Wound healing

Following tongue-tie division there may be a diamond-shaped wound under the tongue. This will heal up by itself and be pink in colour to begin with. Over the first few days it is normal for the wound to look white or yellow and, if your baby is jaundiced, it may even look a bright yellow/orange colour. The size of the wound will reduce and then disappear over the next 14 to 21 days. 

It is advisable to take extra care to thoroughly sterilise any feeding equipment being used to reduce the chance of infection. 

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When to be concerned?

If your baby’s wound looks swollen, red and inflamed or if your baby develops a high temperature, reluctance to feed, is sleepy or irritable please make an urgent appointment with your doctor. If you have any questions about the wound healing please contact us to discuss and / or email us an image of the wound. 

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Bleeding after the tongue-tie division

We will check your baby’s wound after the first feed to ensure all bleeding has stopped. If your baby vomits after the procedure you may notice some pinkness in the milk / vomit. Similarly, you may notice a small streak of blackness in your baby’s stool later on due to a small amount of blood that has been swallowed with the fist feed after the procedure. 

There have been reported cases of bleeding, which has occurred sometime after tongue-tie division, usually on the same day. If this occurs the bleeding is usually very light and is triggered by strenuous crying resulting in the tongue lifting and disturbing the wound or when the wound is disturbed during feeding, particularly if the wound is caught by a bottle teat or tip of a nipple shield. 

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What to do if bleeding starts again later when you are on your own:

• Step 1: First calm your baby by feeding as this helps to stop any bleeding. If this fails and the bleeding does not stop within 15 minutes then move onto step 2

• Step 2: Apply pressure to the wound under the tongue with one finger using a clean piece of gauze or muslin for 5 minutes. Do not apply pressure under the baby’s chin because this can affect breathing. If this still doesn’t stop the bleeding the move onto step 3

• Step 3: Please call Lefko dental surgery on 0041 783 071 444 and take your baby to the Lefko clinic whilst you maintain the pressure on the wound. 

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Your baby’s behaviour

Babies react differently after the procedure. After the first feed, many babies sleep for a period of time due to the surge of adrenaline around the time of procedure. They then may become more unsettled and may be fussy with feeding for a couple of days. 

The Association of Tongue-Tie Practitioner (ATP) collected information from parents about how their babies during the first few days after the procedure. 

·       How much babies slept mainly stayed the same. A few slept more and a smaller number slept less than usual. 

·       Half the babies were unchanged in how much they fed. 

·       Where feeding patterns changed, half of those babies fed more and the other half fed less. For some, this was because feeding improved. Where babies fed less, some parents felt the change was due to the mouth being sore. 

·       A very small number of babies didn’t want to feed at all. If that happens it can help to try another way as a temporary measure – for example, using a sterilised bottle or small plastic teaspoon. 

·       If your baby feeds less than usual, expressing milk will maintain your milk supply and keep your breasts comfortable. 

·       Half the babies who came for the procedure cried as much or as little as they normally did. 

·       The others tended to cry more in those early days, and babies may need extra comfort at this time, from cuddling and closeness, including skin-to-skin contact. 

·       Parents told us that signs of upset were always short lived. Babies who are more than a few weeks old may be more upset than newborn babies, although this varies too. 

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Things you can do to prevent reattachment and to encourage baby to mobilize her/his tongue:

Currently, there is no evidence that wound massage is effective. However, with clean fingers and short nails, there are some gentle fun exercises to encourage tongue mobility 

• Stick your tongue out for your baby to copy

• Run your fingers along your baby’s gums to encourage sideways movements

• Encourage sucking on your finger and attempt a tug of war game’

• In order to prevent reattachment you will have to lift the tongue of your baby all the way up in order to see the wound.  Please watch the following video for instructions. This is the most important part of the exercises. 

• https://www.youtube.com/watch?v=ZXFJHqgawNw

• https://www.youtube.com/watch?v=2JMcbF85ehs  (Melissa Cole)

(4 times a day for 3 weeks)

• Massage  under the chin when baby is sleeping to encourage the tongue to lift up. You can check if the tongue it up by lowering the chin and having a look where the tongue is resting.

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Continuing to breastfeed

·  The procedure usually results in an improvement in breastfeeding, although occasionally, this is not always the case. Some improvements are noticeable straight away but parents have told us that sometimes it can take a few days or even longer. Spending some quiet time with your baby and enjoying skin-to-skin contact can help babies to re-establish breastfeeding.

·  You might need to book a follow up breastfeeding consultation with me if your milk supply is reduced (which is very common occurrence if your baby was tongue-tied). I will be able to help you increase your milk supply.  Alternatively you can also visit your local breastfeeding drop in-group. For dates go to:

For the whole of Switzerland -  https://lalecheleague.ch/en/

·  For more information on how to increase your milk supply you can visit https://www.expatmidwifegeneva.com/post/how-do-i-increase-my-milk-supply