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Many babies have a visible frenulum. A frenulum can be short, thick, anterior, posterior, etc. without being problematic.
It is not the appearance of the frenulum that decides.
It is tongue function that guides the decision.
Frenulum release is considered "the icing on the cake" — it completes a holistic programme of care, but is never the sole therapeutic intervention.
1. In the presence of a pronounced gag reflex
If the baby has a strong gag reflex or refuses all intra-oral stimulation, a procedure may cause an oral feeding disorder. Desensitisation work is then recommended as a priority.
2. If the difficulty is not related to the frenulum
Some breastfeeding or feeding difficulties have another cause:
In these situations, manual and functional work takes priority.
3. If the frenulum is anatomically present but functional
Some so-called "posterior" frenula are visible, but the tongue rises correctly, swallowing is coordinated and suction is effective. Monitoring and follow-up are sufficient in the first instance.
4. If the parents are not yet ready
A frenulum release is never a vital emergency. It must be decided after clear information about the benefits and limitations. Informed consent is essential.
In our practice, we carry out a global assessment of:
Release is only recommended if:
In many cases, manual and functional support allows the situation to be improved without surgery.