Infant Frenectomy

Lip tied infant in Chicago
Photo courtesy of Dr. Ghaheri
Tongue Tied infant in Chicago
Photo Courtesy of Dr. Ghaheri

What is a Lip Tie and Tongue Tie?

A lip or tongue tie is caused by a labial or lingual frenum (or frenulum).  The frenum is a remnant of tissue in the midline. It is either between the undersurface of the lip and gums or the tongue and the floor of the mouth.  If the frenum is too restrictive, it can interfere with breastfeeding and is treated with an infant frenectomy. A restrictive frenum is commonly called a lip tie, tongue tie or tethered oral tissue (TOTs).

What is an Infant Frenectomy?

We know you want the very best for your little one.  When a lip and/or tongue tie is causing a problem we will happily help you accomplish your goals associated with breastfeeding or bottle feeding.

A lip and tongue tie can cause the mother none, some or multiple problems. These include pain when nursing, nipple damage, nipple infection, low milk supply, mastitis, frustration, and sleep deprivation.  It can also cause the infant problems. Some of these include colic, reflux, blanched/blistered lips, poor weight gain, short & frequent feeding sessions due to infant falling asleep at the breast, long feedings due to inability to drain the breast, gumming at the nipple, etc. all due to poor latch.

These may be some signs of tongue or lip tie

  • nipple pain and/or nipple erosion
  • nipple looks pinched, creased, bruised, or abraded after feeds
  • white stripe at the end of the nipple
  • painful breasts or vasospasm
  • poor milk supply
  • plugged ducts
  • mastitis
  • recurring thrush
  • frustration, disappointment, and discouragement with breastfeeding
  • weaning before mom is ready
  • poor latch and suck
  • fussiness and frequent pulling away from the breast
  • clicking sound while nursing (which can mean poor suction)
  • unusually strong suck due to baby using excess vacuum to remove milk
  • ineffective milk transfer
  • spilling milk during feeds
  • jaw quivering after or in between feeds
  • inadequate weight gain or weight loss
  • irritability or colic
  • gas and reflux
  • gets tired about 1 to 2 minutes into nursing
  • sliding off the breast gradually
  • chewing or biting on the nipple
  • falling asleep at the breast without finishing a full feed
  • coughing, choking, gulping, or squeaking when feeding

Consequences of No Treatment

If left untreated, the tissue does not stretch or rip on its own.  At best, the infant will learn to compensate to eat. At worst, the breastfeeding relationship will suffer and/or end.  Later in life there may be difficulty chewing and/or swallowing certain solid foods. It may lead to delayed or difficult to understand to speech. It most likely will alter facial growth possibly causing jaw problems, inadequate space for teeth leading to crowding and the need for orthodontics, and possibly sleep apnea.

How we Perform Infant Frenectomies

In our office, we correct the altered frenum by doing a frenectomy with the LightScalpel CO2 laser.  Most infants will nurse immediately following the procedure. However, we do not expect full resolution of symptoms right away.  This would be equivalent to expecting full recovery after an ACL surgery. We do a comprehensive exam and evaluate a multitude of parameters prior to proceeding with a frenectomy to ensure success for our mothers and infants. Fortunately, we work with a great team of professionals to support you and your little one on this journey.

Together, we’ll do everything possible to help your little one grow up happy, healthy and strong.

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