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Frenulectomy in Children
What you need to know about frenulectomy:
Frenulectomy, or frenulotomy, is surgery to remove a small piece of tissue called the frenulum. A frenulectomy for the tongue may be needed if your child has ankyloglossia (tongue-tie). This condition causes the frenulum to develop too close to the tip of your baby's tongue. The tongue becomes tied down and cannot move as freely as it should. A frenulectomy for the upper or lower lip can help your child's teeth come in correctly. A frenulectomy is usually done if the frenulum is too short, thick, or tight to be cut apart. Surgery may help your baby breastfeed or help your older child speak more clearly.
How to prepare your child for surgery:
Your child's healthcare provider will tell you how to prepare your child for surgery. The provider may tell you not to give your older child anything to eat or drink after midnight on the day of surgery. You may need to stop breastfeeding your baby at least 1 hour before surgery. The provider will tell you which medicines to give or not give your child before surgery. Your child may get an antibiotic through his IV to prevent a bacterial infection.
What will happen during surgery:
Your baby will be wrapped in a blanket and placed in your lap for comfort.
- The provider will choose local or general anesthesia. The decision will be based on your child's age and the thickness of the frenulum. With local anesthesia, your child will be awake but will not feel pain. With general anesthesia, your child will be asleep and free from pain during surgery.
- The provider will hold the tongue or lip out of the way. The frenulum and some tissue around it will be cut with medical scissors, a laser, or an electrocautery device. This device is a needle that is heated by electricity. After the tissue is removed, the incision will be closed with stitches or with heat from the laser or device.
What to expect after surgery:
- Your baby may be able to breastfeed right after surgery. Breastfeeding may also help stop any mild bleeding from the incision.
- General anesthesia may make your child's chest or neck red for a few hours. This is normal.
- If your child received stitches, they will dissolve on their own. It may be painful or difficult for your child to swallow after surgery. Talk to your child's healthcare provider about ways to make sure your child is getting enough liquid. Liquids help prevent dehydration.
- Your child may have some swelling and mild pain after surgery. This is normal and should go away within a few days. Your child may also have a mild fever after surgery. Ask about safe ways to take a temperature before the stitches have dissolved.
- Your child's healthcare provider may recommend speech therapy for your older child. Therapy can help your child improve his ability to say certain sounds. The therapist may teach your child tongue exercises to do for 1 month. The exercises can help your child eat and speak normally and prevent tongue scars.
Risks of frenulectomy:
Your child may bleed more than expected during surgery, or develop an infection.
Seek care immediately if:
- Your child refuses to feed at all.
- Your child shows signs of dehydration from not feeding well. These signs may include urinating less than usual, crying without tears, or having dry, chapped lips. Your infant may have a sunken fontanel (soft spot) on the top of the head.
- Your child has bleeding from his incision area that is heavy, does not stop, or causes him to choke.
Contact your child's healthcare provider if:
- Your baby has problems with latching onto your breast during breastfeeding.
- Your baby is not satisfied after feedings, or you are having severe nipple pain when breastfeeding.
- You are concerned that your baby is not getting enough breast milk or formula during feedings.
- You find breastfeeding painful.
- Your child has a fever.
- Your child has problems swallowing food.
- Your child has problems saying some words or speaking.
- You have questions or concerns about your child's condition or care.
Your child may need any of the following:
- Antibiotics help prevent or treat a bacterial infection.
- NSAIDs , such as ibuprofen, help decrease swelling, pain, and fever. This medicine is available with or without a doctor's order. NSAIDs can cause stomach bleeding or kidney problems in certain people. If your child takes blood thinner medicine, always ask if NSAIDs are safe for him or her. Always read the medicine label and follow directions. Do not give these medicines to children under 6 months of age without direction from your child's healthcare provider.
- Do not give aspirin to children under 18 years of age. Your child could develop Reye syndrome if he takes aspirin. Reye syndrome can cause life-threatening brain and liver damage. Check your child's medicine labels for aspirin, salicylates, or oil of wintergreen.
- Give your child's medicine as directed. Contact your child's healthcare provider if you think the medicine is not working as expected. Tell him or her if your child is allergic to any medicine. Keep a current list of the medicines, vitamins, and herbs your child takes. Include the amounts, and when, how, and why they are taken. Bring the list or the medicines in their containers to follow-up visits. Carry your child's medicine list with you in case of an emergency.
Your child's healthcare provider may recommend speech therapy for your older child. Therapy can help your child improve his ability to say certain sounds. The therapist may teach your child tongue exercises to do for 1 month. The exercises can help your child eat and speak normally and prevent tongue scars.
It may be painful for your child to swallow after surgery. Talk to your child's healthcare provider about the amount of liquid your child needs each day. Liquids help prevent dehydration. The provider may be able to suggest ways to make swallowing more comfortable.
Follow up with your child's healthcare provider as directed:
Your child's healthcare provider may need to make sure your child is eating and healing well. Write down your questions so you remember to ask them during your visits.
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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.
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