Becky, In response to your post on frenectomy vs frenotomy:
I have experienced several older doctors with old ideas about these
procedures.  Some of the older ENT's say they have to be put to sleep
because they could bleed.  Fortunately, we have more doctors who are
learning to do this easy procedure so we don't have to send them to
these doctors who haven't updated. It still makes me sick to my stomach
when an uninformed doctor tells the mom we don't do these for at least
the 1st year, she listens to the doctor and quits breastfeeding.
My understanding is the only time they need to be put to sleep is if the
frenulum is thick, involving the muscle of the tongue, then they have to
have a special procedure done and it must be under anesthesia. And after
working as a hospital and clinic LC for > 30 years, I have not seen one
yet.
We too, do not use discharge instructions as they never have issues.
The only thing I do add is: "after the procedure, if you still
experience pain with nursing, for the next week, do tongue exercises
before each feeding to help bring the tongue forward". The feedback we
have had from a number of mom's doing this is within the week, the pain
is gone.

Jane Helgesen, RN, IBCLC
Burnsville, Minnesota  

Date:    Tue, 12 Sep 2006 10:50:11 -0500
From:    Becky Krumwiede <[log in to unmask]>
Subject: Re: Looking for patient discharge instructions for post-op
infant lingual frenectomy

I haven't seen any responses to your question, so I'll ask.  I'm
confused about why a 25 day old is having a frenectomy under
anesthesia--was the tongue-tie so severe that the baby really needed
suturing after the division?  I do understand the difference between a
frenotomy and frenectomy--are you in a large medical center?  I've
worked as an LC for 15 years in a small hospital, about 1200
births/year.  I'm lucky in that almost all our docs now recognize that
tongue-tie impacts breastfeeding, and it is easy to get it dealt with.  
All the pediatricians and most of the family docs do frenotomies.  
Probably hundreds of babies have had frenotomies since I've been here,
but I've not seen one yet who required frenectomy.  They're done
immediately here during the hospital stay, or in the doctor's office if
not recognized early.  No anesthesia, no big deal from what I can see,
baby is put to breast right after, certainly less traumatic than a blood
draw.  No discharge instructions.  So I'm curious as to your situation.

Becky Krumwiede, RN, IBCLC
Appleton, Wisconsin

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