Laser Frenectomy

for infant tongue and lip ties

BreAnne holding a smiling baby after frenectomy

What is Tongue Tie?

Tongue tie, also known as ankyloglossia, occurs when the tissue between the undersurface of the tongue and the floor of the mouth, called the lingual frenulum, interferes with the normal movement of the tongue. Tongue tie restricts normal range of motion of the tongue and can adversely affect breastfeeding. Tongue tie is associated with persistent pain with latch, slow or poor infant weight gain, reflux and low milk supply.

For more information, including current research on tongue tie, visit our Resources page. Additionally the American Academy of Pediatrics website  has a short video on tongue tie.

When indicated, a procedure called frenectomy can be done to correct tongue tie. This is where a cold CO2 laser is used to remove the tie, releasing the restriction and allowing for more range of motion of the tongue. The procedure is done in our office and babies feed immediately afterwards. Parents and caregivers are instructed on how to perform aftercare tongue stretches and families follow up with a lactation consultant.

What is Frenectomy?

We have dedicated our practice to delivering the highest quality lactation, breastfeeding and postpartum care to our clients and community. This high standard care incorporates the latest technology to better meet your needs. After completing hundreds of tongue and lip tie procedures using other modalities, our team has incorporated laser technique to provide release of infant oral restriction (tongue, lip etc.) in our office. This is called laser frenectomy where a highly focused CO2 laser beam vaporizes, cleanly and precisely, while sealing blood vessels at the same time. The laser frenectomy takes between 5 and 15 seconds to perform, babies and parents are in our laser room for 5 to 10 minutes.
 
In the hands of our experienced provider, the CO2 cold laser provides a safe, precise and often bloodless procedure to release the restriction and babies feed immediately after. We provide comfort measures in office to reduce pain and make the experience positive for everyone involved. A Board Certified Lactation Consultant remains with you and baby after the procedure to help with latch and develop a feeding plan if needed.
 
In addition to this advanced technique, we incorporate lactation, breastfeeding support and infant feeding support in every visit. We also provide evaluation and same day procedures as we know that appointments with a new baby can be challenging. We have close follow up with lactation support and infant oral functioning support in the days and weeks following the procedure.

To book your evaluation for laser frenectomy call (425) 322-4913 or BOOK ONLINE

What to Expect...

If your family has been referred to us for tongue tie you can expect a thorough and gentle evaluation of your infant's mouth and how they are feeding. If your baby is breastfeeding or nursing, this means looking at how your baby is latching. If your baby is bottle feeding, this means looking at how your baby is latching to the bottle. In addition to this thorough exam and because all of our Providers are also International Board Certified Lactation Consultants, we also have the opportunity to address issues like low milk supply, painful latch, persistent sore nipples, slow infant weight gain and other common concerns surrounding breastfeeding and nursing. 

After we have completed the infant oral exam, we will discuss the recommendations and options for you and your infant. This might include a recommendation for frenectomy. This also usually includes working on latch and positioning, care strategies for sore nipples and breasts and a plan to support a healthy milk supply and your infant's weight gain.

If a frenectomy is indicated, we have the availability to do it within the appointment that same day. We review the gentle aftercare recommendations and then apply the topical anesthetic and review pain management options. The procedure takes a few seconds, however we are in the treatment room for 5 to 10 minutes. A family member is often welcome to accompany their infant for every part of the procedure, including into the laser room. After the frenectomy a Registered Nurse Lactation Consultant remains with the family and helps your baby latch to breast or bottle and makes sure that you and your baby are comfortable, recovered and confident with your plan of care.

Babies are sometimes fussy for 24 to 48 hours after the procedure. We often recommend a mild pain reliever like Tylenol (acetaminophen) and provide you with the appropriate dosing based on your baby's weight. We also provide you with our after hours and on call number should you need any urgent concerns addressed. You and your baby follow up within a week, and sometimes sooner, depending on your care plan.

Healing takes place quickly, with lots of healing occurring within the first 48 hours after the frenectomy. A whitish diamond shaped patch develops at the wound site. This is the scab healing over the frenectomy site. As this heals it gets smaller and lighter and usually takes between one and three weeks to fully heal, dependent on the size of the wound site and baby's unique healing abilities. 

What is Aftercare?

Frenectomy aftercare includes gentle infant oral exercises and a light tongue and/or lip stretch. We demonstrate how to do this before the procedure, and encourage families to record the exercises performed on their infant to refer back to. We usually recommend starting these the evening of the frenectomy and recommend them 4 times daily for at least two weeks. When we see you for your follow up we recheck how your baby's mouth is healing and may recommend you extend the exercises another week or two or additional exercises to promote good mobility and healing.

These exercises should not make your baby cry out or screech in pain! In fact, we find less incidents of reattachment or healing down when babies are comfortable, moving their tongues around freely versus guarding their tongue movement in anticipation of pain. 

Need more information? Check out our Resources Page!