Your baby may breastfeed, bottle feed and/or use a pacifier immediately following surgery.
It is important to understand that depending on the initial function and adaptability 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. Sometimes additional therapies are needed beyond that to achieve good function with the new range of motion.
Common Post-Operative Healing Consequences:
- Rarely there can be a small amount of swelling of the surgical site. This does not require any special treatment and should resolve in the first couple days
- Low-grade fever (99-102 degrees F) in the first 48 hrs. is common
- 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 evening is common
- 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.
STRETCHES
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 prolonged. It’s best to be quick and precise with your movements. You do have to use firm pressure that is sufficient to stretch the tissue and open the diamond. However, it is not recommended that you aggressively rub the wound. Getting an affordable LED headlight (like a camping headlight) allows for a little better visibility and may make it easier. The following exercises should be started the evening of the day of surgery. Stretches should be resumed when the baby wakes on their own the next day. Baby should not be woken for any reason this first night. THIS IS THE ONLY NIGHT YOU WILL NOT DO STRETCHES DURING THE NIGHT. We encourage you to maintain the 4-hour schedule for the full 21 days even through the night after the first night. Should the baby wake on their own during the first night it will not hurt to do the stretches on the 4 hour schedule but we do not want to purposefully disrupt recovery sleep the first 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.
LIP-TIE AFTERCARE
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
TONGUE-TIE AFTERCARE
Using 1 finger to anchor the jaw down just inside the lower lip but outside the teeth, 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. Switch and do the same thing on the opposite side. Repeat every 4 hours. 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.
PAIN MANAGEMENT
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 take time to relearn and go through periods where they avoid moving their tongue much to prevent soreness. Be prepared to supplement with bottles or syringe 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:
- Homeopathic remedies
- Nursing (We recommend trying other things first if mom is experiencing a lot of pain or nipple damage)
- Lavender or Epsom salts bath
- Nursing in a bath
- Safe breastmilk washcloth popsicles
- Babywearing
- Skin-to-Skin
- Tylenol (according to the dosing chart we provide which is a comfort dose or according to the recommendations of your pediatrician). See chart below:
Tylenol Dosage
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
12 lbs.=5.4kg=54mg.=1.7cc
14 lbs.=6.3kg=63mg=2.0cc
16lbs.=7.2kg=72mg.=2.3cc
18lbs.=8.1kg=81mg.=2.5cc
20 lbs.=9.0kg=90mg=2.8cc
22 lbs.=10kg=100mg.=3.0cc
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.
FOR ADULT AFTERCARE Please go to “Lip & Tongue-Tie” drop down menu and refer to the “Aftercare for 3 years and up”