Your IBCLC has referred you to a trusted provider to evaluate your baby for tethered oral tissues. What can you expect next?
Continue to do any additional therapies such as body work along with sucking exercises 3-4 times per day before a release appointment. This will help your baby to prepare for their new range of motion following a release.
1. Schedule an appointment with your chosen provider. Scheduling can be easy and can often be done online or by phone. Your chosen provider may request notes from your lactation consultant, specific photos of your baby’s mouth, or both. These notes and photos can help the provider gather a larger picture of the current feeding situation for you and your baby.
At your appointment, your provider will evaluate your baby for tethered oral tissues. Much of the time, parents anticipate the diagnosis of ties. But what next?
Some providers will release the ties the same day of your evaluation. This can work really well for parents who have had feeding support before the release and whose babies are already practicing for a new range of motion.
Other providers may schedule a release at a later date. This can be beneficial for babies who need additional body work, suck training, or time before a release.
2. Tie release (day of): Following the release, your baby can breastfeed almost immediately. Some parents do notice a difference in latch from the first nursing session, but some babies do need more time and practice for feeding to improve.
Talk with your provider about pain management for your baby. The first few days following a release, your baby may be sore or uncomfortable. Pain management can be as simple as practicing normal comfort measures such as skin-to-skin, and your provider may also give you age appropriate dosing for over the counter pain meds such as tylenol or ibuprofen or homeopathic medicine such as arnica.
3. After release: Implement the stretches or lifts as prescribed by your provider. Here is an example: Frenotomy Aftercare Video
In this video, the provider begins with describing the lifts or stretches that you can do to promote the wound to heal with more range of motion.
As the video continues, she will describe massaging the wound site under the tongue. I have seen stretches/lifts alone work well for aftercare, though some parents do massage the wound site. My caution with any lift or massage is that we want to be effective without being aggressive (I have seen a few cases of aggressive massage of the wound site where baby has aversion to going back to breast)
4. Evaluate feeding and motion following the release. Your baby now has the potential to move more freely than ever before, but this can also take extra practice and time to get those movements right for optimal breastfeeding and oral function. As an IBCLC, I generally see babies on day 2-3 post release to evaluate feeding and add additional exercises depending upon your baby’s needs and developments.
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