Stretching will not increase the size of the surgical site. You cannot over stretch. Improper stretching is when you are too gentle. Stretching and examining an infant must be done with the infant’s head supported on your lap towards your belly. This will provide proper direction and force to properly keep the sire open. Babies do not like the stretches, but they are very brief and help avoid the need for another revision.
Start your first stretch tomorrow morning before the babies first feeding. Stretching should only take five to ten seconds at a time. It’s best to be quick and precise with your movements. It is not recommended to go without the stretches for more than 6 hours. You may get bleeding while doing the stretches, this is okay as long as the bleeding stops after applying pressure and/or breastfeeding.
Use your pointer or pinky finger to do the stretches.
Lip Stretch: For the first stretch, pull the lip out and up (no need to hold it for a certain amount of time, this just flanges the lip out similar to breast feeding). 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 finger from her gum across the site, in the direction of the nose.
Tongue stretch: There is only one stretch for under the tongue. Place finger under tongue, push down and scoop tongue up towards the roof of the mouth. Then push down and swipe from one side of the site to the other to ensure site was stretched, as it is harder to see what you are doing under the tongue.
When the upper lip is tethered to the maxillary arch, it cannot fully flange and therefore may prevent a good latch with all the associated problems including nipple damage, clicking etc.
Un some cases the frenum attachments, both upper and lower are so wide and thick, they may be more uncomfortable for the infant and discomfort may last for more than a few days.
The goal of stretching is to keep the surgical site from healing back together and forming a tight scar tissue. Any open oral wound likes to contract towards the center of that wound as it is healing. It does not matter how the surgery is completed, without keeping the two sides of the site apart until initial healing occurs. There will be a high degree of potential re-healing back together.
Five to six times a day is usually enough throughout the daytime or after every feeding. If you baby sleeps 6 hours or longer at night, then wake the baby once between sleeping to do one a stretch, this is necessary for 6 weeks. We would like you to return in one week for a follow up appointment. If you are unable to attend, please schedule an over the phone follow up with an assistant. We then recommend you also have the sites checked by a breastfeeding specialist or midwife that lives closer to you, if you live further away.
In most instances the tongue that is only released in the anterior will not heal together, but when the posterior attachment is released, you must be diligent with the exercise to realizes the full surgical result.
The surgeries are more traumatic for the parents than the infant. The dentist will work inside his or her safe zone, this may impact the decision on how and what to revise.
Healing: What to expect
The site under the tongue and/or lip where the frenectomy was done should appear as a red
diamond shape in the beginning. If there is a small amount of bleeding, apply pressure until it
stops. If it does not stop bleeding please do not hesitate to call Dr. Ivy Yu.
It will progress to being a white diamond shape as healing process begins (this is a good sign).
Over the next days and weeks, the color will progress to pink and then will gradually look like
the rest of the underside of the tongue. The site should remain a diamond shaped; this shows
that the site is not reattaching. If it starts to look like a diamond squished flat or a square,
reattachment may be starting to happen, please call us right away so we can book an
appointment to check. Doing stretching exercises properly and regularly should keep the site
open enough that it will heal with the diamond shape intact and elongated. This will give the
tongue the best range of motion.
If you have any questions about the surgery or recovery, please call or text Dr. Ivy Yu directly
If you have an emergency, please proceed to the emergency department.