A frenectomy is a minor procedure that releases an overly restrictive band of tissue, known as a frenum, located either under the tongue (tongue-tie) or behind the upper lip (lip-tie). This restriction can significantly limit the range of motion of the tongue or lip, often leading to difficulties with latching, milk transfer, and discomfort during breastfeeding. Recovery involves two distinct timelines: one for physical healing of the wound and a separate, often longer, period for functional improvement. Success relies more on the baby learning to use their newly freed oral structures than on the mere closure of the surgical site.
Immediate Post-Procedure Care and Pain Management
The first 24 to 72 hours following a frenectomy focus on managing discomfort and preventing the site from reattaching. Swelling typically peaks within the first two days, and infants are often fussier than usual due to soreness. To manage this discomfort, parents can administer over-the-counter pain relievers, such as infant acetaminophen, following the dose instructions provided by their healthcare provider. Non-pharmacological comfort measures, like frequent skin-to-skin contact, are also highly recommended.
A critical component of the early aftercare is active wound management, which involves specific stretching exercises. These stretches are designed to keep the released tissue mobile and prevent the raw surfaces from adhering back together (reattachment). Exercises are typically performed multiple times a day for the first few weeks, often coinciding with diaper changes, to maintain the achieved range of motion. Parents should expect to see a white, yellow, or grayish patch forming at the surgical site within 24 to 48 hours. This is a normal fibrin clot, or pseudomembrane, which protects the healing wound and is not a sign of infection.
Physical Healing vs. Functional Improvement Timelines
The physical healing of the frenectomy wound occurs relatively quickly, with the tissue generally closing within one to two weeks. Most of the baby’s mouth soreness begins to taper off significantly between days seven and ten post-procedure. The white or yellow healing patch will gradually shrink and disappear between four and six weeks. However, parents must continue the stretching protocols for the full prescribed duration, often four to six weeks, as the underlying tissue is still forming and tightening during this time.
In contrast, the timeline for functional improvement in breastfeeding is often much longer because it involves motor skill development. The baby must learn to break old, compensatory sucking habits and develop new, effective muscle movements. While some mothers report immediate improvement in the baby’s latch, noticeable progress in latch quality and milk transfer usually takes about 10 to 14 days. Full, consistent improvement often requires four to six weeks as the baby’s brain and muscles reorganize to use their new range of motion.
It is common for families to experience a temporary regression in feeding around one to two weeks post-procedure, sometimes referred to as the “honeymoon period” followed by a dip. This often corresponds with the period when the healing wound is contracting, and the baby is actively re-learning how to coordinate their tongue movements. The sustained success of the frenectomy is defined by the baby’s ability to integrate their improved tongue mobility into efficient sucking mechanics over the course of several weeks.
Establishing a Successful Latch and Necessary Support
Achieving optimal breastfeeding success after a frenectomy requires active retraining and support. The procedure simply provides the potential for better function, but the baby must be taught how to use their newly freed tongue effectively. Working with an International Board Certified Lactation Consultant (IBCLC) who specializes in suck dysfunction is considered a priority.
An IBCLC can assess the baby’s new latch, perform weighted feeds to monitor milk transfer, and introduce specific exercises to help strengthen the tongue muscles. They can help the mother and baby navigate the transition by teaching new feeding positions and ensuring that the baby is not relying on the old, ineffective compensatory patterns. In many cases, the baby has developed tension in other parts of the body, such as the neck or jaw, from compensating for the restricted frenum.
For this reason, bodywork is often recommended as a complementary therapy to the frenectomy and lactation support. Professionals like a pediatric chiropractor, craniosacral therapist, or physical therapist can help release built-up muscular tension, which can be a key factor in delayed functional improvement. Addressing these physical restrictions helps the baby better integrate their new tongue mobility, making the latch retraining process with the IBCLC more effective.