What to Expect After Tongue Tie Release (Frenulotomy)

After tongue tie treatment some babies resolve instantly and spontaneously, we hear about these cases online and it can be easy to think that if this doesn’t happen, it hasn’t “worked”.

Suckling requires the use of lots of different muscles and tied babies have had to employ compensatory techniques to feed at the breast or bottle.  Indeed Dr  Ghaheri says:

“An example I often cite was inspired by Dr. Brian Palmer: If I ask you to train for a marathon for 3 months, but during that 3 month period, your shoes are tied together, you will develop a specific way of running the marathon. You might be able to eventually finish that marathon on race day in that fashion. But if I untie your shoes on the morning of race day and ask you to run that marathon in a normal fashion, your training for 3 months won’t help you much. You would have developed a different skill set and muscle strength to compensate.

Tongue-tied children practice sucking against resistance up to the moment their ties are released. Often, there is significant muscular discoordination and habit that doesn’t allow them to nurse efficiently. I don’t think it’s reasonable to expect a mom and child to nurse normally right after a procedure.”

It’s often unrealistic to expect an instant result from frenulotomy, any more than you would if someone separated webbed fingers. How many of us would expect to wake up the next morning and have completely full function and absolutely no soreness or stiffness? When my daughter had a cast removed from her dominant hand following healing of a slight fracture, for several weeks she didn’t use it properly and commented it felt weaker. She passed things to the other hand and we we were told this was to be expected.

After tongue tie treatment,  protruding the tongue may feel unusual.  An adult I spoke to said it felt like sensitive piece of jelly, and the sensation of it moving forward was extremely strange, almost like his tongue was going to fall out.  He commented parts of his mouth were hypersensitive when touched by his tongue which was an extreme “tickle” sensation.

Muscles may ache or feel stiff after a few feeds and there may be a little discomfort from the wound site – although pain wouldn’t appear to be the sole reason as some babies are also fussy post pain relief,  whilst others don’t express any obvious signs of discomfort.

Some babies don’t seem phased and enjoy the easier transfer of milk, one baby this weekend was smiling within seconds as he drank! Polishing off a bottle in 10 mins than nearly took him an hour. Others look visibly confused or startled, some move backwards and forwards checking out what happens with a deep versus shallow latch, and some seem to become frustrated when hungry, tired and things just don’t work how they did.

They may suddenly be able to pull much bigger volumes of milk which some swallow easily whilst others used to bunching up the back of the tongue may cough and splutter and look horrified at. Babies are individuals and just like 10 will respond differently entering a bright chaotic play place (some running with abandon embracing the chaos, whilst some run backwards embracing their caregiver!), some will barely flinch during a heel prick test whilst others cry long and hard – there are no rules.

This is why it can be helpful to work with an IBCLC or suchlike who can help provide ongoing support over the coming weeks – keep in touch to ensure things are moving in the right direction. Lactation involves two people and two bodies, we can’t just bring it down to removing frena.