After The Procedure
General Questions
How should I prepare for recovery after the procedure?
Initially, your child’s mouth will be numb at the site of the procedure. This will last for approximately 2- 4 hours. Please prepare to ease your child’s discomfort by having pain medication on hand. Stay ahead of pain for the first day, using Tylenol and/or Arnica (and Ibuprofen for children older than 6 months of age) as needed.
We recommend having at least 2 of the 3 medications on hand so that you are already prepared on procedure day!
If you have traveled a distance of a couple of hours, please consider bringing Tylenol or Ibuprofen (depending on what is appropriate for your child) so that you can give a first dose before traveling home.
You can time the medications so they will be at peak effect for the therapy sessions. Also make sure to not skip the stretches after the procedure has been done, as these are essential to prevent reattachment of the tie(s).
When can I do the post procedure exercises?
You may start these exercises 6-8 hours after the revision, unless given different instructions by Dr. Agarwal. If there is any bleeding after the procedure, Dr. Agarwal may have to use silver nitrate locally to control it and you will be instructed to not do exercises for at least the next 24 hours.
Can I breastfeed or give my child a pacifier after the procedure?
Of course! You may feed your baby directly after the procedure and give them a pacifier if needed. If you are bottle feeding, have your bottle ready post-procedure. After the procedure, our staff IBCLC will guide you to a lactation room. Our Staff IBCLC can also demonstrate the exercises if needed. Pain management and wound care will be reviewed with you, as well. You will be encouraged to feed while onsite so that baby is as comfortable as possible for the trip home.
Older children can be given their regular diets after the procedure. Cold foods and beverages, ice creams and popsicles are particularly comforting to children as they temporarily numb the area.
Should we use coconut oil after the procedure?
After a tongue and/or lip tie revision, we do not recommend using coconut oil because this may cause faster healing of the tissue and the tongue tie might re-attach. In addition, the application of coconut oil requires you to go onto the wound, but we want you to go AROUND the wound when dealing with the tongue tie site.
In the past we were suggesting the use of coconut oil on the wound and one of our older videos on exercises still has it there, but since we have not found this practice to be useful and do not suggest that anymore.
How long before the white patch of skin under the tongue/lip stops looking so prominent? What is the white stuff?
Right after the procedure, the wound is going to look slightly reddish and may have a very small amount of bleeding which can be seen as pink saliva. Very often, you cannot even see the wound because there is no bleeding and the red color associated with the procedure is minimal. However, starting the next day or so, you will start seeing the wound covered with a whitish or yellowish membrane. If your child is significantly jaundiced, this film may appear almost look fluorescent yellow or even sometimes slightly greenish. This is the healing tissue of the body which you would see covering any kind of oral ulcer. This area usually looks like a diamond and serves as a good landmark for where to stretch the wound.
Sometimes during the stretching exercises, there may be minimal bleeding, but other than this, bleeding almost never seen. You don't need to go over the wound to remove the white tissue. If you happen to go over it, either by accident or during exercises, the whitish film may slough off and you will see a clean looking wound below it with a whitish base. Do not panic - this is normal.
Over the next 4-5 days, the white diamond tissue will start getting smaller. If it starts looking like a straight horizontal line you will know there is some reattachment happening, You should do more stretching to keep the diamond shape.
By about the 7th or 8th day, the film usually sloughs off and you will start seeing light, pink area below the tongue. What we want to see is a diamond shape, though lesser in size. You still need to do exercises after the wound is not seen and takes the color of the normal mucosa. This can happen anywhere between 10 days to 3 weeks.
Is my child's personality going to be affected by the procedure? Are they going to be miserable during the healing process?
In the first 3-4 days after the procedure the baby may show signs of pain and discomfort. We suggest aggressive pain management with appropriate medications and other modalities including skin to skin contact, soothing activities like baths, breast feeding, singing and cooing, gentle touch, and light swaddling. This seems to work very well for the majority of the babies.
Many families do not want to use any medications for pain and that is an option. However, we suggest that if the child seems to be in pain, medication should be administered so that we minimize the chances of breast aversion or later feeding difficulties. Pain associated with the procedure is a normal phenomenon and does not mean that there is a complication or infection. Once the pain associated with the procedure subsides, babies usually get much happier as they are able to feed better.
Every child is different and some do not need any medications, while some need around the clock medications for the first 3-4 days. There is no way to see beforehand which category the baby will fall into. Pain after the 5th day is unusual. If they seem to be in significant discomfort after the 5th day we suggest you call the frenectomy provider and get the child evaluated.
We have often seen that when parents change feeding patterns from exclusive bottlefeeding to exclusive breastfeeding, if the babies do not adapt well, the frustration the baby expresses may be perceived as pain.
The baby will continue to have some discomfort with the exercises for the remaining 6 weeks, but should not be in frank pain and shouldn’t need any medications unless the wound has been reopened for any reason.
It is very important that parents be emotionally ready to handle the baby’s pain as we have often seen that parents react negatively to the perceived pain in the baby and in turn, will stop doing exercises. This results in increased chances of reattachment. It is extremely important that parents are aware of and comfortable with the pain management strategies after the procedure.
It is very interesting that in a large percentage of cases babies who were perceived as fussy and clicky pre-procedure over the long run become very happy and amiable afterwards. This is a frequently noted observation in our practice.
My child had the procedure a few days ago, but has started becoming more fussy today and resisting the exercises. Is this normal?
Yes, this can still happen because the nerve endings are still irritated. For most children, the first 24- 48 hours are the hardest, however after day 3, the discomfort usually begins to subside as the inflammation starts decreasing.
Staying on top of pain management is very important. Call if you are still having to use Acetaminophen or Ibuprofen 4 times/day, past 3 days, as we may need to change the after-care instructions.
After the first 3 days, we still suggest giving medication for the pain, (Tylenol, Arnica, Ibuprofen), but only as needed.
My pediatrician/family does not know about tongue/lip ties. What can I do to help other parents and babies avoid going through what I had to go through?
Advocacy is a very important part of our tongue tie program. The connection between a mother and the maternal community is extremely strong and invaluable. We suggest that you reach out to other mothers through social media mom groups, friends, and family and share your experience. This does not mean judging your pediatrician (as they have not been trained for handling tongue ties). Sharing the information is vital, in this day and age you can become an agent of change and help many other mothers to breast feed or help children to improve their speech. You can also talk to your pediatrician and share your story with them.
We have been very fortunate already from moms sharing their stories with the community. In the past years, some of the fiercest critics of Agave have become some of our strongest supporters. We often ask mothers for testimonials, attendance to summits/lectures because they are able to share their personal experience with the audience. If you would like to help out with this, please reach out and let us know. It can be very important for other providers and mothers to hear your story.
Exercises
Any tips/tricks on how to get my child's tongue up to stretch the wound?
Build on the skills you developed by doing the pre-procedure exercises. If the child has already experienced the exercises before the procedure they are more likely to negatively react to having your fingers in their mouths for exercises.
Remember to start with clean, well-rinsed hands.
Try to make this a playful routine so that you are effectively stretching the tissue and child’s discomfort is kept to a minimum. These exercises do not take a long time to do; however, they should be done consistently to avoid re-attachment.
If your child prefers cold temperatures, you can try freezing teethers or using narrow cylindrical shaped ice cubes wrapped in gauze (like breast milk popsicles).
Try to position your child in a way that’s most comfortable for them and you, while giving you access into their mouth. You can position your baby on a stable surface, such as your lap or a changing table so that you can see into baby’s mouth. If helpful, place a rolled up hand towel or receiving blanket behind their neck to help their head flex back, making it easier to see the inside of their mouth. The goal of these exercises is to keep the wound from reattaching. This can usually be achieved through activities that involve elevating the tongue, protruding it (while the mouth is open, versus only sticking it out while lips are still closed) and moving it from side to side.
Can my child sleep through the night without stretches and pain control or should I wake them up?
Preferably the stretches should be done around the clock in spaced out intervals, but we do not want to wake a sleeping baby if we can let them go an extra hour or two. If your baby sleeps 6-7 hours at night, just do a good session prior to sleeping, and as soon as they wake up. It should be noted that many parents have reported to us that the easiest time to do the exercises is when the child is sleeping. Keep in mind that also without waking up for stretches they are not having any pain control at night and might be in a bit more pain when you do the stretches first thing in the morning.
We do not suggest waking the child up for pain meds if they are sleeping comfortably.
After 6 weeks of exercises, should I keep doing them?
In the human body, healing tissue changes in appearance over a long time. In our experience we have seen that there is a decrease in incidence of reattachment when the exercises are done for 6 weeks.
However there is a finite chance that there will still be reorganization of the wound and this attachment may happen. We often see wounds that look like they have reattachment, but over the next several months improve considerable and the movement of the tongue improves. This can go in the opposite direction as well. Wound healing is not a static process, it is dynamic.
My child won't suck on a pacifier or on my finger. How do I do the suck training?
Many babies do not perform “non-nutritive sucking”, and won't suck on something they do not find comforting. However, some babies won't function without a pacifier in their mouths. If you can try a drop of breast milk on your finger and see if they will suck that way, and then try a little tug here and there, it will be beneficial.
If your baby won’t suck or just gives up when you start to tug, just keep trying.
What tips are there for doing exercises with my toddler?
The best behavioral technique that works for toddlers is that they are easily distractible. A lot of parents are able to play with the child and get them distracted while performing the exercises. Also make sure that the child has adequate pain control on board, because if they exercises are hurting a lot it will be more difficult for parents to distract the child. The exercises can be done is a very playful manner in which the child can be asked to imitate the parents when moving the tongue around. Another game to play to see if the child can lick (peanut butter, jelly, etc. by moving their tongue from side-to-side.
For pain management, you can try giving your child colder foods like ice cream or a popsicle. This may incentivize them to cooperate and provide pain relief at the same time.
What tips are there for doing exercises with an older child?
If you have not had the procedure done yet, try to do the exercises 3-5 times a day before the procedure, to allow the child to get used to the exercises and having your hands in their mouth.
Start when your child is quiet and non-agitated. Talk them through the exercises. You can have them do the exercises on you for fun and to build more trust and familiarity with them. Using a mirror may provide a visual cue for some children and create an additional element of fun as well. We advise to try doing the stretches while your child is sitting up, like in a bouncer, swing or car seat. This can help make getting the tongue up easier.
If your child becomes distressed or upset, please respect their cues and stop the exercises. Make sure to provide comfort and console them. Building trust with your child is very important to avoid oral aversion before or after the procedure! We understand that toddlers and older children can make this process more challenging. Just do your best!
For pain management, you can try giving your child colder foods like ice cream or a popsicle. This may help relieve pain near the tongue/lip tie site.
Pain Meds
How long should I expect my child to be in pain?
Proactive pain management is very important. For most babies, the first 24 hours are the hardest. After day 3, the discomfort subsides considerably. Some babies don’t seem bothered much at all, and others can be fussier than usual for the first 5 days or so.
When should I start pain medication at home?
Each baby metabolizes the numbing medicine (lidocaine) differently so starting pain control before your little one is in a lot of pain is very important. Starting Tylenol (or Ibuprofen or Arnica) within the first few hours of being at home is recommended. Also, keeping on top of dosing will be very beneficial to making sure this transition goes as smoothly as it can. If your baby is at the peak of pain before control medication is started, it can become very difficult to get him / her calmed down enough to eat. So, staying on top of pain is very important.
How soon after the procedure should I give my child pain medication?
For most babies, the first 24-48 hours are the hardest. Staying on top of pain management is very important. We suggest that you may start giving pain medication 2 to 2.5 hours after the procedure. If you have traveled a distance of a couple of hours, please consider bringing Tylenol or Ibuprofen (depending on what is appropriate for your child) so that you can give a first dose before traveling home.
What is Arnica? Where can I get Arnica 30 C?
Arnica 30 C is a homeopathic treatment that can be used for pain relief. There are several formulations of Arnica on the market, but we highly suggest purchasing Arnica 30 C (aka: Arnica ‘Montana’ 30 C). You can purchase this medication at Sprouts, Whole Foods, or Amazon.
To use Arnica: Take 10 pellets and dissolve it in 1 to 2 tablespoons of water or breast milk. You may have to manually disintegrate the pills if they do not dissolve. Once made, the solution is good for 24 hours.
Once you are able to get the Arnica to dissolve: Give 10 drops of that liquid as needed. For fussiness or inflammation, it can be given every 30 minutes to 1 hour until child is calmed. For preventative use, give once every 3-4 hours or at the time the Tylenol is given. No dosage and effectiveness correlation has been established, and hence the use of Arnica depends on how the child is responding. Arnica can be given every 30 min for up to 5 times, and these can be repeated 2-3 times/ day.
Though we have found Arnica to be very useful in taking the edge off the pain, Tylenol/ Ibuprofen provide much better pain relief and Arnica should be used only as an adjunctive medication. Many parents have been able to use just Arnica for good pain control, but that is rare.
Are there any other natural pain relievers I can use?
At this time we do not recommend any other natural pain relief options, but feel free to consult with a naturopath for more information.
Would infant Orajel be useful after the procedure?
After a tongue and/or lip tie revision, we do not recommend using an Orajel for pain relief as that formulation has been taken off the market for the potential complication of causing methemoglobinemia. Instead of Orajel, we suggest the use of Tylenol or Ibuprofen (for children > 6 months old) and the dosage is based on your child’s age and weight. Additionally Arnica 30 C, (a homeopathic remedy) can be helpful.
Is Tylenol safe to use if I suspect my child has the MTHFR genetic mutation?
Many parents are now suspecting this genetic mutation in their babies and concern is starting to spread with social media . If you have concerns, please address them with your provider or pediatrician prior to this appointment.
MTHFR is an enzyme. In instances when mutations in MTHFR cause the enzyme activity to be severely impaired, it can lead to elevated level of an amino acid called homocysteine. Buildup of this amino acid may increase the risk of blood clotting and heart disease. With what we know about the MTHFR gene mutations, acetaminophen metabolism is not affected by this enzyme. At Agave, we have a minimalistic approach and prefer not to use any medications, if we do not have to. We do not recommend routine use of pain killers. However if you still have concerns, please discuss them with your health care provider.
Symptoms After Procedure
Is lip swelling after the procedure normal?
This is completely normal because the lip is a soft tissue with limited space, hence injection of local anaesthetic may cause swelling, and as the tissue heals there may be further swelling. Most lip swelling goes down in 2-3 days.
I suspect my child is developing breastfeeding aversion. What should I do?
Breast aversion is a rare occurrence after frenectomy. With the present protocol of the exercises at Agave Pediatrics we have not seen many cases of breast aversion. However it is seen in babies who are already at risk for breast aversion. Such babies may have been poor feeders, or had failure to thrive, or other sensory issues. It can also be sometimes seen secondary to extremely vigorous exercises or poor pain control.
If you do believe that your child is facing breast aversion, the first thing you should do is to see an IBCLC who can help you truly diagnose it. If breast aversion is clinically disgnosed, we suggest you decrease the exercises to a minimum, increase pain control, and increase non-nutritive nurturing activities with your baby, such as skin to skin contact.
It is very important that the nutrition of the baby is given due importance as this may sometime require bottle feeding, syringe feeding, and in extreme cases, tube feedings.
I see a little growth under the tongue after the procedure. What is that?
Sometimes after the procedure, you may see a granuloma at the site of the wound. This may be consistent with the destruction of a small salivary gland or sometimes hypertrophy of the tissues from exercising it too vigorously. If you see such a growth, we recommend that you bring it to our attention. This is a rare occurrence and in our experience, it generally does not need any further treatment. It usually goes away in a couple weeks to months.
My child has been drooling a lot since the procedure. Is that normal?
Any injury inside the mouth increases saliva production. This is because saliva has healing and anti-inflammatory properties. This is a normal response and should not cause any concern.
Interestingly, in many older children who have problems with excessive drooling (due to the inability of the tongue to direct the saliva for swallowing) it is remarkably reduced after the procedure.
My child had the procedure but still has gas/reflux. Is this normal? What should I do?
Yes, this is normal and something that happens after the procedure. This is usually due to your little one being able to suck stronger. Try giving your child gas drops and gripe water to help decrease gas and reflux, as well as lots of burping during feeds and after feeds, as needed. Also, if you have a carrier, you can use that to help with comfort and decreasing the reflux, as well.
If you haven't already, we would also suggest working with a bodywork specialist. Experts believe bodywork helps babies latch after a frenectomy. They believe this will help with compensations for when the tongue or lip was not functioning properly. This includes a high tone or low tone suck, clenched jaw, biting, feeding better on one side over the other, and other issues like torticollis.
If your child is really uncomfortable, you can give them a nice warm bath, or even get in the bathtub with them and feed that way. We recommend doing this when you have a helper at home so they can help getting in and or if the tub.
If this is happening after a release and does not improve even after 10-14 days after the procedure, please bring this issue up at the follow up appointment. Your child may need an upper lip tie frenectomy also.
Even after the lip tie is released, the muscles might be tight around the mouth and could still be affecting the seal. This may take strengthening of the muscles and the process of learning how to use them. We suggest continuing the exercises and continued follow up with a bodywork specialist.
My child had a procedure done but is still clicking. Is this normal?
The clicking itself is not an issue - this just means that the tongue is either still weak, might still have a little restriction, or there is air intake. If everything is going well, the child is eating fine, and isn't overly gassy or having issues with reflux, just be patient and keep up the stretches. The clicking is more of a symptom of the problem than a problem by itself!
Prior to getting the procedure done, I had pain with breastfeeding. These symptoms went away right after the procedure but are now starting to return. What should I do?
If you haven't already, we would recommend working with an IBCLC to help you, and give you specific suck training exercises to try and improve your nipple pain.
If you believe the ties may have reattached, ask an IBCLC to evaluate the milk production and milk transfer. If the ties have slightly reattached, they may need to be opened up. If this is early enough in the process, some extra pressure will open the wound, (it might bleed a little, and that's okay, just breastfeed your baby afterwards), but if you think it is anything more than that, please contact our office. Keep in mind that some reattachment is expected but we want to minimize it as much as we can and get functional improvement.
Some IBCLCs feel comfortable in stretching and opening the wound. You may want to check this with your IBCLC.
If symptoms are still not improving, schedule a visit with one of our nurse practitioners or Dr. Agarwal for further evaluation and treatment options.
Reattachment
At our follow-up we were informed of mild reattachment. When would we consider getting it revised?
We see a lot of anxiety associated with 'reattachment'. When any tissue heals, there is fibrous tissue laid in between the two sides of the wound which bridges the gap, and it later remodels itself. This happens after tongue tie surgery also. After the procedure, the increase in the movement of the tongue (after cutting the thick tie tissue) causes improvement in the symptoms. We expect this improvement to continue, hoping that it heals with new fibrous tissue which is not as tight. In the meantime the muscles also get initiated. Hence we recommend start working with bodyworkers even before the procedure is performed and definitely after the procedure. This forms the basis of initial and continued improvement after the tongue tie procedure.
As the wound heals, if the symptoms have improved, there is NO need to consider it to be a 'reattachment' even though it may look like the frenulum has grown back. Very simply stated, the diagnosis of tongue tie in the first place is dependent on the symptom complex and movement of the tongue, and the diagnosis of reattachment is also dependent on the same. The appearance of the frenulum is only a secondary issue. Anatomical 'reattachment' is acceptable to an extent, as long as there is functional improvement. In this circumstance the procedure DEFINITELY does not need to be repeated. If the symptoms have improved, let us not consider reattachment to be a bad word. Hopefully, we have been able to alleviate some concerns.
I am worried about reattachment. Can I post pictures or Skype and get feedback?
Pictorial representation is only a fair representation to diagnose tongue ties or reattachment after the procedure. Per our ‘Agave Approach’ we refrain from making judgements or evaluating just by looking at pictures, as this can be completely misleading and may make you believe that the baby may need another procedure (when they do not), or missing reattachment and the necessity of performing an additional procedure. Pictures may speak a thousand words, but they do not take the place of an in-person evaluation. We are also not offering evaluations by Skype/remotely.
My child had a procedure done a few days ago. The site is white - does that mean it is infected?
Within 24 hours or so of the procedure, a white diamond shape will be seen at the wound site. This is normal healing tissue, not a sign of infection. You may want to take a picture of this for size reference. (If your child is crying and their tongue is raised, it is fairly quick to get a picture before comforting them!)
It is important that you try to maintain the diamond shape with the exercises, until it is completely healed. The edges of the white diamond should stay sharp. If the diamond is shrunken or not even from one side compared to the other, there may be reattachment happening. You will likely be able to release it yourself with your fingers. You may want to give your baby some medication for discomfort if you need to do a firmer exercise to open it up. Some re-attachment is expected, but minimizing it is important for overall improvement. Only do this if you feel reattachment! We want to avoid irritating the wound if possible.
Early on there should not be any tissue stopping your finger like a “speed bump” in the fold area. Later in the healing process a small ‘speed bump’ is normal, however it should be much smaller than what your child had before the procedure.
Why does reattachment occur? Could it happen if I am not doing the exercises right?
Reattachment occurs due to the babies’ normal healing process. We can decrease the rate of reattachment by proper exercise. It should be known that it is not possible to prevent all reattachment with exercises as we have seen it occur with or without exercises. However, the incidence is significantly decreased with proper exercise. Hence we strongly recommend them. If your baby has reattachment, it is not an indication that your technique was faulty or you are “not a good parent”.
Please make sure that you learn the technique well and do it as prescribed. There are many ways of exercising the wound. The most important and fundamental things which decrease chance of reattachment are stretching the wound and making the tongue move. Please see our
videos for further explanation.
There are cases in which a tongue which looks to have reattached completely but functions much better than it was before the procedure. In this instance it is not called reattachment.
When does a child's "heart tongue" go back to normal? Is it a sign of reattachment?
The heart tongue can be developmental because that is how the tongue developed in utero. After the procedure, over time, almost all tongues will improve in appearance. However, in severe cases you may still be able to see a small notch at the tip of the tongue, which is to be expected.
If after the procedure, the tongue loses its heart shape, but in the next couple of weeks starts looking like how it looked before the procedure, it may be a sign of reattachment. Having said this, the most important sign of reattachment is a regression of symptom improvement.
How often are revisions needed after the initial procedure?
The need for a revision after procedure is solely dependent on the function. If you have noticed that the symptoms associated with the tongue have at first improved and then regressed, which may indicate a need for a revision.
In our clinical experience we have noticed that there is a decrease in reattachment with proper exercises, evaluation, and treatment by a bodyworker and IBCLC.
We also receive many patients who have had a procedure elsewhere with not much improvement in symptoms. For these patients, we do our evaluations and determine the need for another procedure, after which the symptoms are often improved. It is impossible to determine whether this was due to a partially-done procedure or reattachment.
Specialists
How important is it to work with a bodyworker after a frenectomy procedure?
Tongue tie diagnosis is frequently associated with other musculoskeletal issues like torticollis. Because of these issues, we believe it is very important to work with
a bodyworker (depending on your child’s age and symptoms). Bodyworkers are physicians with experience in osteopathic manipulative medicine, myofunctional therapists, physical therapists, occupational therapists, feeding therapists, and chiropractors with experience in working with children.
Pediatric chiropractors and other body workers do not work by adjusting the baby’s joints, they work on the muscles and their attachments. These interventions are extremely important for successful improvement in function after the frenectomy. Often, just working with a bodyworker may improve symptoms to an extent that a frenectomy may be either delayed or may not need to happen. It is very important to seek service from bodyworkers who are specifically trained in oral tie issues in children as opposed to a bodyworker who only works with adults.
It is important to keep in mind that some bodyworkers have differences in opinions with your regular medical providers on certain health related issues. We highly recommend getting a medical evaluation and treatment for issues within the purview of general pediatrics from a pediatrician.
We recommend bodywork for children with oral ties as we have seen improvements associated with a holistic approach. Our recommendation is narrowly focused on this issue and the management of oral ties. Please check with your regular primary care providers about continued follow ups with the bodyworkers.
What is all this talk about chiropractic therapy, myofunctional therapy, and craniosacral therapy? What is it for?
When a baby develops in utero with tongue and/or lip ties, it’s not just those areas that are tight; the muscles of the head, neck, face, and back can also be tight. Releasing the tongue or lip tie addresses just one of the muscle/fascial structures - many other muscular areas are still very tight, even after the tongue/lip release.
Osteopathic manipulative medicine, myofunctional therapy, feeding therapy, craniosacral therapy, and chiropractic therapy address these issues. Many practitioners perform a combination of these therapies and are highly effective in improvement of function.
When should I see a Lactation Consultant (IBCLC)?
It varies. Some parents see a Lactation Consultant (IBCLC) on the day of the procedure even though your baby may be in pain or very sleepy after the procedure. The 3-5 days after the procedure can be some of the roughest days for your little one, so trying new positioning and new feeding techniques might be overwhelming. Discussing this with a lactation consultant on the day of your visit and/or with your provider would be the optimal way to identify the best time to see a lactation consultant for a follow up and for trying new feeding techniques.
How should I go about getting an IBCLC?
Post-procedure, our
own IBCLCs at Agave will meet with you to review our aftercare protocol, assist with latching the baby if desired, and review basic, age-appropriate, lactation management. Complicated lactation situations will be referred to your own IBCLC.
If you have a relationship with an IBCLC, it is best that you follow with them, as we tremendously value relationships between families and their caregivers. If you do not have an IBCLC that you are working with already, we will refer you to IBCLCs that share our evidence-based philosophy, our safety protocols, and our proven model of care.
Any recommendations for myofunctional/craniosacral/chiropractic therapists?
Experts believe that myofunctional/craniosacral/chiropractic work helps babies latch before and after a frenectomy procedure. They believe this will help with compensations for when the tongue or lip was not functioning properly. This includes a high tone or low tone suck, clenched jaw, biting, feeding better on one side over the other, and other issues like torticollis.
At Agave, we have worked with many professionals. Please make sure that your bodyworker is certified in the discipline that they are practicing.
We have
Ramya Kumar, SLP, IBCLC at our Glendale location who specializes in myofunctional therapy and craniosacral therapy. At our Glendale and Chandler locations we have
Dr. Katie Neuer, DO who specialises in osteopathic manipulative medicine.
Others include: Dara Salzano Dacunha D.C. (Scottsdale), Chrissy Stamm-Christian, D.C. (Phoenix), Thrive Chiropractic--Dr. Shana Gorman-Dunn, D.C. (Phoenix), Integrated Therapies, LLC -- Allison Kennelly, MS. CCC-SLP (Phoenix). There are other professionals in the valley who we also recommend and a list may be obtained from our office or your IBCLC.
Any recommendations for Lactation Consultants in Phoenix/Tuscon?
Some include:
The Milk Spot - Central Phoenix
Arizona Breastfeeding Center - Tempe
North Star Wellness - Gilbert
Mommy Help Center - at home visits in Phoenix
Modern Milk - Scottsdale and Gilbert
Southwest Perinatal Education Services - at home visits in the East Valley
Breastfeeding Counseling - Northern Arizona
Breastfeeding USA - multiple Phoenix locations
Banner Desert Support Group - meets every Thursday 1-2:30 p.m
La Leche League of Arizona - multiple Phoenix and Tucson locations
Mama's Latte - Northwest Tucson
All About Breastfeeding - Tucson (Northwest Hospital meets every Wednesday at 1PM or 6PM at the Women’s Center classroom)
