Frenulotomy for Tongue-tied Newborns

Some children are born with an inherited birth defect in which the lingual frenulum, the tissue that connects the tongue to the bottom of the mouth, is abnormally short, which can restrict movement of the tongue. This condition is commonly referred to as “tongue-tied”. While this condition does not always cause symptoms, some children may experience difficulty nursing, eating, speech problems, or social obstacles because of their condition.

Because a shortened frenulum restricts the range of motion of the tongue, a frenulotomy (sometimes called a frenuloplasty or frenulectomy) may be recommended. A frenulotomy is a surgical procedure performed to clip the frenulum and release the tongue. This procedure can be done at any age, but is most commonly done for breast-feeding newborns in the hospital during the first few days of life or in the physician’s office. At this age, stitches are usually not needed and the baby can breastfeed immediately after the procedure. After a frenulotomy is performed on a breast-fed baby, the mother often reports a deeper latch and significantly less pain. Although it is considered a safe and simple procedure, risks of a frenulotomy may include infection, scarring and excessive bleeding. Sometimes, the frenulum reattaches and the procedure has to be repeated.

The Frenulotomy Procedure At Pimri Pediatrics

Dr. Nic Peters is trained to perform frenulotomies in the office. Your child does not need to already be a patient of Pimri Pediatrics or of Dr. Peters for him to perform the procedure. Beforehand, he will explain the procedure and you’ll be able to ask any questions you have. Then the baby will be swaddled and placed on the infant warmer bed. With special tools, the frenulum is cut and pressure is applied to limit any bleeding. Then the family is asked to feed the baby immediately afterwards. The suction in the mouth created with feeding helps limit bleeding and starts the healing process. Mothers who breastfeed are often amazed how comfortable feedings feel after the procedure.

At this time we only perform procedures on the anterior (front) frenulum. Lip ties and buccal ties are best performed with a laser machine, since they can have more bleeding. Posterior tongue-ties should also be performed with a laser. We only perform this procedure on newborns. Older children should see a specially trained dentist or oral surgeon for the procedure.

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