Sorry this reply is so late.

There is one instance when a frenotomy could do harm:  in a baby with
Pierre Robin sequence (micrognathia, posteriorly placed tongue, and
often cleft palate), the tongue falls back into the airway, impeding
respiration.  If a baby with this sequence has a tight frenulum, it can
help to keep the tongue forward.  In fact, the tongue is sometimes
sutured forward to prevent respiratory distress in these infants.

Otherwise, there is little pain and little bleeding with frenotomy, as
the frenulum is relatively avascular and poorly innervated in infants.
Some babies in my practice have not wanted a finger in their mouths for
24 hours or so after the procedure, but they seem to get over it
quickly.

As the mother of a teenager who should have had his frenulum clipped at
birth and did not until age 10, I can say that the effects of NOT doing
it are far worse.  My son had severe sleep apnea, maloclusion, a high
narrow palate, and speech difficulties from his tongue tie.  Instead of
a snip with a sterile scissors, he required tonsilectomy to expand his
airway, maxillary expansion to widen his palate, orthodontia, and years
of speech therapy.  His speech improved after the surgery, but his
tongue function overall is still poor, he still cannot lift his tongue.
His grades also skyrocketed once he was sleeping properly!  Brian Palmer
has slides of my son's mouth before and after, which I sent him as a
"thank you" for pointing me toward maxillary expansion to solve the
sleep apnea.

(I suspect this is because the brain seems to map the body early on, and
resists major changes to the mobility of the body parts.  Myofunctional
therapy is supposed to be helpful in this regard, but I have no personal
experience with it.)
--
Catherine Watson Genna, IBCLC  New York City  mailto:[log in to unmask]

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