Immediate relief after frenotomy is rare, and is most common in infants 
who have the frenotomy very young, or who have been fingerfed with 
stimulation to reduce tongue retraction and posterior elevation 
(humping) so know what to do once the tongue is freed.  Most of the tt'd 
babies in my practice take from a few days to a few weeks to do a good 
job feeding, and those with the more posterior tongue ties take longest 
to improve after frenotomy, as a rule.

I hesitate to provide a standardized care plan for anything, as each 
mother baby dyad is unique. Basically what we want to do are:
nipple hygeine = soap and water cleansing 2x-3x a day to reduce the risk 
of mastitis
feed the baby (preferably in a way that facilitates future breastfeeding)
support mom's supply (almost always involves pumping, unless baby can 
get all he needs from the breast in a timeline that mom can tolerate).
refer to someone who can do the frenotomy.
provide whatever help they need afterward.
Catherine Watson Genna, IBCLC  NYC

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