Your baby may breastfeed, bottle feed and/or use a pacifier immediately following surgery.
It is important to understand that depending on the type of tongue-tie or lip-tie your baby had, improvement with breastfeeding may not be immediate. It can take 3–4 weeks or longer for your baby to learn how to use his or her tongue in an effective manner. We strongly encourage you to follow up with lactation support 5-7 days following your procedure.
Common Post-Operative Healing Consequences:
Rarely there can be a small amount of swelling of the surgical site. This does not require any treatment
Low-grade fever (99-102 degrees F)
Slight bleeding of the surgical area for one to two days: IF bleeding does not stop with nursing or pressure with gauze within 10-15 min, contact Dr. Prather.
Extreme fussiness and frustration the first day.
Improvement with breastfeeding may not be immediate. It can take time for your baby to learn how to use his/her tongue and other orofacial muscles in an effective manner.
Your baby’s mouth heals quickly and stretching exercises are very important after the procedure to make sure that the area that was released doesn’t heal back together. Before starting the exercises, make sure that your hands are clean and your fingernails are short. These stretches are NOT meant to be forceful or prolonged. It’s best to be quick and precise with your movements. You do have to use pressure that is sufficient to get baby to open wide and completely lift the tongue but do not aggressively rub the wound. I feel that getting an affordable LED headlight (like a camping headlight) allows you to get the best results.
The following exercises should be started the evening of the day of surgery. Stretches should be resumed the next morning. THIS IS THE ONLY NIGHT YOU WILL NOT DO STRETCHES DURING THE NIGHT. It is necessary you do at least one stretch during the night for the next 21 days to prevent reattachment and for best results, we encourage you to maintain the 4-hour schedule for the full 21 days even through the night.
Before beginning, position yourself above the baby with the baby’s feet going away from you for the stretches.
Buccal Tie Aftercare
Place your middle fingers in the cheeks and roll up and beside the jaw bone pulling out and as you push up toward the cheekbones.
Using your thumb and middle finger in a pincer grasp firmly grasp the upper lip and lift out and up over the nostrils. Hold for a few seconds while pressing your index finger across the surgical site once. Repeat every 4 hours during the day and once in the middle of the night for 21 days.
Using 1 finger to anchor the jaw down just inside the lower lip, open the mouth as wide as possible and use the other index finger to press the pad of the index finger down into the floor of the mouth under the tongue. Maintaining downward pressure begin moving the index finger back toward the base of the tongue and push the tongue back and toward the throat. You will press over the surgical site as you do this and you need to put enough pressure to cause it to open and lengthen. Hold the stretch for a few seconds. Switch and do the same thing on the opposite side. Repeat every 4 hours during the day and once in the middle of the night for 21 days. If the baby is biting and opening the mouth is difficult try using a finger as a bite prop back between the jaws in the molar area and use the opposite finger to push down and back under the tongue.
Most of our babies do very well following their procedure. However, every baby is different and we encourage you to be prepared for extra fussiness and need for extra cuddles for the first 4 days following the procedure. Babies may also go on a nursing strike. Be prepared to supplement with bottles as needed and try not to stress during this time as it will pass and baby will resume their normal schedule as soreness and frustration lessens.
Some things you can try to calm your little one include:
- Arnica Comfort nursing (We recommend trying other things first if mom is experiencing a lot of pain or nipple damage)
- Lavender bath or nursing in a bath
- Safe finger washcloth popsicles
- Tylenol (according to the dosing chart we provide which is a comfort dose or according to the recommendations of your pediatrician). See chart below:
1 mL = 1 cc
Conversion Table for 160 mg/ 5cc bottle:
6lbs.=2.7kg= 27 mg. = 0.8cc
8lbs.= 3.6 kg=36mg.=1.1cc
10lbs.= 4.5kg. =45 mg. =1.4cc
If all these methods fail, do your best to keep in mind that fussiness will pass and try to take turns between mom and dad so one parent does not become overwhelmed.
Adults can perform the same lip and tongue-tie exercises recommended for infants, but can typically handle performing them independently. For pain, we again recommend over the counter pain relievers like Tylenol or Advil. You can ice the treated area for a few minutes at a time to decrease discomfort and reduce swelling or inflammation.
You should fully recover within three weeks. If at any time you experience fever, severe pain not abated with store-bought pain relievers, extreme swelling that makes speaking, chewing, or breathing difficulties, or other signs of infection, contact us immediately.