Newborn Lip/Tongue Tie Release

Although often overlooked, an infant’s tongue- and/or lip-ties  can lead to feeding struggles that affect the child’s weight gain and ultimately cause mothers to stop breastfeeding. If you or your baby are struggling with any of the symptoms below, please contact our office at (847) 498-1595 for a consultation and potential treatment or appropriate referral for care.

Mothers symptoms may include:

  • Painful nursing
  • Creased or flattened nipples
  • Blistered or cut nipples
  • Incomplete breast drainage
  • Plugged ducts or mastitis
  • Inability to nurse without using a nipple shield
  • Decreased milk supply

Babies symptoms include:

  • Poor latch
  • Poor weight gain
  • Reflux or frequent spitting up
  • Frequent gassiness and fussiness
  • Clicking or smacking noises when eating
  • Dribbling milk out of mouth
  • Frustration when eating
  • Inability to hold a pacifier
  • Prolonged nursing or bottle-feeding sessions

We work closely with lactation consultants to determine if laser treatment is necessary to alleviate symptoms and improve the overall breastfeeding experience.

After Lip- or Tongue-Tie Release

Your goal is to have the area heal and give the most mobility possible. You should do the stretches with the baby lying down on a changing table, bed, or couch facing away from you like during the exam. Begin doing the stretches the DAY AFTER the procedure. Gloved or clean hands with nails trimmed should be used for stretches.

  1. If the lip or cheeks were released, first put your fingers all the way in the fold of the lips and pull the lip or cheek up and out as high as possible, so you can see the white diamond(s) open. Push right on the area(s), in and up gently but firmly. It may bleed slightly (occasionally), but if you notice bleeding that is concerning, call us.
  2. For the tongue, with one index finger, push down right behind the gum pad in the floor of the mouth, and push into and lift the tongue up and back just above the white diamond to put tension on the wound for a few seconds and repeat 3 times. Use your non-dominant thumb to push down on the gum pad and hold the mouth open. It may bleed slightly the first day or two, this is not a concern.
  3. The main issue is to open and see the “diamond” all the way up on the lip and especially the tongue. If you notice it is becoming tight, then stretch/push a little more to open it back up.
  4. Repeat this 4 times a day for 3 weeks.
  5. If you can’t follow up with us in person, please do a “deeper stretch” and push twice as hard one time at 7 days to ensure the tie isn’t growing back. You will notice some bleeding if it reopens or stretches out, which means it was growing back a little bit, and now it’s reopened. Hold pressure with gauze or a paper towel for 4-5min and it will stop. Symptoms may improve after the stretch.
  6. Play in your child’s mouth a few times a day with clean fingers to avoid causing an oral aversion. Tickle the lips, the gums, or allow your child to suck your finger.
  7. The released area will form a wet scab after the first day. It will appear white and soft. It may change color to yellow or even green. This is not infection, but is just a scab in the mouth. The white / yellow area will get smaller each day lengthwise, but HEALING IS STILL HAPPENING! So even though the white scab is not as visible, you must continue stretching or the surgery may need to be repeated. If you have any concerns, please contact our office.

Follow up with a lactation consultant is critical if nursing. Bottle-feeding babies will benefit from visiting a feeding therapist. You should expect one better feed a day (two better feeds the second day, etc.). Sometimes there’s an immediate difference in feeding, and sometimes it takes a few days-weeks. Skin to skin, warm baths, and soothing music can be very beneficial to calm the baby.

For pain give CHILDREN’S TYLENOL (160mg / 5mL) starting WHEN YOU GET HOME and for the next 2-3 days every 4-6 hours. For babies who weigh 6lbs give 40mg or 1.25mL, 7lb give 1.5mL, 8lb give 1.75mL, 9lb give 2mL, 10lb give 2.25 and 11lb give 2.25mL. Babies 12-14lb can have 80mg or 2.5mL, 15-17lb give 3mL. If your child is 6mo old and 12-17lbs, you can give Infant’s Motrin (ibuprofen) at 1.25mL (50mg). If your baby is refusing to nurse or seems to be in pain, please check the Tylenol dose is correct, and find an alternative way to get milk in (bottle, syringe, cup).

Your child’s lip may swell up slightly for a few days, and the released areas may be sore for a few days, at one week look much better, and at 2-3 weeks look much better and almost normal.