What Tool is Right for My Infant's Tongue Tie Release?
What Tool Should I Choose
For My Baby’s Tongue Tie
Release?
As a dedicated IBCLC in the Boise area, I get questions on tongue tie release all the time. I would like to share what I have learned and why I feel the way I do about tool choice. Often I hear professionals in the tongue tie community say any tool is fine as long as the provider knows what they’re doing — which is true to an extent.
However, after several years of experience and working with various providers, I believe that not only is the care provider you chose important but so is the tool. I want you and your baby to have a successful breastfeeding journey.
Today, I’m going to give you the pros and cons of different tools used for tongue-tie release as well as a personal example!
The Pros & Cons of
Various Options of
Tongue Tie Release
The Diode Laser:
Pros
This laser is referred to as a contact laser and will only remove tissue that you touch making it the safest tool choice for infants.
Cauterizes tissue well, which decreases bleeding.
Less likely to burn into the muscle site as it’s a contact-only laser.
Cons
Takes more time than the other laser option, CO2. (Still only taking roughly seconds for the entire process).
More likely to cause some scar tissue.
The CO2 laser:
Pros
Cleaner cut.
Faster procedure than diode.
Cons
CO2 lasers are non-contact lasers, increasing the chance of burning too far into the tongue muscle.
Less pain as long as no burning into the muscle.
What about scissors/scalpels?
Only a handful of clients of mine have had a tongue tie release with scissors, as most parents are not comfortable with the risk of bleeding and a blade in a moving mouth.
Here is a list of things to know if you are considering a scissor release:
It’s difficult to get a full release with scissors. Once the first cut is made the blood can make it difficult for the provider to see if a full release has been made.
When the tissue is not cauterized there tends to be more bleeding, which makes the procedure last longer to stop it.
An awake infant with a sharp object in their mouth is a risk. Most parents are not comfortable with the thought of a blade in their awake infant’s mouth. (I get it!)
I have seen scissor releases that seem to heal way too fast. I believe it’s from the blunt cut with no cauterization. I have seen reattachment within days, which then requires a revision with more frequent stretching. Not ideal for anyone…
It’s the most common technique used by ENT’s and pediatricians. Sadly, most aren’t trained on full releases and thus we don't see improvement of symptoms.
Maybe not the list you were hoping for, but this is my personal experience being in this field. Luckily there are always outliers to everything. A nurse practitioner, Jennalee Hill, has been doing tongue tie releases in the Pocatello area for several years.
“Micro-serration scissors can help decrease reattachment,” she says. But to my knowledge, most providers doing scissor releases do not know about this special cutting tool! All the more reason to make sure you trust your provider and health care team.
What does this all mean for adult tongue tie releases?
When it comes to adult or older children releasing the diode is not strong enough to get the job done, so a CO2 or scissor is a better choice. With this age group, we’re far less worried about a moving target and thus less concerned about complications.
Whatever you do choose, please do your research to ensure the provider of your choice has good reviews. They must have the training and know what they are doing, or you may be paying for an incomplete release or a botched procedure and an extra sad baby.
Good questions to ask
the provider you are
considering:
How many procedures have you performed? Ideally, the provider is doing at least several a week to ensure experience. At least a few hundred under their belt would be ideal.
What training have you had for tongue-tie releases? Providers should be getting training with someone knowledgeable in the field. This is crucial for your baby’s safety.
What is your success rate? If the success rate is high, that is a good sign that the provider is doing the release appropriately and has a good follow-up.
What is your reattachment rate? This is a good indicator of how well the provider is teaching aftercare stretches and following up appropriately.
Do you work with a team for bodywork and aftercare follow-up? This is essential for optimal results. The team is what ensures mom and babe are successful post-release to keep the wound from reattaching.
Bodywork helps the body to learn how to do different things and release tension from compensations. The IBCLC will help to ensure the mom’s milk supply is improving and the baby is transferring appropriately.
Do you know what a posterior tie is? If they do not know about posterior ties, then they will not be doing a full release. (Run!)
Is there a diamond shape wound? If there is not a diamond-shaped wound under the tongue, then you do not have a full release.
Do you recommend aftercare stretches? This is a must to avoid reattachment.
Do you put babe under general anesthesia? This is not recommended for babies under 1 year of age.
Baby Bonds Is Here To Support
Your Tongue Tie Journey
For those in Boise or surrounding areas, I work with the top provider in the state, Dr. Sam Zink and Shannon Gardiner, PA. We see people from all over Idaho and the surrounding states. I offer at-home or clinic consults to support your breastfeeding journey.
I know how stressful it is to want to breastfeed and you shouldn’t have to struggle – even if your baby has a tongue tie. Not every tie requires a release either, so it’s best to work with people you trust and feel comfortable with.
The Baby Bonds team has amazing results with tongue tie releases because we know all the important pieces to this puzzle. We empower parents to care for their babies during the entire process. We know you can be a breastfeeding dyad and thrive!
Reach out to me if your babe needs an assessment for possible tongue-tie.
Which tool should I use?
Does tool matter?