Setting up expectations can help everyone feel more comfortable and at ease. Here’s what to expect at your first appointment, including some useful tips.

Assessment

  • Your appointment will begin with a review of your intake paperwork and talking to you about what brings you to our clinic

  • We will also:

    • Weigh your baby 

    • Assess baby’s oral anatomy and suck function

    • Observe feeding

      • Make feeding suggestions/adjustments to feeding technique

      • Look at baby’s mechanics

    • Answer feeding related questions

    • Check strain patterns

      • We have noticed that particular patterns of tension arise in the body as a result of uterine positioning, birth history and/or tongue & lip ties

      • Together with baby’s history and function, we can build a more complete picture of the root cause of baby’s trouble

    • Check/address related issues the lactating parent is experiencing

Treatment

We will discuss our findings and treatment options as a team. You will have the opportunity to ask questions. Your input is valued!

Many babies have procedures the same day as the initial appointment. For some scenarios, it may be more appropriate to make other changes (feeding plan, bodywork, suck training) and re-evaluate at a later date.

The frenula we assess are: lingual frenulum (tongue tie), labial frenulum (lip tie) and buccal frenulum (cheek tie).

What is the procedure like?

Dr. O’Hara performs frenotomy via surgical scissors under 3x magnification.

The procedure itself is very quick. If there is enough tissue to warrant numbing via injection, there is a bit of time between the injection and waiting (about 3 minutes) for your baby to get totally numb. The procedure would then proceed, which takes minutes. To parents, those minutes can feel long!

After the procedure, Dr. O'Hara may briefly hold pressure on any site needed (typically upper lip tie site) to help with bleeding, but gets your baby back in your arms as soon as possible. The blood loss from the procedure is minimal medically speaking, but we understand that seeing any blood can look alarming to a parent.

What is done for comfort during the procedure?

We prefer to pre-dose with tylenol which we typically recommend continuing at home. We have topical numbing and a lidocaine with epinephrine injection available. We also give babies a small amount of sugar or expressed breastmilk, which is standard of care for procedures in children under 1 — sugar has a special endorphin effect on this age group. A team decision will be made as to the appropriate combination of supports for your baby.

What is recovery like?

You will have a number of tools to help keep your baby comfortable. We will give you gentle aftercare exercises to perform (see aftercare for more detail). Your baby should be eating/sleeping at least as well as they were before the procedure. If there is a negative change, pain is the most likely contributor and indicates the need to reference your personalized care sheet to increase comfort measures for your baby.

Follow-up

If your baby has a procedure, we will usually have you come back in about 1/2 week to check clip site healing and feeding progress. We will address strain patterns using Craniosacral Therapy (CST) and gentle Myofascial Release (MFR). Some families may not need to come back again. Some families will benefit from further follow-up and treatment. 

Tips for a smooth visit

As you can imagine, accomplishing the above takes a lot of focused time and patience. We appreciate your understanding if you need to wait for an extended time for your appointment. 

Here are some tips to make your experience more comfortable:

  1. While we have snacks at hand, you may want to pack food—especially if you have dietary restrictions.

  2. Pack any personal care items you may need.

  3. If you are using a bottle or a nipple shield, please bring it to the appointment. Bring extra milk/formula if you have been supplementing.

  4. Plan ample time if you need to schedule childcare or have additional appointments to attend.

  5. The front yard is a great place to hang out if you have a toddler with you.

  6. Grab a Seattle meal before or after your appointment! There is great food blocks away: Cafe Javasti (GF options), Starbucks, Van Gogh Coffee House, and Grateful Bread are all nearby.