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Infant Frenectomy with Laser
An infant frenectomy is a minimally invasive procedure used to treat tongue-tie (ankyloglossia) and lip-tie. These conditions can interfere with breastfeeding and may affect oral development. Using a laser allows for precise treatment, reduced discomfort, faster healing, and a low risk of complications.
What is a Frenulum?
The frenulum is a small band of tissue that connects the tongue to the floor of the mouth or the upper lip to the gums. In some babies, this tissue is unusually tight or thick. When it restricts movement, it is called a tongue-tie (tongue movement limited) or a lip-tie (lip movement limited).
Why Might a Frenectomy Be Needed?
A restrictive frenulum can:
• Make breastfeeding difficult – leading to poor latch, low milk transfer, poor weight gain, and sometimes nipple pain.
• Affect oral development – by limiting normal sucking and feeding patterns, and later, the transition to solids.
• Cause feeding discomfort – creating frustration for both baby and parent.
Releasing the frenulum often helps improve feeding and comfort.
What to Expect During a Laser Frenectomy
The procedure usually takes only a few minutes:
1. Consultation: The dentist examines your baby and discusses whether a frenectomy is needed.
2. Procedure: A soft tissue laser releases the frenulum.
3. Aftercare: Most babies feed immediately after. Mild swelling or tenderness may occur but usually resolves quickly.
Post-Procedure Care
Care recommendations have changed. Stretching exercises were once advised to prevent reattachment, but newer evidence shows they are not necessary for most infants. Stretches may cause discomfort or oral aversion without clear benefit. Most babies heal well without them, though your provider will guide you based on your child’s needs.
A follow-up visit may be scheduled to check healing and feeding progress.
What the Research Says
Parents should know what current research shows:
• Cochrane Review (2017): Frenotomy (release) consistently reduced nipple pain for mothers in the short term, but the effect on infant feeding was less clear. Some studies showed improvement; others did not. No serious complications were reported. Long-term benefits remain uncertain.
• American Academy of Pediatrics (2024): The AAP notes that evidence is limited on whether frenotomy improves long-term breastfeeding or prevents future speech problems. Not all babies with tongue-tie need treatment, and many feed well without intervention. Decisions should be individualized, ideally with input from a lactation consultant. Frenotomy is considered safe when clinically indicated, with rare complications.
• Stretches: The AAP also advises against routine post-procedure stretching and cautions that stretching can cause unnecessary pain, distress, and even oral aversion without clear benefit as most infants heal well without it.
Bottom line for parents: A frenectomy can sometimes make a meaningful difference, especially in relieving pain and improving latch. However, it is not a guaranteed solution. Breastfeeding is complex, and many babies benefit most from a combination of release, skilled lactation support, and time to adapt.
References:
• O’Shea JE, Foster JP, O’Donnell CPF, Breathnach D, Jacobs SE, Todd DA, Davis PG. Frenotomy for tongue-tie in newborn infants. Cochrane Database of Systematic Reviews. 2017; Issue 3. Art. No.: CD011065.
• Kaplan M, O’Connor ME, Feldstein DA, et al. Identification and Management of Ankyloglossia and Its Effect on Breastfeeding in Infants. Pediatrics. 2024;153(2):e2024067605.
A Personal Experience: Why We Chose Frenectomy for Our Children
As a pediatric dentist, I’ve treated many infants with tongue-ties and lip-ties, but it wasn’t until my own children were born that I truly understood how much these conditions can affect breastfeeding.
Our first child had no restrictions, so we weren’t expecting any issues with our next babies. But when our second daughter was born, we noticed right away that she was very tongue-tied, with a limited range of motion and she struggled to feed effectively. At two days old, I performed a laser frenectomy to release her tongue. The procedure was quick, and in the days that followed we saw clear improvements in her ability to move her tongue, latch, and feed.
When our third child was born, we faced a similar challenge. This time, it was both his lip and tongue that were restricted. His lip wouldn’t flange properly over the breast, which made latching difficult and caused significant discomfort for my wife. I released both his tongue and lip with the laser, and again, we noticed positive changes in his feeding over the following days.
These experiences reminded us that while a frenectomy can be very helpful, breastfeeding is complex. Even with a release, improvement isn’t a guarantee, but in our case, the procedures made a real difference for our family.
As both a father and a pediatric dentist, I’ve seen firsthand how addressing a tongue- or lip-tie early can support better feeding and comfort for both baby and mother. For us, these interventions provided reassurance and a stronger start for our children.
Below are pictures of my two children who had a release.
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