These are my thoughts around the controversy of oral ties. As a periodontist, I regretfully did infant frenectomies in the 1970s because I never thought about more conservative approaches. Having learned about the fascial web and other aspects in the past 45 years, I now recommend a skilled IBCLC and a Gillespie Approach therapist for infants with oral ties.
In my perfect world, every newborn would be checked for fascial strain. I am passionate about teaching this concept to the medical profession. The Gillespie Approach happens every hour until the neonate is strain-free and a skilled IBCLC is consulted as soon as possible before surgery is recommended. If surgery is done, post-op therapy is a must since all surgery creates new fascial strain patterns in the web.
In the second, more common scenario, a breastfeeding issue still exists days or weeks after birth. A mom may think her baby is eating fine to live, but may not consider a poor latch, leaking milk from baby’s mouth, incomplete feeding, and other “minor” difficulties as problems. In our world, every baby needs to breastfeed like a champ.
I would follow the same game plan—a strain-free baby and a skilled IBCLC working with mom. Do the most conservative work first to possibly avoid surgery and post-op therapy.
A frenectomy is not always a slam dunk for a happy baby outcome. Since the body is interconnected in space and time, oral ties are part of a complex fascial network. The therapist needs to help the body release all of the oral fascial strain and, most importantly, all the strain patterns running through the body into those oral ties.
Abdominal strain (colic), gastrointestinal strain (gas, indigestion, and constipation), diaphragmatic strain (reflux and breathing issues), and other strains can pull into these oral tissues. Basically, any combination of these body issues and the breastfeeding problem can be rooted in the same strain pattern due to birth trauma. Unfortunately, very few medical providers now think that way.
You can now see how incomplete bodywork may result in surgical disappointment. If the total picture has not been addressed, a baby cannot be truly happy and healthy.
Before you have surgery for other ties, please consider this viewpoint. In my surgical residency fifty years ago, our instructors taught us to hold off on surgery for lip and buccal ties until the child was at least 10–12 years of age.
Many times we would see a baby, toddler, or young child with a thick heavy upper lip frenum. As the maxillary bones and soft tissues normally grow, the frenums generally recede to a benign position without surgery.
Bottom line: I am not the last word on oral ties, and I do not tell parents what to do. Do your own research and make the best decisions for your child.
