Review of your intake form, discussion of antenatal and post natal health, and medical issues relevant to Lactation.
Review of any previous lactation history, present breastfeeding difficulties, and feeding aspirations/ goals.
Baby’s naked weight, clothed pre and post feed weight. Interpretation of findings, and where necessary measurement of other growth parameters ie head circumference and length.
Examination of baby’s mouth and in particular identification of ankyloglossia and assessment of tongue mobilities necessary for feeding.
Identification of additional treatable pathology ie Thrush.
Interpretation and discussion of findings.
Observation and assistance with an entire breastfeed, explanation of feeding behaviours; Winding and satiety cues, pre and post feeding behaviours, amendments to latch etc.
Visual assessment of treatable breast pathology.
Demonstration and assistance with milk expression and supplementary feeding methods.
Discussion of summary of findings, and initiation of a feeding/ treatment.
Summarisation of consultation findings and feeding/ treatment plan in the PHCHR (red book).
Naked and clothed pre and post feeding weight of baby.
Frenulotomy patients only, assessment of surgical site, wound and scar progression. Disruption of wound adhesion with consent and if clinically indicated.
Observation of an entire feed as above.
Initiation of a revised feeding plan.
Call Katherine between 8am and 7pm,
7 days a week for FREE telephone advice.
Baby is weighed naked and before and after a feed.
Parents are assisted to both view and palpate the frenular tissue, and taught the post surgical wound and scar management manoeuvres.
Parental consent is taken, the risks and benefits of Frenulotomy discussed, also the alternatives to Frenulotomy.
Paracetamol suspension can be administered by parents 15 minutes before surgery if age appropriate.
Baby is wrapped and parents instructed how to hold baby securely for the surgery.
The tongue is elevated with a grooved director that isolates safely the tissue to be divided away from other oral structures. The frenular tissue only is divided with blunt tip curved strabismus scissors, and blunt dissected with the closed scissors tip or gloves finger tip to attain an adequate sub lingual romboid.
Instruments used are either disposable or sterilised in house by the dental practice team.
Baby is then handed to the mother for feeding this is used to achieve rapid haemostasis ( stopping any bleeding). Very very occasionally / rarely finger tip pressure or use of a topical haemostatic dressing may be required.
When baby has fed and bleeding has stopped parents are assisted to view the frenulotomy site before returning home.
A new feeding plan is issued.
Feeding and the Frenulotomy site are reviewed face to face 5 to 7 days and again 14 days post surgery, additional follow up appointments as required at no extra charge. Katherine is available 8 am to 7pm by phone any day of the week for any questions/ concerns at other times by messaging.
Katherine’s Frenulotomy practice is Tiny Tongues procedures are only offered at Dental Beauty, 69 Addiscombe Rd, Croydon,CR0 6SE.
Katherine cannot treat recurrent Tongue-tie or residual tissue following Frenulotomy by another practitioner, she can however assess your baby and refer to her colleague Mr Shailesh Patel FRCS (paeds) for revisional surgery if clinically indicated. tonguetieclinic.co.uk
Frenulotomy at Tiny Tongues is only offered following a thorough oral and feeding assessment with a feeding plan initiated to trial interventions to improve feeding. Surgery is offered only if clinically indicated to improve feeding, this is at a different appointment.
Book a consultation with our expert lactation consultants and get the guidance and support you and your baby need to thrive.
