Getting a tongue tie release is a steppingstone in the right direction to alleviate the symptoms of your tongue tied baby or child. The release, however, is only a small part of what is required to overcome tongue tie difficulties.
For a list of symptoms relating to tongue ties, click here.
A successful release is accompanied by bodywork, IBCLC and aftercare, and how this is performed and timed, is crucial. Thorough planning must be done prior to the release, to ensure that bodywork and IBCLC practitioners are available, that aftercare exercises are rehearsed and pain suppressing medicine at hand.
In this article, we will address the timeline of the tongue-tie release, and give you insights into when to do bodywork, aftercare, consult the IBCLC and more.
Before:
- Identification of possible tongue tie
- Remember that symptoms are more indicative than the appearance of the tongue tie
- Oral motor therapy
- Daily until diagnosis
- Book appointment with bodyworker and plan for the below treatment schedule prior to release
- Book IBCLC appointment to be held prior to release
- Book consultation with appropriate treatment provider
For more information on bodywork, click here.
Day -2: 2 days before the release
- First bodywork appointment
- Perform exercises at home based on bodyworker recommendations (e.g. TummyTime! exercises)
- Stack up on pain suppressing medicine
Day -1: 1 day before the release
- Perform exercises at home based on bodyworker recommendations (e.g. TummyTime! exercises)
Day 1: The day of the release
- Administer pain suppressing medicine prior to the release
- Tongue tie release
- Perform aftercare, preferably every 4 hours for a total of 6 times daily
- If aftercare is especially stressful for your child, consider doing it only every 6 hours, but be sure to do it thoroughly then!
- Perform aftercare for a full 6 weeks post release.
- Perform exercises at home based on bodyworker recommendations (e.g. TummyTime! exercises)
For a video guide to aftercare exercises, click here.
Day 2: The day after the release
- Administer pain suppressing medicine if necessary
- Consultation with IBCLC
- Aftercare every 4 hours
- Perform exercises at home based on bodyworker recommendations (e.g. TummyTime! exercises)
Day 3
- Administer pain suppressing medicine if necessary
- Consultation with bodyworker
- Aftercare every 4 hours
- Perform exercises at home based on bodyworker recommendations (e.g. TummyTime! exercises)
Day 4
- Pain suppressing medicine should not be necessary, but continue if the child seems in pain during aftercare exercises
- Aftercare every 4 hours
- Perform exercises at home based on bodyworker recommendations (e.g. TummyTime! exercises)
Day 5-7
- Update IBCLC on latch, wound, supply etc.
- Consultation with bodyworker
- Aftercare every 4 hours
- Perform exercises at home based on bodyworker recommendations (e.g. TummyTime! exercises)
Day 8-11
- Consultation with bodyworker
- Aftercare every 4 hours
- Perform exercises at home based on bodyworker recommendations (e.g. TummyTime! exercises)
Week 2
- Wound check with release provider
- Aftercare every 4 hours
- Perform exercises at home based on bodyworker recommendations (e.g. TummyTime! exercises)
Day 14
- Consultation with IBCLC on latch, wound, supply etc.
- Aftercare every 4 hours
- Perform exercises at home based on bodyworker recommendations (e.g. TummyTime! exercises)
Week 3
- Wound is at highest contraction stage of healing
- Day 15-17: Consultation with bodyworker
- Consultation with IBCLC on latch, wound, supply etc.
- Aftercare every 4 hours
- Perform exercises at home based on bodyworker recommendations (e.g. TummyTime! exercises)
Week 4
- Day 22-24: Consultation with bodyworker
- Consultation with IBCLC on latch, wound, supply etc.
- Ease up on the aftercare, reduce to 4 times daily and try to avoid nighttime
- Perform exercises at home based on bodyworker recommendations (e.g. TummyTime! exercises)
Week 5
- Day 29-31: Consultation with bodyworker
- Consultation with IBCLC on latch, wound, supply etc.
- Aftercare 4 times daily
- Perform exercises at home based on bodyworker recommendations (e.g. TummyTime! exercises)
Week 6
- Wound should feel soft and pliable
- Day 36-38: Consultation with bodyworker
- Consultation with IBCLC on latch, wound, supply etc.
- Aftercare 4 times daily
- Perform exercises at home based on bodyworker recommendations (e.g. TummyTime! exercises)
Week 7+
- Consultation with bodyworker if needed
- Consultation with IBCLC if needed
- Stop aftercare
- Stop home exercises
At the end of the sixth week, the treatment is concluded, and the effects of the procedure can be fully assessed. After week six it can still make sense to proceed with bodywork exercises, however this should not be due to the procedure, but normal stiffness in the body.
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I may be missing some things here; however, having provided hundreds of tongue tie releases over 35 years before retiring 10 years ago, I am just now freshly looking at tongue tie information on the Internet, being prompted to do so by issues facing family infants and parents in generations after mine. I never recommended aftercare exercises, and I never was aware of any patients with reattachments; however, I did suture most all patients with resorbable sutures, and sometimes in the surgical procedure I did carefully sever submucosal fibrous tissue to the right and left of the midline in what might be called undermining. I invented nothing new but just used with an open mind the techniques I was taught in my residency in the mid-1970s for what was termed “anterior lingual frenectomy.” (I am currently confused by finding the term “posterior tongue tie release.”) Most infants immediately abandoned their compression technique and switched to a thrusting technique on their mothers nipples. Many of these even while still under the effect of the very small amount of local anesthetic. Those that didn’t switch spontaneously and immediately, did switch soon. Recovery was reportedly quick & easy with little or no analgesic needed, no open wound and no difficult post-op exercises. Not one failure to improve feeding was reported back to me. I used a scalpel and no laser, so I do not know; however, I suspect laser procedures might be done in a way to get the same results without suturing as I got with suturing.
(Neither maxillary nor mandibular frena were seen as an infant issue, and for multiple reasons of efficiency and effectiveness were treated about age 6, if still indicated for long-term bone health.)
I am looking up this info because I’m dealing with a posterior tongue tie that has just reattached for the 4th time. Our dentist says to do the exercises for 10 days. She’s only had 1 other baby reattach. I hate to put my baby through it again, but he cannot nurse. I’m worried about buildup of scar tissue. Have you heard of a baby with multiple reattachments?
Hi Britney,
Thank you for your question. It is possible for tongue ties to reattach multiple times. Usually if this happens more than once, my experience tells me that either the procedure was not conducted fully (she did not release the tie sufficiently) or aftercare was not performed adequately (we recommed 6 weeks of aftercare). You write dentist, be aware that alot of dentists do not know enough about tongue ties, so you should consider finding a preferred practitioner who specializes in ties. You are completely correct though, that scar tissue builds up, and that the more procedures you perform, the harder it is to gain mobility. Have to explored other options beside a new procedure? Like working with an IBCLC or performning bodywork? If you decide to get the procedure again, you should wait atleast 6 weeks since the last procedure, and should follow a 6 week aftercare program incl. bodywork and working with an IBCLC.
I truly hope your baby will nurse soon.
Kind regards,
Mark