Frenulums are a normal band of tissue that connects and limits the movement of a mobile structure in the body. The most common examples are the lingual frenulum and the labial frenulum in the mouth, which attach the tongue to the floor of the mouth and the lips to the gums, respectively. They are only abnormal if they are thickened or restrict normal movement of the tongue or lips.

The main indications for surgical management of a tongue or lip tie are:

- breastfeeding problems

- failure for baby to gain weight

- significant pain or nipple trauma to the mother, or

- potential problems with speech or tooth decay in the future

If a mild to moderate tongue or lip tie exists and the mother and baby are not experiencing any abnormal symptoms, there may not be any reason to treat it.

The optimal age at our clinic is 1-4 weeks but we are happy to perform the procedure on babies up to the age of 6 months.

No, your baby does not require a referral letter to obtain a Medicare rebate.

Risks of a tongue or lip tie release (frenotomy) are rare but can include:

bleeding, infection, scarring or re-adhesion of the tissue, damage to surrounding structures like salivary glands, and temporary issues such as mouth discomfort or poor feeding post-procedure.

The procedure may also not resolve the initial feeding problem.

You will be provided with emergency contact numbers at the time of the procedure so that your clinic doctor is contactable if there are any problems.

We recommend a single dose of paracetamol 45 min prior to your appointment ionly f your baby is over 4 weeks of age AND 4kg weight.

Your baby is given 1mL sucrose orally at the time of procedure, which is proven to reduce procedural pain for infants.

In some circumstances, we use a topical anesthetic or inject a local anaesthetic to prevent the baby from having any sensation in the area during the procedure.

If the "snip" procedure is performed without anaesthetic, most babies resume feeding within 5-10 minutes. Feeding and latch is often better immediately and further improvement is observed over the next few days once the baby gets used to being able to use their tongue without movement restriction.

If the baby has had a local anaesthetic to the frenulum, either in topical or injectable form, the lip and/or tongue may be numb making it difficult for the baby to attach temporarily. It may take a number of hours for the baby to have full sensation back and able to latch.

It is not unusual for a baby to sleep 6-8 hours after the procedure or to miss a feed. Some babies will be irritable for a number of minutes to hours afterwards. Behaviourally, most babies are back to themselves within 24 hours.

There are no routine post-operative requirements following the "snip" procedure.

If a local anaesthetic has been used, the frenulum has likely been cauterised with a diathermy or laser. The anaesthetic will last few a few hours. This cauterised area may form a yellow ulcer that may be uncomfortable. You can use a topical anaesthetic cream, such as lignocaine jelly, or use panadol if the baby is over 4kg AND 4 weeks old.

Stretching exercises are not pertinent but may be helpful in preventing the scar from contracting and causing some resitriction.

No stretching exercises are required for your baby following the procedure.

No follow up is routinely required following the procedure but we can see any patients that are worried or concerned.

We will also liaise with your GP or paediatrician if required.

Please contact our office for up-to-date service fees and associated Medicare rebate details.