or the new frenulum will not be as long as possible and the surgery will need to be repeated.

Lip Stretch

  • With clean hands, grasp the upper lip and lift up and back towards the nose.
  • Hold this position for no more than 30 seconds.
  • Then use the pads of your index fingers to massage along the gum ridge. Be gentle and make sure you rub high into the fold under the lip. Rub about 5 times side to side and up and down. This step should take no more than 5 seconds.

Tongue Stretch

  • With clean hands, place both index finger tips at the left and right corners of the diamond.
  • Allow fingers to sink down into the floor of the mouth (the "squishy" area) and engage closer together. 
  • It is helpful to use the other remaining finger(s) to push down on chin to help keep mouth open.
  • Use both index fingers to lift the tongue up for 20-30 seconds. When done correctly, tongue should lift and diamond will unfold.
  • Gently massage into the diamond up and down and side to side about 5 times each way using moderate pressure. 

Suck Training Exercises

Important: Suck training exercises are helpful for regaining proper tongue function. The exercises below are NOT intended to replace the in-person help of a lactation consultant or health care professional. Any delay in seeking expert help may put the breastfeeding relationship at further risk.

Use these exercises before feeding or as a playtime activity. Be sure to stop any exercises that your baby dislikes. It is not necessary to do every exercise; only use those that are helpful for your baby. Before beginning, wash your hands and be sure your nails are short and smooth. It is best to work directly with a lactation consultant to determine which exercises are best for you and your baby.

Exercise 1: Finger Sucking
Use a finger (with a trimmed and filed nail) that closely matches the size of your nipple. Place the backside of this finger touching the underside of the nose. This should stimulate the baby gape widely. Allow the baby to draw in finger, pad side up, and suck. The tongue should cover the lower gums and your finger should be drawn to the juncture of the hard and soft palate. If the tongue is not forward over the lower gums, or if the back of the tongue bunches up, gently press down on the tongue (saying "down" and use forward (towards the lips) traction.

Exercise 2: Down and Out Stroking
Begin as in exercise 1, but turn finger over and press down and the back of the tongue and draw slowly out using downward and forward (toward lips) pressure on the tongue. Repeat a few times.

Exercise 3: Lateralizing Side to Side
Gently stroke the baby's lips until the mouth opens, and then stroke the lower and upper gums side to side The tongue should follow your finger.

Exercise 4: Circular Strokes
Touch the baby's chin, nose and upper lip. When the baby opens wide, gently massage the tip of the tongue in circular motions pressing down and out, encouraging the tongue to move over the lower gums. Massage can continue back further on the tongue with light pressure as the fingers moved back on the tongue and firmer pressure when the finger moves forward. Avoid gagging the baby.

Exercise 5: Desensitizing Gag Reflex
If a baby has a high or narrow palate and gags on the nipple or insists on a shallow latch, it may help desensitize the palate. Begin by massaging the baby's palate near the gum-line. Progressively massage deeper, but avoid gagging the baby. Repeat exercise until the baby will allow finger to touch his/her palate while sucking the a finger. It may take several days of short exercise sessions to be effective.

Tips for the Tight and Tense Baby

If your baby does not open wide, a gentle massage may help relax the jaw and facial muscles. A skilled body-worker such as a chiropractor, osteopath or craniosacral therapist who specializes in infant care may also help your baby. Begin with a light fingertip circular massage under the baby's jaw from back to front on both sides.

Contact our office today to schedule your appointment!

3630 Hill Blvd Suite 401 Jefferson Valley, NY 10535
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