What to expect during your child’s tongue tie procedure
We know “frenectomy” sounds scary, but hopefully after reading Dr. Bethany’s guide you’ll feel prepared, educated and calm before your child’s procedure.
Consultation
Your first consultation with Dr. Bethany is a 60-minute session to evaluate if the lip and/or tongue tie release is the best option for your baby.
Before your appointment, you will fill out a variety of forms providing insights on your baby’s medical history, feeding concerns, birth history, and if there’s any concern’s with the family’s feeding journey as well as your feeding goals.
During your consultation, Dr. Bethany discusses your baby & family’s needs and takes a conservative approach to care. She provides alternative methods where possible, and only prescribes a frenectomy when needed.
She will review your individual circumstances and any frenulum that needs treatment (lip, tongue, and/or cheek). She will discuss how having an optimal functioning tongue not just for feeding, but for oral health can provide long-term health benefits for your baby as they grow through the years.
You can ask questions, share how you’re feeling, laugh, cry——or whatever feels best for you! This is a time for you to get to know Dr. Bethany and see if this is the right choice.
If you would like (and the schedule allows), the frenectomy can be performed same day if that is something Dr. Bethany can recommend after her assessment and evaluation.
Please know that Dr. Bethany recommends you feed your baby 30-45 minutes prior to the appointment time. This allows your baby to be comfortable during the consultation and if necessary, the procedure is done on the same day, your baby will find it soothing to feed right after.
The night before the tongue tie procedure
The night before frenectomy, you might feel anxious or nervous but that’s normal.
While you might feel like you need to prepare your child for the procedure, the reality is your child has no fears or worries about it.
The biggest focus actually needs to be on…. YOU!
We recommend trying to relax and do whatever makes you feel. most at ease. Take a bath, watch a movie, meditate…etc.
Happy, relax parents transfers the same energy to the baby! The more calm, and confident you can be the better your baby will feel!
If you’re still feeling anxious, take a look at our testimonials page and feel rest assured you’re in good hands.
The day of the tongue tie procedure
The day has arrived and your family is on the way to Dr. Bethany’s office.
Arrival
When you arrive, please text the office at (626)797-7551.
The procedure
Next, the team will bring you to one of Dr. Bethany’s consultation rooms. Dr. Bethany will talk with you before she begins to make sure everyone is comfortable and on the same page of care.
Dr. Bethany will go over the consent form needed for treatment. She will then gently swaddle your baby and apply a safe numbing gel on your baby where the procedure will happen. The numbing gel she uses is very fast acting and very short lived as we encourage baby to feed right after the procedure.
Due to laser safety reasons, parents will be waiting in the consultation room which allows you to prepare for your baby to feed right after the procedure. Dr. Bethany with her assistant will perform the lip and/or tongue tie release with her CO2 laser. The procedure itself is a couple of seconds long. Your baby will be with Dr. Bethany for a couple of minutes as she does her laser safety check, perform the release, and she takes photos of the wound site area right after.
Dr. Bethany will un-swaddle your baby and bring your little one directly back to you. We encourage you to feed directly after in any way you prefer with the recommendations of your lactation specialist (breastfeeding, bottle feeding, finger syringe feeding).
We are prepared for you! Dr. Bethany created her consultation rooms with comfort in mind so we have breastfeeding pillows (the Boppy and My Brest Friend), regular pillows if you need one for your back, a breastfeeding stool to rest your feet on, and if needed, a bottle warmer.
The wound care tutorial
Next, Dr. Bethany answers any questions and walks you through how to manage your baby's wound for the first two weeks and after. You will leave with a video tutorial of your own baby so you can reference and watch when you’re not in the office making sure you feel comfortable at home.
Dr. Bethany will give you a text a couple of hours after the procedure so you will have her direct number for support and if you have any questions during the wound healing process.
Communication with your collaborative care team
Dr. Bethany will send to any of your providers (doulas, midwives, lactation specialist, chiropractors, craniosacral fascial therapists, infant occupational therapists, pediatrician, etc.) a clinical report of findings, as well as photos to keep your care team informed at your request.
Billing and Insurance
Dr. Bethany chooses to build a patient-centered model for her practice that does not allow insurance companies to dictate the care she provides, which means that she is not contracted with insurance carriers. Payment will be expected during the time of your visit. Our office does provide a superbill at your request that you may submit to your medical and/or dental insurance company to reimburse you directly according to the terms of your policy.
If a release procedure is done, Dr. Bethany provides a letter of support with an additional document containing extensive research that supports the frenectomy. With your superbill, we encourage you to submit the letter and research documents to your insurance to help with your reimbursement according to your insurance policy.
The day after the tongue tie procedure
Your child will likely feel tired from the procedure and possibly more fussy than normal.
Be sure to follow the wound care guidance that goes over in details of what to expect. Dr. Bethany also encourages you to follow up with your lactation specialist for feeding support after the procedure.
Follow-up Visit #1
During the 2nd visit, Dr. Bethany will check-in on the baby and parents. She will evaluate how the wound from the procedure is healing and will perform an in office wound care stretch for you. She reviews wound care instructions again and helps to answer any questions after the first week of the procedure. She reassures parents making them feel supported and love.
Follow-Up Visit #2
Dr. Bethany checks in to make sure everything is healing well in week two. She explains what to do in managing the wound for the next 4 weeks as well as any recommendations needed to help optimize function for baby’s new range of motion baby will have for the lip and/or tongue.
FAQs
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There’s no minimum age. Dr. Bethany has done releases on babies who are 24 hours old and older. It all depends on her detailed assessment and evaluation as well as your collaborative care team that’s supporting you during this time. It’s always a discussion with the families and your care team of when is the most optimal timing of release and what are the goals that we want to accomplish together by doing the release.
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Dr. Bethany takes all precautions to make sure your baby is comfortable during the procedure. Dr. Bethany applies a safe numbing gel in the area where she will perform the procedure. By using the CO2 laser for the procedure, we know it helps minimize any discomfort.
Dr. Bethany’s CO2 laser from LightScalpel is a state of the art device that produces a concentrated beam of light. The highly focused CO2 laser beam vaporizes cleanly and precisely while sealing blood vessels at the same time.
Here are some of the amazing advantages when using a LightScalpel CO2 laser for the procedure:
Minimized Bleeding: As it vaporizes the tissue, the LightScalpel laser seals small blood vessels. The resulting reduction in bleeding makes a frenectomy a quick and easy procedure.
Less Swelling and Discomfort: The LightScalpel CO2 laser beam seals lymphatics, resulting in less post-operative swelling and discomfort associated with traditional scalpel procedures.
Reduced Risk of Infection: The sanitizing effect of the laser minimizes the risk of infection and means faster healing.
Shortened Procedure Time: Less bleeding ensures the improved visibility of the treatment area. This helps to minimize the duration of the procedure.
Faster Recovery: Reduced trauma, minimal to no bleeding, and less swelling and discomfort means the infant can breastfeed immediately after the procedure.
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Your investment is $265 for a 60-minute consultation. If a frenectomy procedure is indicated, that investment is $650regardless how many areas need treatment (lip, tongue, and/or cheek). Total investment with the procedure is $915 (up to 2 years old).
If a consultation is done and Dr. Bethany feels a frenectomy is not the right choice or we need additional care first prior to the frenectomy, you will always get a detailed email from her about what was discussed, what path you would like to take in the care for you and your baby, and any referrals needed to provide you a plan to reach your goals.
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This is a good discussion to have with Dr. Bethany as she wants to make sure that your decision to do the procedure is right for your baby and your family. A frenectomy can always be done later and Dr. Bethany will give you a care plan of what to do to help provide other support in the meantime.
Just know that if a frenectomy is recommended, the lingual frenulum will not stretch over time (which is what a lot of pediatricians say who don’t understand the basic anatomy of the tissues made up of collagen fibers and are not taking into consideration of the anatomical location of where the frenulum is on the tongue). The tight lingual frenulum impacts the tongue’s range of motion from functioning, not eliminating any of the signs and symptoms you may be experiencing and can cause your baby to compensate in function. If you decide to delay the frenectomy, it just means there’s a potential for more pre-therapy intervention to prepare your baby before the procedure. Dr. Bethany always wants to make sure that if she does any frenectomy to give your baby’s tongue more range of motion that you and your baby are set up for success to improve function and to help you on a better path of your feeding journey.
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Very low. The sanitizing effect of the laser minimizes the risk of infection and means faster healing.
You may purchase your own latex free gloves if you would like for the wound care stretches, but it’s not necessary to if you have the proper hand hygiene before doing the wound care stretches. When doing the wound care, you want to make sure that you are always washing your hands with soap and water and that your nails are short and not sharp.
Following Dr. Bethany’s recommendations in how to do the wound care stretches is also crucial so we are not irritating the tissues in the wrong way.