What is a Frenectomy / Frenotomy?

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Frenotomy is a procedure used to correct a congenital condition when the lingual (tongue) or labial (lip) frenulum is tight resulting in restriction of function. This may potentially result in difficulty of breastfeeding and other concerns such as dental, digestive and speech issues. If your lactation consultant or doctor feels that this procedure is warranted, then the following is what you can expect.

LIP TIE

A tight upper lip frenum attachment may compromise full lip flanging and appear as a tight, tense upper lip during nursing. This can result in a shallow latch during breastfeeding. Additionally, the tight upper lip may trap milk, resulting in constant contact of the milk to the front teeth. This can result in decalcification and dental decay can develop when the milk is not cleaned off of these areas. This same issue can occur with bottle-feeding. If the frenum attaches close to the ridge or into the palate a future diastema (gap between the teeth) can also occur.

TONGUE TIE

A tight lower tongue frenum attachment may restrict the mobility of the tongue and appear as a cupping or heart shaped tongue when the tongue is elevated. This can result in an inability to get the tongue under the nipple to create a suction to draw out milk. Long term a tongue tie can result in speech problems and/or issues later with transferring food around the mouth for chewing. Approximately 3-5% of the population presents with this condition.

SYMPTOMS

Some babies can have ties and not be symptomatic. To know if the ties are a problem we ask two major questions: "Is the baby getting enough to eat?" and "Is nursing comfortable for the mother?"

Symptoms can be as follows:

Baby’s Symtpoms

• Poor latch
• Attempting to latch
• Colic symptoms
• Reflux symptoms
• Poor weight gain
• Continuous feedings
• Gumming or chewing of the nipple
• Unable to take a pacifier or bottle

Mom’s Symptoms

• Creased, cracked, bruised, or Slides off nipple or falls asleep while blistered nipples
• Bleeding nipples
• Incomplete breast drainage
• Infected nipples or breasts
• Plugged ducts
• Mastitis
• Nipple thrush