Appointments may last approximately an hour and both parents or one parent (with parental responsibility) and a family member/friend are welcome to attend, but I will require a signed online consent form from a parent before the attendance of the appointment. Links to this form will be within your confirmation and reminder emails.
Please bring a blanket to swaddle your baby for their procedure (if it is required), some milk if they are not feeding from the breast/chest and also bring their red Child Health Book to confirm identification of the baby.
The appointment is initially for a full consultation to assess the baby, this may or may not include recommendation of a Frenulotomy or bodywork therapy.
We will discuss further details from the Medical Consultation form, some family history and details regarding the baby’s birth, feeding methods and behaviours and alongside this information, an examination of the baby’s mouth and tongue will inform if the Frenulotomy is recommended.
If a Frenulotomy is indicated, it will be performed once you have confirmed consent secondary to the signed Consent form and once you feel fully informed regarding the procedure and its after effects.
We will wrap the baby up with their arms by their sides and I will ask for your support to gently keep them secure in their swaddle. The tongue tie is divided quickly as safely possible using single use, blunt ended, curved, sterile scissors. There may be a small amount of bleeding seen on the gauze applied immediately afterwards which is normal.
I will ask you to prepare for either a breast or bottle feed to give straight away and I will support you with any help required if breast/chestfeeding and any ongoing support if necessary.
We will then discuss the healing process that your baby is going to go through and you will have plenty of opportunities to ask any questions you need to before you leave the clinic.
There are a small number of blood vessels and nerves that supply the frenulum, so it is reasonable to assume there may be some mild discomfort. Your baby may be unsettled or fussy for a few days following the procedure. However the majority of babies will undergo the procedure with little or no distress and settle immediately once feeding.
The main risk of this surgery is of excessive bleeding and this is a rare complication with 1:400 babies requiring pressure placed onto the wound following a procedure, 1:7000 requiring adrenaline in hospital and 1:77000 requiring suturing/cautery (ATP 2018). Damage to any surrounding structures is possible but an extremely rare risk which I minimise by using curved, blunt ended scissors and asking you to ensure the baby is wrapped up well and supported securely.
In approx 3% of cases, residual frenulum may remain or reattach, and a further procedure may be necessary to achieve further improvement (ATP, 2017). However, I will always suggest first considering non invasive methods to improve feeding such as lactation support and bodywork such as Craniosacral therapy, Osteopathy and Chiropractic care. After approximately 6 weeks post surgery, if we do not feel that your baby’s symptoms have improved significantly, I suggest you book a follow up appointment with me to re assess your baby’s tongue function and we can make a care plan in that appointment that is right for your baby.
A baby can face challenges if they are bottle feeding, such as;
Also, when the baby is taking solid food they also may struggle to move the food around their mouth in the presence of a Tongue Tie.
Just call, text or email me and we will discuss an appropriate plan that may include further breast/chestfeeding support, Craniosacral therapy and/or a follow up appointment.