A Parent's Guide to Post-Frenectomy Care

As a leading pediatric chiropractor specializing in Tethered Oral Tissues and post-frenectomy support, I understand this can be a challenging time for you and your baby. Please know that our entire team is committed to supporting you through every step of this healing journey.

If a tongue or lip tie is suspected, we recommend checking in with an IBCLC with a specialization in Tethered Oral Tissues, as soon as you suspect a concern. Your care team should include an IBCLC, a specialty-trained pediatric chiropractor and a release provider if you choose to get a revision.

Our philosophy at MotherBaby Wellness Co. is to prioritize function and to always start with a less invasive approach (bodywork) first. Many parents come to us for help when they are looking for bodywork to release tension or to help them prep for a more successful revision and aftercare. Whatever you choose is right for your family, we are here to help you navigate the difficult diagnoses of tethered oral tissues and support you every step of the way. 

Table of Contents

1. What to expect
2. Pain management
3. Lactation support
4. Chiropractic support
5. Essential Stretches
6. Such Training Exercises
7. Oral motor & sensory therapy
8. Infant neck stretches

Understanding your baby's recovery timeline. 

Please remember that recovery is individual to each baby. While this timeline represents typical healing patterns, your child's experience may vary. Feeding improvements are usually gradual, often taking 2-4 weeks to develop fully. For many infants, the frenectomy procedure is just one component of comprehensive care, additional therapies may be necessary for optimal results such as bodywork with a certified pediatric chiropractor. Partnering with an IBCLC who specializes in suck dysfunction is also crucial for achieving the best outcomes.

Healing Timeline

In the first few days after the procedure, your baby may be extra fussy and experience noticeable soreness, especially within the first 48 hours. This is completely normal. A white patch will begin forming at the site. This is healthy healing tissue, not a sign of infection. Pain relief measures on a consistent schedule can help ease discomfort, and feeding may be more challenging at first. If so, reach out to your lactation consultant for support and alternative strategies. Comfort measures like skin-to-skin contact, cuddling, and a calm environment can be especially soothing.

As the first week progresses, discomfort should gradually begin to ease, though some babies remain a bit unsettled. The healing site will continue to change in appearance, and it is an ideal time to start or resume chiropractic care with a pediatric chiropractor trained in post-frenectomy care. Feeding may still feel inconsistent as your baby adapts to new oral movements, and small improvements may take time, this is very normal.

Between weeks 2 and 4, most babies show steady progress. The healing patch starts to shrink, stretching becomes less uncomfortable, and feeding tends to improve. Continued visits with your lactation consultant or bodyworker can be helpful if needed. 

By weeks 4 to 6, discomfort typically resolves completely, stretching exercises are often no longer necessary, and the new frenulum takes on its final form. Feeding usually feels much smoother, though ongoing support is available for any remaining concerns.

What to expect after your baby's procedure. 

It’s completely natural to feel uncertain during your baby’s healing process. Here are some common experiences that may occur, along with reassurance and guidance for supporting your little one.

Increased Fussiness or Crying

Your baby may seem more unsettled than usual, especially during the first week. This is a normal response as they adjust and heal. Offering comfort, closeness, and staying on top of pain relief, rather than waiting for signs of discomfort, can make a big difference. Regularly scheduled pain management is often helpful for several days, and in some cases, up to a week.

Sleep Changes

You may notice your baby sleeping more than usual. This can be due to several factors, relief from discomfort, tiredness after the procedure, or the calming effects of medication. Let your baby rest as needed, and trust that this is part of their natural recovery process.

Feeding Adjustments

As your baby gets used to new tongue movements, they might temporarily struggle with latching or seem frustrated during feeds. These changes are expected and should gradually improve. Sometimes, symptoms may even seem to worsen before they get better. Staying in close contact with your lactation consultant or IBCLC during this time can offer support and help ease this transition.

Drooling and Saliva Bubbles

You might notice extra drooling or bubbles around your baby’s mouth. This is very common and simply means their body is responding to both healing and increased tongue activity. It usually resolves on its own as they adjust.

Spitting Up or Slight Choking

Some babies experience more frequent spitting up or mild choking as they learn to feed with their new oral function. While this can be concerning to witness, it’s usually short-lived. Your lactation consultant can guide you through any needed adjustments.

Mild Bleeding After Stretches

A small amount of bleeding during or after stretches may occur. This is normal and typically looks like more than it is because saliva mixes with the blood. Rest assured, it’s not harmful and does not affect the safety of feeding.

Pain management post-frenectomy

Understanding your baby's discomfort.

For most babies, the first 48-72 hours after a lip tie or tongue tie procedure are the most challenging. The good news is that discomfort typically subsides after day 3, and feeding becomes progressively easier. Consistent pain management during this recovery period is essential for your baby's comfort and successful healing.

Comfort Measures

Try these soothing techniques to comfort your baby:

• Skin-to-skin to help soothe baby & promote breastfeeding. This naturally increases oxytocin levels which can also help to reduce pain levels
• Baby wearing to provide comfort through closeness and gentle movement
• Warm bath feeding with Epsom salts for relaxation. Try to latch in the bath together if having a hard time nursing or refusing to nurse
• Singing softly to your baby
• Creating a calming environment by:
  • Reducing sensory input
  • Limiting visitors
  • Spending more time at home
• Breastmilk popsicles applied to healing areas
• Gentle infant massage

These combined approaches will help manage your baby's discomfort while supporting the healing process after their frenectomy procedure.

Homeopathic & Natural Support

For babies & children: 

• Bach Kids Rescue Remedy: Use as directed on packaging.
• Arnica 30c: For swelling and healing. Dissolve 5 pellets in 1 oz of breastmilk, formula, or water. Give 5–10 drops every 1–2 hours as needed (or every 15 minutes during acute discomfort).
• Staphysagria 6c: 1 pellet dissolved in breastmilk or formula, given twice daily to support wound healing.
• Hypericum 30c or 30x: For nerve pain and healing; give 1 pellet dissolved in breastmilk or formula, twice daily.
• Breastmilk Popsicles: Use silicone popsicle molds OR freeze breastmilk flat, break into small chips, and place in baby’s mouth to reduce pain.

Topical Pain Relief Options:

• Diluted Clove Oil: Mix 7 drops of clove oil with 2 ml of fractionated coconut oil. Apply 1 drop along the upper gumline and 1 drop under the tongue during each stretching session.

Specialized lactation support

IBCLCs with advanced training in tethered oral tissues (TOTs) play a key role in recognizing and supporting families affected by oral restrictions such as tongue, lip, and buccal ties. These ties can influence feeding efficiency, oral development, and overall function. Identifying these restrictions requires more than a quick visual check. It involves a detailed functional assessment to fully understand how the tissues are impacting your baby. 

Lactation consultants who specialize in oral restrictions bring a unique blend of clinical expertise and compassionate care. Many have completed extensive continuing education in this area and maintain strong collaborations with other pediatric providers to ensure a well-rounded, integrative approach to care. 

We love to collaborate with IBCLCs and are happy to make a referral based on your child’s specific needs.

Specialized chiropractic support for TOTs

Gentle & Supportive Pediatric Chiropractic

As your pediatric chiropractor, I'll provide specialized gentle adjustments that help to reduce tension after the frenectomy procedure. These adjustments are crucial for releasing tension patterns that may interfere with proper healing and optimal feeding mechanics. At MotherBaby Wellness Co, our approach focuses on addressing the whole body and nervous system to support your baby's oral function.

We Offer Comprehensive Bodywork

Our bodywork therapies specifically address structural issues that affect feeding performance. Babies receiving our specialized care typically show enhanced healing and rehabilitation. Our office provides:

• Pediatric Chiropractic Care: Gentle, specific adjustments to optimize nervous system function and structural alignment.
• Craniosacral Therapy (CST) mixed with Sacro Occipital Technique (SOT): A gentle hands-on approach that releases deep tensions in the cranial system and throughout the body
• Myofascial Release Therapy: A safe, effective technique applying sustained gentle pressure to release connective tissue restrictions that may affect oral function

Care Plans for Post-Frenectomy

Our care plans are always individualized and designed to help your child meet their health goals in a reasonable time. Pediatric chiropractic care is incredibly effective but it does require two things: time and repetition. For optimal outcomes, it is always recommended to follow the care plan outlined for your child. 

A lot of parents want to know what factors shape their child’s care plan so here they are:

• Your health goals for your child & What you share during your consult
• How significantly basic ADLs (activities of daily living) are affected
  • For a baby this is eating, sleeping & pooping
• Physical examination & degree of tension or restrictions
• Neurological scans & Nervous system load/stress
• Body’s level of adaptability
• Length of time dysfunction has been present

Essential Stretching Exercises

Equipping You with the Tools you Need at Home for Optimal Healing 

The absolute most important thing that we can do as providers is to equip parents with the tools and education that they need to be successful at home. 

It is important to know that the lasered tissue naturally attempts to reattach to its original position during healing. Our stretching protocol guides the healing process to help to prevent reattachment at the wound site.

Consistency is key. 

Please follow the techniques outlined on the following pages carefully and diligently & also make sure to follow your provider’s recommended stretches in addition to the following. Please feel free to review techniques and ask questions at any time during our care together.

Stretching Protocol Frequency: 

Begin on the day of procedure and continue every 4 hours (including overnight) for 4 complete weeks or as directed by your provider. 

Remember, your consistent care will significantly improve your baby's healing and comfort during this important recovery period. Try to make these stretches fun to avoid oral aversion. Sometimes using coconut oil helps babies to increase tolerance.

Infant Facial Massage

Perform 1-2 times daily for 3-5 minutes. Always use gentle pressure.

Facial Massage Guide

Forehead: Gently massage skin following arrows. Light pressure on green dot for 30 seconds.

Eyes: Gently massage skin/eyebrows in both directions.

Cheeks/Upper Lip: Massage skin following arrows. Next take pointer & thumb & place cheek in between to gently massage with little circles.

Mouth: Massage skin around mouth in both directions

Chin: Light pressure on blue dot for 30 seconds

Suck Training Exercises

Please use these exercises as a starting point and combine with your lactation consultant’s custom recommendations. Begin with clean hands and smooth, short fingernails.

Finger Sucking

Select a finger similar in size to your nipple. Position the back of this finger against your baby's chin, with the fingertip touching the underside of the nose to stimulate the baby’s mouth to open. Allow your baby to draw in your finger with the pad facing upward and gently rest on baby’s palate to stimulate sucking.

Gag Reflex Desensitization

For babies with high/narrow palates who gag on the nipple or maintain shallow latches, gradual desensitization may help. Begin by massaging near the gumline on the palate, progressively working deeper while avoiding gagging. Continue until your baby comfortably accepts a finger touching the palate during sucking. This is a process that will require repetition over time.

Lateral Stimulation

Stroke both lower and upper gums from side to side. The goal here is to have baby's tongue should naturally follow your finger's movement.

Down and Out Stroking

Start as you did above then rotate your finger and apply gentle downward pressure on the posterior tongue while slowly drawing outward, maintaining downward and forward pressure. Repeat several times.

Circular Stimulation

Brush baby’s lips to stimulate opening then gently massage the tongue tip with circular motions, pressing downward and outward to encourage tongue extension over the lower gums. You can continue this while slowly moving starting point backward. Repeat several times.

Oral Motor & Sensory Therapies

After a tongue tie release, some babies adapt quickly, while others may need extra support to relearn how to use their tongue and mouth effectively. In addition to bodywork, oral motor and sensory therapy can play an important role in helping your baby develop more coordinated sucking, swallowing, and feeding patterns.

Whether or not your baby would benefit from this type of therapy depends on their unique situation. Your provider can help you determine the right next steps. If additional support is recommended, here are some specialists who may be involved:

• OT/PT (Occupational or Physical Therapist): These therapists may be helpful if your baby has difficulties with feeding coordination, body awareness, or motor function.
• SLP (Speech-Language Pathologist): SLPs can assess and support both feeding and early speech development when oral coordination is an issue.
• OMT (Orofacial Myofunctional Therapist): These specialists help retrain and restore balance to the muscles of the mouth and face, supporting improved tongue movement and oral function.

Always talk to your care team about who might be the best fit for your baby. We are always happy to make the appropriate referrals.

Infant Neck Stretches

Babies' neck muscles connect directly to the jaw, affecting oral function. When muscles around your baby's neck and face hold tension, it can contribute to various issues including limited range of motion, flat head concerns, and even reattachment of tongue tie. 

The following exercises are designed to support complete healing by addressing whole-body support. You can perform these stretches during playtime, after bath, or at diaper changes.

Thank you for considering MotherBaby Wellness Co. for your child's pre & post-frenectomy care.

My team and I are deeply committed to supporting your baby's successful healing journey through proper bodywork and holistic care. Remember that while this process requires patience, the integration of chiropractic care with frenectomy aftercare will help your child achieve optimal oral function and whole-body wellness.

Should you have any questions or concerns at any point in your child's recovery, please don't hesitate to reach out at (952) 452-9712. We're here to support you every step of the way.

Warmly,

Dr. Chrisi Kelly, DC, CACCP, CPM, LM

Pediatric Chiropractor & Midwife