There is connective tissue, known as a frenulum, that connects your infant’s tongue to the bottom of their mouth; another frenulum connects your infant’s upper lip to their gums. At times, excessive connective tissue, or connective tissue that is too short or too tight, can cause it to be difficult for your infant to breastfeed.
An infant frenectomy is a procedure which modifies or removes the frenulum, allowing the infant to breastfeed normally.
What Are Tongue Ties and Lip Ties?
The tongue is attached to the bottom of the mouth with a piece of tissue called a lingual frenulum. The upper lip is also attached to the upper gums with a similar piece of tissue, called a lip frenulum.
These frenulums help to stabilize movements. The lip frenulum helps the lips stay attached to the gums as your body changes and grows; the lingual frenulum helps stabilize the tongue and anchor it to your mouth. Both play important functions in speech, eating, and swallowing.
In approximately 10% of infants, these frenulums will be too short, too tight, or too thick, causing conditions known as tongue tie (for the lingual frenulum) and lip tie (for the lip frenulum). These conditions can make it difficult for the infant to breastfeed; they may lose their latch, or make clicking sounds when feeding.
Tongue ties and lip ties can cause babies to gain weight more slowly, experience reflux (spitting up), and other symptoms like irritability. The mother may experience pain when breastfeeding; breastfeeding may also take much longer than it should. The main risk of lip ties and tongue ties is that a baby may not get enough food, which can put them at serious risk of other health conditions. When tongue ties and lip ties are limiting a baby’s ability to eat, a frenectomy may be helpful.
Is a Frenectomy Procedure Painful?
There are several different methods that can be used for a frenectomy procedure, from frenectomies using scissors and scalpels to the more modern laser frenectomies. Modifying the frenulum to alleviate a lip tie or tongue tie can cause some discomfort, but this discomfort is much better than the alternative. The areas being modified will be numbed before the procedure begins.
A baby can begin breastfeeding immediately (or almost immediately) after a frenectomy. This means that while the procedure may cause some discomfort, it should not cause enough discomfort to stop the baby from breastfeeding.
How Long Does the Procedure Take?
A frenectomy on a tongue tie or lip tie can be performed quite quickly; the procedure usually takes 15 minutes or less.
What Is the Recovery Time for an Infant Frenectomy?
The recovery time for an infant frenectomy is almost immediate; babies can usually feed without difficulty immediately after a frenectomy for a tongue tie or lip tie. There are some additional tips that your dentist may give you to ensure a healthy recovery, including lip lifts (for a lip frenectomy) and tongue lifts (for a tongue frenectomy).
Is a Frenectomy Necessary?
All babies are born with frenulums, including:
- The lingual frenulum, which attaches the tongue to the bottom of the mouth
- The upper lip frenulum, which attaches the upper lip to the gums
- The lower lip frenulum, which attaches the lower lip to the gums
- The buccal frenum, which connect the cheeks to the gums
Of these four, only the first two (the lingual frenulum and the upper lip frenulum) commonly require surgery—and even then, only about 10% of babies will experience lip tie or tongue tie.
A baby’s upper lip frenulum will change as the baby grows. For this reason, a frenectomy to eliminate lip tie is only recommended in severe cases of lip tie. The lingual frenulum is less prone to change; for this reason, frenectomies to correct tongue ties are more common.
When Should a Frenectomy Be Done?
An infant frenectomy should be performed when a baby’s tongue tie or lip tie is severe enough that they cannot breastfeed properly. When medically necessary, it’s best to perform a frenectomy early; doing so decreases recovery time and gives the baby the best chance to feed and gain weight normally.
Signs and Symptoms of Tongue Ties and Lip Ties
There are several signs and symptoms of tongue ties and lip ties:
- The baby has difficulty latching during breastfeeding
- Breastfeeding takes a very long time
- Breastfeeding becomes painful for the mother
- The mother experiences inflammation or infection of the breast
- The mother experiences sore or cracked nipples
- The mother experiences low milk supply
- The baby chews more than they suck
- The baby isn’t gaining weight as quickly as they should be
- The baby feeds for a long time, takes breaks, then feeds for a long time again
- The baby makes clicking noises when feeding
- The baby always seems hungry
These can all be signs of tongue tie or lip tie, though problems breastfeeding can be attributed to other conditions. Talk to your doctor and your baby’s pediatrician—an infant frenectomy may be the best course of action.
What To Expect During Recovery
After the infant frenectomy procedure, most infants are able to breastfeed immediately—and breastfeeding right after the procedure is recommended.
You can expect your baby to be sore for a few days after the procedure. Infants may be sore for a day or two, or for up to 10 days—though some infants are largely unbothered after the procedure. Your dentist may recommend mild pain medication to help alleviate discomfort.
Swelling is not uncommon, and a diamond-shaped wound will appear in your baby’s mouth—under the lip or under the tongue. This wound may be yellowish or pus-like in colour—this is normal. A small amount of bleeding is also to be expected, especially after the stretches we will describe in the next section. This is also normal.
Remember that when blood mixes with saliva, it can appear as though there is more bleeding than there actually is. If there is any bleeding, it is usually minimal and can last for the first 2-3 days, and generally only after stretches. When there is prolonged bleeding, excessive bleeding, or bleeding that occurs after the first 2-3 days, visit your baby’s dentist.
Tips for Successful Recovery
We recommend extra skin-to-skin contact, cuddle time, and warm baths together, as well as extra breastfeeding time during the recovery—though depending on the state of affairs before the frenectomy, you may find that less breastfeeding time is necessary.
The main technique to improve recovery after an infant frenectomy is to use stretching exercises. These are used so that scar tissue does not restrict movement; without stretching exercises, there’s also an increased chance that the frenulum will reattach. When you visit our dental clinic for an infant frenectomy, we’ll provide you with detailed instructions on lip and tongue stretches and other aftercare.
Schedule a Consultation With Dental House
Whether your infant is experiencing tongue tie or lip tie, our dental clinic can help. Our dentists treat our little patients with incredible care, reducing recovery time and lowering discomfort. Get in touch with us today!