Why do we start with exercises and bodywork before a frenectomy?
When I assess a parent and baby for feeding dysfunciton I always assess for ties. That doesn’t mean just looking at baby’s anatomy, but also looking at feeding and asking the parent about symptoms and issues. This is how we differentiate between a normal frenulum and a tie.
Then once we have established that there is functional loss, compensations, and issues, we say it’s a tie, and then we start prep work. Parents ask why wouldn’t we just send the baby for a release or frenectomy?
Think about if you were to need knee surgery. Maybe you had a small injury and then with constant use it got worse and worse. Before deciding about surgery any doctor is going to send you to a physcial therapist. PT is going to help your knee get stronger, going to decrease the issues now and hopefully avoid surgery. However, if you are still in need of surgery, it will help you be stronger and more ready for the operation.
Frenectomies are similar. By starting with oral exercises, we build strength and endurance, helping the muscles to work together and improve funciton now. We also use rhythmic movements to decrease stress on the nervous system and increase movement for the body (which also helps decrease body tension). And we work with skilled bodywork providers to help the body decrease tension, increase function and work better now.
If baby is sent to a release right away, without preparing not just baby and their body, but also the parent and family for release, the result will rarely be good. Most likely things will get worse and both the parents and providers will think that frenectomies make things worse. When the reality is that doing a frenectomy UNPREPARED is what makes things worse!
How long the prep takes, how many appointments or providers are needed depends on you and your baby. If things are straightforward and improving with prep work, it might not be too long, especially is baby is gaining weight and doing well with their compensations. However, if baby isn’t gaining, can’t get into midline, is super stressed, parent is overwhelmed, things will take longer. In general, in my practice it’s typically 2-3 weeks of prep, but there are tons of variables!
The most important reason to do prep is that doing this might mean your baby doesn’t need a release! With oral exercises, rhythimc movements and skilled bodywork, oral funciton should improve, and that can mean no release is necessary.
So if you are wondering about your baby’s tie, remember that the prep work is super important, and any provider that says it’s not necessary isn’t one to work with!