Tongue Ties- After The Release
Tongue ties are something everyone has heard of, but most know very little about it. They have been treated for thousands of years, yet even the medical community is still debating over them. It is estimated that 20% of newborns have some sort of intraoral physical restriction. Many doctors, dentists, nurses, and lactation consultants can pick out the obvious ones. The easy to diagnose TOTs (tethered oral tissues) are sometimes “snipped” or “clipped” in the hospital or pediatrician office with scissors. Sometimes this does the trick, but usually, there is an incomplete release and no post-op therapy guidance. This can lead to scarring, re-attachment, and continued difficulty breastfeeding (along with possible issues with speech, sleep, and breathing in the future). One of the most important steps of the process is post-release.
Utilizing our non-touch CO2 laser, we can release a tongue or lip tie in under 20 seconds, with almost no bleeding, minor discomfort, and quick healing. We can discuss the benefits of using the soft tissue laser over scissors or scalpels in infants another time, but today we are going to discuss what can make or break our outcomes, post-release!
1. Lactation consultant follow-ups
Every baby we treat in office has already been evaluated by a lactation consultant (and usually a pediatrician). I am an expert in the evaluation of anatomy, its functionality, and treatment, they are experts in breastfeeding itself! New moms need to follow up with their lactation consultants post-release. Our babies come out learning at a rapid pace. After 2 weeks we throw a wrench in that learning and give them a brand-new tongue and/or lip! They have to now re- learn how to properly use them to make breastfeeding more successful and less uncomfortable for both the mother and themselves. Positioning issues can be easily addressed, and they can perform weight checks pre and post feeds to see how much transfer is occurring. It is a huge part of the process and in my book, critical for the best overall outcomes.
2. Stretches/exercises starting the next day
One of the biggest shocks, I get out of parents is when we go over stretching after the release. Many are not aware they are in for a little homework after the procedure! When we release TOTs with a CO2 laser, the tissue starts to heal very rapidly. We did all the work to give the tongue all that mobility, we want to keep it that way as it heals. I recommend 4-6 stretches for 4-6 weeks after the release, to prevent re-attachment, maximize the healing process, and achieve the best possible result. If left to heal naturally, many tongues will re-attach and hinder outcomes. It sounds like a lot of work at first, especially for new parents whose entire world is already upside down. So I recommend performing stretches on a changing table, right before you change their diapers. They are already in a bad mood, they go to the bathroom at least 4-6 times a day and you can knock out the stretches and clean them up. Parents that are actively engaged in the post-op stretching, typically have the best outcomes, it’s something we stress from start to finish in our office!
3. Follow up appointments in our office
At the Tampa Tongue Tie Center I like to see patients 1 week and 3 weeks after release in the office to monitor healing and help answer questions. These visits can be as important as the procedure itself, we do not charge for any follow-up visits and encourage all parents to make it back for the re-evaluations. At these quick appointments, I can access the healing process and make sure there is no infection or re-attachment. If we see re-attachment, we can deep stretches to return to a full release. We also take photos of the wounds healing, to gain information on the success of our release. Finally, we talk with the parents to see if symptoms are improving, review stretching information if needed, and answer any other questions parents may have. We receive a ton of feedback at the appointments; without them, we would not have the successful outcomes we see!
4. Discomfort and pain relief
Many parents are primarily concerned with the post-op discomfort and how the babies will handle the recovery. This is completely understandable, we are performing surgery, on an infant, we want them to be comfortable after the release and not cause more issues than we began with. This is one of the many reasons we use the LightScalpel CO2 laser for our releases. The procedure itself is extremely quick, minimizing discomfort during the procedure. The precision, wavelength, and minimal heat the laser produces also increases post-op comfort, so feeding strikes are extremely rare and so is the need for Tylenol. If an infant is having obvious discomfort, we can provide the appropriate medication, but even this is typically only the evening of the procedure. Since switching to the non-touch laser from my previous model, discomfort is rarer and most babies do extremely well!
There are other aspects of the post-operative process, but these are the main things we like to focus on. With a proper diagnosis, quick/easy treatment, and solid parental follow-through, we can help mothers and babies thrive! If your family would like to schedule an appointment or are interested in more information on tongue tie or lip tie treatment in Tampa visit the Tampa Tongue Tie Center today!
