I’ve just been informed that my baby has a tongue tie and/or lip tie. What do I do now?
If you are breastfeeding and you think your baby has a tongue tie or lip tie, it is best to contact an International Board Certified Lactation Consultant (IBCLC) near you and schedule an appointment for an evaluation. These specialized lactation consultants have advanced training for breastfeeding issues including complex situations, medical conditions, high-risk babies, etc. IBCLCs are experts in the field of breastfeeding medicine and will spend time gathering a thorough feeding history, observing breastfeeding, doing an oral assessment, and making a care plan. Then if the baby needs to be evaluated further for a tongue tie and/or lip tie, your IBCLC may recommend that you call our office at 563-556-2711 and schedule an appointment with Dr. Kristen Berning. If there is a restrictive tongue tie and/ or lip tie present, a laser frenectomy procedure can release the tethered oral tissue so that function and range of motion can improve for feedings.
Appointments for infant tongue tie and lip ties are scheduled in a timely manner. Emergency appointments (such as newborns losing weight) are scheduled as soon as possible. Non-emergency appointments are usually scheduled within 2-3 weeks. During the initial phone call, patient information is obtained, online registration instructions are given, and important forms are emailed.
We can discuss insurance and payment options over the phone. Insurance information can be verified in advance in many cases. Nearly all dental insurance is accepted and filed. Parents may file medical insurance themselves if they want to try to get medical insurance assistance for the exam and frenectomy procedure. We will provide the medical codes and a letter of medical necessity when requested. However, it can be difficult to receive medical insurance reimbursement for a procedure done in a dental office.
Prior to appointment, we request parents to please do the following:
- Complete our New Patient Questionnaire for your infant.
- Complete the Breastfeeding Questionnaire form that will be sent via email, and email it back to office.
- Read the emailed forms entirely. Watch the video links on the "Aftercare Instructions" that demonstrate the stretches and post-op exercises. You can even start to practice these on your infant at home.
- Have a plan for post-op discomfort and purchase anything needed ahead of time.
Dr. Berning suggests that parents try not to breastfeed or bottle feed 60 minutes before procedure, since a hungry baby goes to breast or bottle better immediately following procedure, and eating comforts baby.
Day of Appointment
When parents and baby arrive at our office for their appointment, they are escorted to a private consultation room. Dr. Berning will review their breastfeeding history with them.
- After discussing the feeding and medical history, Dr. Kristen Berning will perform a functional exam on the infant with the parent in a knee-to-knee position. Intraoral photos are taken for record keeping.
- Dr. Berning will then discuss findings, recommendations, risks, benefits, and alternatives.
- If indicated, Dr. Berning will discuss the laser frenectomy procedure, post-procedure exercises and active wound management.
- Some appointments are just an exam and consultation. Most times, the laser frenectomy procedure can be done at the same visit. If parents decide to proceed with laser surgery, a consent form is signed. Most of the time, parents wait in a private consultation room during the procedure. In some circumstances, a parent remains in the treatment room for the procedure.
- Depending on the age of the patient (and other factors) some topical or local anesthetic may be used. No general anesthesia is used in our office.
- The baby is swaddled. Laser protective eyewear is required and worn for baby and all present in the treatment room.
- The LightScalpel CO2 laser release procedure is completed and baby is encouraged to feed immediately after the procedure.
After the procedure
- Mother and baby may take time as needed to breastfeed and/or bottle feed after the procedure.
- Dr. Berning will review aftercare instruction videos with the parents.
- Parents are encouraged to schedule follow-up appointments for therapy as needed with providers including: IBCLCs, speech language pathologists, myofunctional therapists, occupational therapists, physical therapists, cranial sacral therapists, pediatric chiropractors, etc. Releasing a tongue-tie or lip tie is sometimes only a piece of the puzzle. Some children may need additional attention from other providers especially if they are older and improper breastfeeding techniques have been established.
Dr. Kristen Berning provides support for breastfeeding moms who are dealing with lip and tongue ties. She uses a LightScalpel CO2 laser to perform lip tie and tongue tie releases, including posterior tongue ties and buccal ties. To schedule a consultation or ask questions about laser lip and tongue tie revision with Dr. Kristen Berning, please call 563-556-2711 or contact us online. We serve families in the Dubuque and Tri-State area and other cites including Waterloo, Cedar Falls, Iowa City, Cedar Rapids, and regions of northeast Iowa, southwest Wisconsin and northwest Illinois.