home care for post-op frenotomy burnaby

Home care for post-op frenotomy

There are two two important concepts to understand about Oral wounds

1. Any open oral wound likes to contract towards the center of that wound as it is healing (hence the need to keep it dilated open).

2. If you have two raw surfaces in the mouth in close proximity, they will reattach.

Remember:

Post-procedure stretches are key to getting an optimal result.
These stretches are NOT meant to be forceful or prolonged. It’s best to be quick and precise with your movements.
It is recommended that you purchase an affordable LED headlight (like a camping headlight) to allow you to get the best results.
We highly encourage you to approach these exercises in a positive manner.

Helpful Tips

If your baby is extra fussy, be sure to use lots of skin-to-skin contact. This increases oxytocin levels, lowering pain sensitivity.
If latch has become difficult, try taking a nice warm bath with your baby and try latching in bath.
If your little one is extra squirmy during the exercises, try using a swaddle.
Although not necessary, you may find the exercises more comfortable using nitrile gloves.

Normal Post-Treatment Occurrences

Increased fussiness and inconsolable crying during first week
Make sure you stay ahead of discomfort and be proactive with pain medications.

Bleeding after stretching

A little bit of blood in a pool of saliva appears worse than it really is. If this occurs, nothing needs to be done and it is safe to feed immediately.

Trouble with latch during first week

Due to the initial soreness and re-learning of suck, feedings may be inconsistent the first week. In some cases, latch or symptoms may worsen before they get better. It is critical to work with an IBCLC for any feeding related issues.

Increased choking and spitting up

Some babies may have a harder time adjusting to an increased milk flow. This is usually temporary and should be addressed with your IBCLC.

Increased drooling and saliva bubbles

The healing process increases saliva production. Also, your infant may be adjusting to a new range of motion and can have difficulty controlling saliva. This is usually temporary.

Increased sleeping

This may be due to medication, exhaustion, or that the infant is feeling better and is more satisfied. Sleep may act as a coping mechanism for discomfort

When you need to call the doctor

Although rare, please do not hesitate to call or text Dr. Ivy Yu at 604-617-9091 if you experience the
following:

Fever greater than 38.5° C
Uncontrolled bleeding
Refusal to feed (bottle and/or breast) for over eight hours

Thank you so much for choosing us! We truly wish you and your
baby a fast and easy recovery. Understand that feeding
problems are quite common so you are not alone. Please reach
out for emotional support from others who understand.

What You May Expect After The Procedure

Please note that not all babies follow the typical healing timeline depicted below.

Week 1

Week 2

Week 3

Week 4

Baby will be sore, expect fussiness

Soreness starts to taper off day 7-10

Implement suck training exercises 2- 3x daily

Post-op stretching routine no longer necessary, gentle messaging of new frenulum encouraged

Healing “white patch” forms, this is “nature’s ban-aid”

Baby may be fussy

Healing patch shrinking

Healing patch gone and new frenulum takes final shape and position

Pain meds given as needed

Baby is re- learning how to suck

New frenulum forming

Bodywork, OT, PT, AND LC follow-ups as needed

May have trouble with latch

Feedings may be inconsistent

Bodywork and LC follow ups as needed

Continual progress with feeding

Have back up feeding plan and comfort measures prepared

LC follow up within the first 5 days is highly recommended establish daily tummy time routine

Start to see signs of improvement with feeding

Pain Management Recommendations

Under 6 Months:
Infant Acetaminophen/Tylenol (80mg/1ml concentration) ____________________ ml
Dose based on weight; given every 6-8 hours for first few days as needed for pain

Over 6 Months:
If infant is older than two months and Tylenol is ineffective, get consent from pediatrician for Ibuprofen use.
Infant Drops lbuprofen/Advii/Motrin (40mg/ml concentration) ml
Dose based on weight; given every 6-8 hours for first few days as needed for pain

What are the "White Diamond" Healing Patches?

The released area will form a wet, soft scab after the first day. This is nature’s “band-aid” and while typically white in color, in some cases it is yellow. The diamond will peak in size by day seven and then start to shrink over the following week.

Stretch each side six times a day for the first two weeks through the day. Then stretch the site three times a day for four weeks, for a total of six weeks. Stretching should only take five to ten seconds at a time. It’s best to be quick and careful with your movements. It is NOT recommended to go without stretches for more than six hours. If your baby sleeps longer than six hours, then wake the baby once between sleeps to do one more.

STRETCHING PROTOCOL

Lingual Frenum (Tongue)

There is only one stretch for under the tongue. With clean hands, place the pointer or pinky finger under the tongue, push down and scoop the tongue up towards the roof of the mouth. Then push down and swipe from one side to the other to ensure the site was stretched, as it is harder to see what you are doing under the tongue.

Stretch the tongue up (indicated by arrow shown) and hold for 5 seconds. You should be able to see the entire diamond stretching vertically.

Lingual Frenum (Tongue)

With clean hands, pull the lip out and up (no need to hold it for a certain amount of time; this flanges the lip out similar to breastfeeding). For the second stretch, using an adequate amount of pressure, place your finger all the way up under the lip and rub from one side of the site to the other, then roll the finger from the gum across the site in the direction of the nose.

REMEMBER

Your mouth is a gateway to the rest of your body and your oral health influences your overall health. We see you as a unique individual with unique wants and needs. We believe knowledge is power. During your visit with us we will spend time giving you the information and tools you need to help empower you to optimize your dental health and overall wellness.

Understanding the connection between your oral health and other medical conditions will help you to enhance your quality of life.

Our mission is to provide you and your loved ones with overall health, through oral health. Please spread the word about what we are doing here at My Smile Health Centre!

Dr. Ivy Yu

home care for post-op frenotomy burnaby