WHAT YOU NEED TO KNOW:

What do I need to know about frenulectomy? Frenulectomy, or frenulotomy, is surgery to remove a small piece of tissue called the frenulum. A frenulectomy for the tongue may be needed if your child has ankyloglossia (tongue-tie). This condition causes the frenulum to develop too close to the tip of your baby's tongue. The tongue becomes tied down and cannot move as freely as it should. A frenulectomy for the upper or lower lip can help your child's teeth come in correctly. A frenulectomy is usually done if the frenulum is too short, thick, or tight to be divided. Surgery may help your baby breastfeed or help your older child speak more clearly.

How do I prepare my child for surgery? Your child's healthcare provider will tell you how to prepare your child for surgery. The provider may tell you not to give your older child anything to eat or drink after midnight on the day of surgery. You may need to stop breastfeeding your baby at least 1 hour before surgery. The provider will tell you which medicines to give or not give your child before surgery. Your child may get an antibiotic through his IV to prevent a bacterial infection.

What will happen during surgery? Your baby may be wrapped in a blanket and placed in your lap for comfort.

• The provider will choose local or general anesthesia. The decision will be based on your child's age and the thickness of the frenulum. With local anesthesia, your child will be awake but will not feel pain. With general anesthesia, your child will be asleep and free from pain during surgery.
  
  
• The provider will hold the tongue or lip out of the way. The frenulum and some tissue around it will be cut with medical scissors, a laser, or an electrocautery device. This device is a needle that is heated by electricity. After the tissue is removed, the incision will be closed with stitches or with heat from the laser or device.

What can I expect after surgery?

• Your baby may be able to breastfeed right after surgery. Breastfeeding may also help stop any mild bleeding from the incision.
  
  
• General anesthesia may make your child's chest or neck red for a few hours. This is normal.
  
  
• If your child received stitches, they will dissolve on their own. It may be painful or difficult for your child to swallow after surgery. Talk to your child's healthcare provider about ways to make sure your child is getting enough liquid. Liquids help prevent dehydration.
  
  
• Your child may have some swelling and mild pain after surgery. This is normal and should go away within a few days. Your child may also have a mild fever after surgery. Ask about safe ways to take a temperature before the stitches have dissolved.
  
  
• Your child's healthcare provider may recommend speech therapy for your older child. Therapy can help your child improve his ability to say certain sounds. The therapist may teach your child tongue exercises to do for 1 month. The exercises can help your child eat and speak normally and prevent tongue scars.

What are the risks of frenulectomy? Your child may bleed more than expected during surgery, or develop an infection.

CARE AGREEMENT:

You have the right to help plan your child's care. Learn about your child's health condition and how it may be treated. Discuss treatment options with your child's caregivers to decide what care you want for your child.