Tongue Ties and Lip Ties
Release of Tongue and Lip Ties
We aim to perform treatment promptly following your consultation—often on the exact same day. Acting quickly is essential: the sooner a baby’s tongue tie or lip tie is freed, the higher their chances of achieving successful breastfeeding in the long term!
Getting Ready before your consultation
Stretching and Strengthening Exercise
Often, infants requiring the removal of tethered oral tissues (lip or tongue ties) may have weak or disorganized suck patterns. Prior to your procedure, practicing certain exercises can help bolster both your confidence and your baby’s coordination for the upcoming frenectomy. These movements also support quicker recovery and reduce the risk of reattachment. Aim to do them four times daily until the day of the procedure. Coordinate closely with your lactation consultant for specific recommendations, but here are some to get started:
- Have your baby suck on your finger while you gently press onto their palate. As soon as they begin sucking, lightly push your fingernail down into their tongue. This briefly interrupts the sucking reflex while your baby pushes back, usually causing a small break in the seal. Then lift your finger to re-trigger sucking. Repeat as tolerated.
- While your baby sucks on your finger, gradually pull outward in a “tug-of-war” motion, encouraging them to resist by sucking harder. This exercise helps strengthen the tongue. You can use a pacifier in a similar way.
- Gently move your finger from side to side along your baby’s lower gum line. Their tongue will follow, which promotes stronger lateral movements.
- Place one finger inside your baby’s cheek, and your thumb on the outside, then rub or massage in slow, gentle motions. This can reduce tension in the cheeks.
Day of the Procedure
For pain relief, you can administer acetaminophen (Tylenol) about 30 minutes before the frenectomy. This offsets discomfort and allows you to focus on your baby. Be sure to use the manufacturer-provided dropper and confirm the dosage of 160 mg/5 mL (avoid concentrated formulas). If preferred, you may opt for an alternative remedy or no medication at all. During the procedure, we’ll apply a topical anesthetic, so not every child requires medication in advance.
Aftercare
After you return home, please notify us immediately if your child experiences ongoing bleeding, has a fever over 101.5°F, or refuses to feed (breast or bottle). In the days following the procedure, the incision site often develops a whitish or yellowish scab. This appearance is normal (it may look yellow if your baby’s bilirubin was high). The scab may peel between days 5 and 7, sometimes revealing small red spots (petechiae) that can ooze lightly. By about two weeks, most of the surgical area is healed.
POST SURGERY, TONGUE AND LIP TIE EXERCISES AND STRETCHES.
Video Credit: A big thank you to our friends over at La Petite Dent Pediatric Dentistry and Orthodontics in Nanuet, NY for letting us share this awesome video!
After Surgery Exercises and Stretches
Here’s where the real diligence starts! The biggest concern after a frenectomy is reattachment of a tongue or lip tie. Because surgical wounds naturally contract during healing—and because mouths heal so rapidly—tethered tissues can close too quickly and bring back feeding challenges. By doing the following exercises six times per day for the first four weeks (then tapering over the next two weeks), you significantly reduce the chance of reattachment.
Learning how to stretch and strengthen your child’s lip or tongue can initially feel intimidating or anxiety-provoking, but it does get easier. Remember, we are always just a phone call away. Keep it upbeat so your child senses playfulness instead of stress. Perform each stretch gently but with consistent pressure, positioning yourself at the “12 o’clock” spot—directly above your baby’s head—whether your baby is in your lap or on a comfortable surface.
Upper Lip Stretches
Place two fingers beneath the upper lip and gently pull upward, aiming to raise the lip toward the nose. Then move side to side six to eight times. The goal is to prevent the lip and gum from healing back together where the tie once was.
Under the Tongue Stretches
With two fingers under your child’s tongue, “lift up” the back section and gently raise it toward the roof of the mouth. Picture the laser incision as forming a diamond shape. The tongue requires three key stretching movements:
- Pick up the tongue’s posterior (back) portion toward the palate, hold for three seconds, then repeat six to eight times. Try to fully extend the diamond so the site under the tongue is clearly visible.
- Place a finger in the center of the diamond and perform small circular movements to open that space.
- Turn your finger sideways and roll it from the center toward the edges of the diamond, working upward and downward. This “rolling pin” action keeps the incision site flexible and prevents muscle tightening at the tongue’s base.
Support
It’s vital to continue care with your lactation consultant or physician following the frenectomy. They’ll spot any signs that your child may still be compensating—or “working around” difficulties—and guide you both toward effective feeding strategies.
Here is a helpful article on how a team-based approach can nurture a more positive breastfeeding experience.
We welcome your calls at any time if you have questions or concerns. Your baby’s well-being is our shared mission, and we’re here to help in every way possible!
