Tongue-tie everywhere… full frenotomies without additional costs

Foreword:

Tongue-tie is currently a very “trendy” topic. It can sometimes seem as if, when a lactation consultant reaches their limits, the tongue-tie is quickly blamed. I make sure to explore all possible causes with you before considering any surgical intervention.

There are many self-proclaimed “specialists”—even though an official qualification as a “tongue-tie specialist” does not actually exist.

I had the opportunity to attend one of the first German training courses on this topic in 2018 and have continued my education ever since, completing at least 20 hours of further training per year, primarily in the US. Beyond that, my experience speaks for itself. I work freelance in a large oral and maxillofacial surgery practice and regularly support frenotomies as well as assist in cleft lip and palate surgeries. References are available upon request—just ask.

I can also speak from personal experience about the differences between laser procedures and scalpel techniques and provide a clear, realistic assessment.

Before recommending a frenotomy, we always evaluate the full picture. We optimise breastfeeding conditions and assess conservative measures first.

I work within a strong network of professionals and can connect you with the right specialists. It is essential that bodywork and, where appropriate, speech therapy exercises are integrated into daily life.

Recently, I established contact with a speech therapy practice specialising in dysphagia (swallowing disorders). In collaboration with a radiology department, they offer specialised imaging to identify exactly where in the mouth swallowing dysfunction occurs—allowing for targeted therapy.

I am happy to support you and your baby from the first suspicion through to a potential frenotomy—and beyond, including active wound management until full healing.

Wound management – and the reality behind social media

I dedicate a separate section to wound management (AWM) for a reason. It is an emotional but essential topic. Online forums are full of conflicting information—some emphasise its importance, others claim it’s unnecessary.

From experience, I frequently meet families who have already had a “release.” Often described as a “very gentle” or even “romantic” procedure: the baby lies on the mother’s lap, and the practitioner creates a tiny, pinhead-sized opening in the frenulum using a laser.

When parents ask whether anything needs to be done afterwards, they are told: “No, no—it was done with a laser.”

Breastfeeding may improve for 5–10 days—then the original problems return, often worse than before.
“The frenotomy didn’t work. We would never do it again.”

In other cases, a newborn’s frenulum is slightly snipped with scissors. Yes, something was done—but it was not a full release.

A frenotomy is a surgical procedure. That may sound uncomfortable, but it is the reality. If the procedure is done correctly and sufficiently, the body can heal—even if wound management is not carried out perfectly five times a day. But this only applies when the release has been done properly.

So yes, it may feel nice to “gently stroke” the area instead of doing proper wound work—but unfortunately, that does not lead to lasting results. Irony intended.

Working together

If you have already been working with a lactation consultant, we can collaborate as a team. I can support as a specialist resource while your consultant continues to guide you.

The process

After a detailed assessment, we observe breastfeeding together:
Can positioning be improved?
Is your baby tense or restricted in movement?

A holistic perspective is essential. A frenotomy without appropriate follow-up therapy rarely leads to lasting success.

None of us wants to cause unnecessary pain to a baby. That is exactly why every consultation on tongue-tie must be individualised.

In some cases, we improve the situation with conservative approaches. In others, a timely release may be recommended.

Together, we create a structured plan including exercises, movement work, and supportive therapies—before and after a frenotomy.

I will explain in detail:
– how the procedure is performed
– the different methods (laser vs. scalpel)
– pain management
– what to expect afterwards

You can also read more about my personal experience and my direct comparison of laser vs. scalpel in my blog.

My goal

To provide you as parents with both professional clarity and emotional support.

Further reading

Tongue-tie – a topic in lactation consulting

Isabella Dechant, Andrea Hemmelmayr, Holtex, Márta Guóth-Gumberger, Paul Thomas
Professional review: Márta Guóth-Gumberger, IBCLC and Univ.-Prof. Dr. Daniela Karall, IBCLC

Tongue mobility is key

The tongue plays a crucial role in feeding and speech. It must be highly mobile and consists of multiple muscles working in coordination. A healthy, functional tongue can sort, manipulate, transport, and prepare food for swallowing.

It is also essential for coordinating sucking, swallowing, and breathing.

Exercises after frenotomy

Post-frenotomy stretching exercises are controversial among professionals.

However, the organisations I have trained with recommend active wound management. I am happy to explain the reasoning in a personal consultation.

We will discuss how and how often to perform stretches—and I will share practical tips to make them more manageable for both baby and parents.

Here are three short examples:

https://www.youtube.com/watch?v=R_qnkhlwl84
English, massage from 2:48 is particularly helpful for release and relaxation.

https://www.youtube.com/watch?v=Qb-TO-ZvNEM
English, pain-free massage during sleep.

https://www.youtube.com/watch?v=2JMcbF85ehs
English, very baby-friendly approach.