During Your Appointment
The appointment may last up to an hour and both parents or a parent and other supporting person are welcome to attend.
On the day of your appointment can you please ensure that your baby does not feed for the hour leading up to the appointment. This is so that they will be willing to feed after the procedure. A parent or adult with parental responsibility will need to sign a consent form and may be asked to hold the baby's head during the assessment and/or procedure.
Please bring along your usual changing bag supplies for baby including everything you need to feed or make up a feed for your baby. You may bring a sterile dummy/soother if your baby uses these. You will also need to bring a clean blanket to swaddle your baby in and your Red Book.
We will complete a feeding assessment and review your telephone consultation paperwork. Your baby will be assessed and we will agree with you a treatment plan. If it is decided that your baby would benefit from a frenulotomy, then this will take place once you have signed a consent form. Your baby will be monitored before you are discharged home.
A frenulotomy procedure involves using a pair of sterile, blunt-ended scissors to cut the connective tissue under the tongue (frenulum) that is restrictive and causing feeding difficulties. This will leave a diamond shaped wound under the tongue that will slowly heal over the coming days. During the procedure, your baby will be swaddled and their head held into position. The procedure is normally very quick and your baby will need to feed immediately after to help stem any bleeding. No anaesthetic is required for this procedure but if your baby is old enough, they can take some pain relief if needed.
After Your Appointment
After your appointment, keep your baby close, skin to skin, calm, and fed. They may be feeling a little unsettled for the first 24-48 hours after the procedure and require more comfort than usual. Keep your aftercare information nearby and monitor for signs of bleeding. Hand in your GP letter to the Surgery as soon as possible. Do not let your baby cry for prolonged periods as this may disrupt the wound and increase the risk of bleeding. If your baby is old enough to take analgesia/pain relief, then you may wish to offer this if you feel that they are in pain.
You are advised to not leave the clinic until your baby is settled and there are no signs of bleeding. You will be given information on how to manage a bleed at home and when to seek medical attention. If you have any concerns, you can make contact with the clinic for additional support. You can find this information here. If your baby is showing any signs of illness, such as a temperature, rash, or reduced feeding and nappy output then seek medical attention as usual.
You will be offered a telephone call within 48 hours for a follow-up and you can access the service for 6 weeks post-procedure should you need to. For ongoing feeding support, you will need to book an appointment at an additional cost. After 6 weeks, you will be discharged from the service.
The wound may not be noticeable or may look like a "hole" or "diamond" shape underneath the tongue. The wound will start to look white/yellow in color after the first few days and this is the normal healing process. Ensure all feeding equipment is sterile and continue with tongue exercises. You do not need to massage the wound.