When Is a Frenotomy Indicated for an Infant?

Breastfeeding your infant can bring a range of benefits, including a reduced risk for asthma, stomach bugs, type 1 diabetes, and sudden infant death syndrome (SIDS). In some cases, though, normal breastfeeding isn’t feasible without a frenotomy.

Also known as a frenectomy or “tongue clipping,” this minimally invasive procedure may be just the thing to turn your breastfeeding challenges around.

Our pediatric team at Sellwood Medical Clinic, with four locations in the metro Portland area, provides frenectomies, when indicated, to benefit you and your baby. Here’s a closer look at this in-office treatment, including when to consider it.

Frenulum problems in babies

A frenulum is a piece of tissue that connects two structures in your body. The frenulum involved with breastfeeding attaches your baby’s tongue to the floor of their mouth.

A tight frenulum causes a condition known as ankyloglossia, or tongue-tie, which can make it difficult for your baby to breastfeed.

Signs a frenotomy is needed

While an expert can sometimes detect a tight frenulum with a visual exam, a baby’s tight frenulum often becomes evident based on residual effects. 

Breastfeeding signs your infant needs a frenotomy include:

• Difficulty latching or staying latched
• Cracked or sore nipples (from your baby’s shallow latch)
• Poor infant weight gain
• Noises such as clicking during breastfeeding
• Restlessness during breastfeeding
• Frequent reflux from swallowing air

Your baby might also have a heart-shaped tongue or struggle to move their tongue normally. 

After an exam to rule out other potential factors behind your breastfeeding difficulties, your provider will let you know if a frenotomy is in order.

What happens during a frenotomy

A frenotomy is a quick procedure, usually only taking a few seconds. Your provider will hold your baby’s tongue toward the roof of their mouth and cut through the tissue near their tongue in a single motion. 

Frenectomies don’t require sedation, although some providers offer a small amount of a sugar solution for added comfort. 

While the procedure brings a small risk of excessive bleeding, there’s usually only a drop or less of blood. Other side effects, such as feeding aversion or scarring, are rare. 

What to expect after a frenotomy

Aided by breastmilk and saliva, frenotomy incisions tend to heal swiftly. Your baby may benefit from frequent feedings for several days post-procedure. Any swelling should resolve within a few days.

In some cases, nursing improves immediately after a frenotomy. Don’t be alarmed, however, if positive changes take some time. For the best results, be sure to schedule any recommended follow-up exams. 

Moving forward, you may benefit from breastfeeding support from one of our board-certified lactation consultants. 

To learn more about frenotomy specifics or get personalized infant support, call Sellwood Medical Clinic today or book an appointment online here.