Tongue-Tie

The following is an exerpt from Ankyloglossia: Assessment, Incidence, and Effect of Frenuloplasty on the Breastfeeding Dyad
Jeanne L. Ballard, Christine E. Auer and Jane C. Khoury

In children older than 4 months, anesthesia is usually required because of the infant?s strength and awareness. In early infancy, however, the procedure may be accomplished without anesthesia and with minimal discomfort to the infant. The infant is placed supine with the elbows held flexed securely close to the face and the assistant?s index finger on the chin for stabilization. The tongue is lifted gently with a sterile, grooved retractor so as to expose the frenulum. With sterile iris scissors, the frenulum is divided by approximately 2 to 3 mm at its thinnest portion, between the tongue and the alveolar ridge, into the sulcus just proximal to the genioglossus muscle. Care is taken not to incise any vascular tissue (the base of the tongue, the genioglossus muscle, or the gingival mucosa). There should be minimal blood loss, ie, no more than a drop or 2, collected on sterile gauze. Crying is usually limited to the period that the infant is restrained. Feeding may be resumed immediately and is without apparent infant discomfort. No specific aftercare is required except that breast milk is recommended for at least the next few feedings.