If you are worried about your baby after the procedure PLEASE CALL ME for reassurance, however the following information is what to expect in the first few days following the procedure.
Unfortunately, for most mothers the tongue tie release is NOT AN INSTANT FIX
The procedure can sometimes mean a reduction in nipple pain immediately, but in most cases, it takes time, patience and perseverance for the baby to increase the strength in their tongue in order to be able to feed more effectively.
It is important to continue with Lactation Consultant support following the release to ensure that things improve.
What to Expect:
Occasionally the 2ndfeed or third feed following the procedure doesn’t seem to go as well. This is because depending on how tight the tongue tie was, sometimes the tongue SPRINGS up towards the roof of the mouth and the baby struggles to get it back down to move in the right way. The baby has a disorganised suck following the procedure as they are just not used to moving their tongue in a new way.
If baby is particularly fussy, struggling to latch you can:
· Express a little milk onto a teaspoon and give this directly to calm them down to latch.
· Encourage baby to suck on a clean finger to establish a rhythmic suck, bring baby to breast still sucking…whip finger away and encourage the latch that way.
· If you have any expressed milk, using a syringe ‘dropper’ the milk onto the breast whilst the baby is trying to latch, and if they come off again, drop milk into the corner of their mouth whilst they are suckling to encourage them to stay there.
· Baby may be a little grumpy, have plenty of skin to skin cuddles for comfort and reassurance, and don’t forget to look after yourself too! (eat and drink well, and get rest when you can)
· There should be NO MORE BLEEDING, however some older babies put their fingers in their mouths and ‘knock’ the wound site, which may cause a small bleed or oozing. This can be normal, just FEED the baby and it will stop.
CALL SARAH IF ANY FURTHER BLEEDING OCCURS (this is Very rare)
Baby may be still a little grumpy or disorganised with their suck, you may find that you have to encourage them using the techniques above, or they may be feeding better than before.
· Continue with skin to skin, remember to take care of yourself too.
Day three for some babies can be the worst day for feeding. The tongue is a muscle, and has had a period of time with restricted movement. Similar to when an adult exercises for the first time in a while, day 3 after exercise the muscles in the body ACHE. Day 3 tends to be an achy day for babies following release, as a result they can be grumpy again and may struggle with the latch again.
If your baby is old enough for analgesic you may wish to consider a dose of paracetamol or ibruprofen FOLLOW THE RECOMMENDED DOSE FOR YOUR BABY’S AGE ON THE PACKET
· Continue with skin to skin cuddles for reassurance and hormone boost for baby
· The White/Yellow Patch under the tongue might appear today THIS IS NORMAL.
The White/Yellow Patch Under the Tongue
The white/yellow diamond shape under the tongue following the procedure appears a couple of days later and can be there for up to a week. IT IS NORMAL -there is no need for any wound care.
DO NOT MASSAGE UNDER THE TONGUE:
· This increases the risk of infection,
· Is stressful for mum and stressful/uncomfortable for the baby,
· Increases the presence of scar tissue which can restrict the tongue worse than the frenulum itself. (which may result in general anaesthetic at Southampton Hospital needed to excise the scar tissue in order to release the tongue)
Re-occurrence of the Tongue Tie
If your baby is less than 3 weeks old, there is a possibility that more frenulum will come forward under the tongue with normal rapid physiological growth. You might feel that some of the original symptoms may come back. In my experience about 3% of babies who were less than 3 weeks old at the time of the original division, will need to have a further division.
What to do:
· Come to the Clinic or have a follow-up consultation as soon as you feel the symptoms returning
· If a re division is needed/required this is done at NO FURTHER COST TO YOU (home visits are charged at the normal follow up rate, 2nd divisions in a clinic sessions are Free)
If your baby is older than 3 weeks but has had slow weight gain, then suddenly increases weight after the tie release, more still may come forward due to rapid physiological growth.
Rarely, more tie comes forward in older babies too. I cannot guarantee that this will not happen, therefore it is essential for improvement for you to seek continued Lactation Consultant support.