Perguntas Frequentes

A restrictive tongue-tie, also called ankyloglossia, is a congenital condition where the lingual frenulum (the membrane under the tongue) is too short, too thick or too anterior. This limits tongue mobility and can cause breastfeeding difficulties, oral feeding disorders and speech problems.

The frenulum can be visible (anterior) or hidden under the mucosa (posterior).

Several signs may indicate a restrictive tongue-tie:

• Heart-shaped tongue when baby cries or sticks out the tongue
• Difficulty lifting the tongue to the palate
• Limited lateral tongue movements
• Clicking sounds during breastfeeding or bottle-feeding
• Very long feeds (over 45 minutes)
• Insufficient weight gain
• Significant nipple pain in the mother

An evaluation by a trained professional (IBCLC lactation consultant, paediatric osteopath, specialist midwife) is recommended to confirm the diagnosis.

Não, a amamentação não deve ser dolorosa para além dos primeiros dias. Persistent nipple pain, cracked nipples, bleeding or a pinching sensation can indicate a poor latch, often caused by a restrictive tongue-tie or lip-tie.

It is important to consult an IBCLC lactation consultant or a trained midwife promptly. Do not suffer in silence — help is available and can transform your breastfeeding experience.

Yes, not only can you breastfeed after a frenectomy, it is actually recommended! Putting baby to the breast immediately after the procedure has several advantages:

• Breast milk has analgesic and healing properties
• Sucking exercises the tongue and prevents adhesions
• It reassures baby

In the first few days, breastfeeding may be slightly uncomfortable for baby as they discover their new tongue mobility, but improvement is often rapid.

A frenectomy is a simple and quick procedure that involves cutting the restrictive tongue-tie or lip-tie to free mobility. It can be performed:

• With laser: cauterises vessels, minimal bleeding
• With sterile scissors: classic method

The procedure takes a few seconds to a few minutes and is performed by a trained dentist or ENT specialist. In newborns, local anaesthesia is generally sufficient.

After the procedure, stretching exercises are needed for 2–3 weeks to prevent the frenulum reattaching.

Yes, stretching exercises after frenectomy are essential to prevent the frenulum reattaching (adhesions).

The professional performing the procedure will show you the precise movements: stretching the tongue upward and sideways, massaging the wound site.

These exercises must be performed 4 to 6 times per day for 2 to 3 weeks. Although uncomfortable for baby (a few seconds of crying), they are necessary to ensure the success of the procedure.

A frenectomy can be performed at any age, from the very first days of life if necessary:

• Newborn (0–3 months): very quick procedure, excellent healing, ideal time for breastfeeding
• Infant (3–12 months): still possible and beneficial
• Older child or adult: feasible but may require general anaesthesia

There is no upper age limit, but the earlier it is done, the simpler and quicker it is.

Our directory lists specialists in all French-speaking cantons:

• Vaud: Lausanne, Montreux, Nyon, Yverdon, Vevey, Morges
• Valais: Sion, Martigny, Monthey, Sierre
• Genebra: Geneva city, Carouge, Meyrin
• Fribourg: Fribourg, Bulle
• Neuchâtel: Neuchâtel, La Chaux-de-Fonds
• Jura: Delémont, Porrentruy

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Managing sucking disorders often requires a multidisciplinary approach:

1. IBCLC lactation consultant: breastfeeding and sucking assessment
2. Paediatric osteopath: treatment of bodily and cranial tensions
3. Trained midwife: postnatal follow-up
4. Dentist or ENT: frenectomy if necessary
5. Speech-language therapist: oral feeding disorders, post-frenectomy follow-up
6. Paediatric physiotherapist: oro-facial exercises

These professionals work together for comprehensive care.

Fees vary depending on the professional and canton:

• IBCLC consultant: 100–150 CHF (partial reimbursement depending on supplementary insurance)
• Osteopath: 100–150 CHF (depending on supplementary insurance)
• Midwife: postnatal consultations covered by basic insurance
• Speech-language therapist: covered on medical prescription
• Frenectomia: 200–500 CHF (partial reimbursement possible)

Always check with your health insurer and ask for a quote.

Refusal of lumpy foods, pronounced gag reflex, oral hypersensitivity and very long mealtimes can indicate oral feeding disorders.

A speech-language therapist specialising in infant orality can assess your child and suggest appropriate oro-facial stimulation exercises. A gradual approach with desensitisation and food play helps the child accept different textures.

It can also be helpful to consult an osteopath to check for tension in the jaw and skull. Never force your child — a gentle, patient approach is essential.

A restrictive tongue-tie does not correct itself over time.

When to consider frenectomy:

• Significant breastfeeding difficulties
• Nipple pain in the mother
• Insufficient weight gain in baby
• Desire to breastfeed long-term

It is not always urgent: some mothers compensate and continue breastfeeding despite the frenulum. The important thing is to be well informed and supported by trained professionals. The final decision is yours.

Unfortunately, not all healthcare professionals are trained in restrictive frenula and their impact on breastfeeding and orality.

If you are experiencing pain, if breastfeeding is difficult, or if your baby is not gaining weight well, trust your parental instinct.

Consult a specialised and trained professional: IBCLC consultant, paediatric osteopath, midwife or dentist specialising in frenula. A second opinion is always possible and recommended.

Improvement varies by case:

• Immediate (within a few hours): baby feeds better, less pain for mum
• Progressive (a few days to 2 weeks): baby relearns to use their tongue
• Complete (2–4 weeks): healing finished, maximum benefits

Some babies need osteopathic follow-up or IBCLC support to optimise sucking. If no improvement after 3–4 weeks, consult again for re-evaluation.

Frenectomy is a very safe procedure with few complications. Risks are minimal:

• Slight bleeding (normal, stops quickly)
• Temporary discomfort (1–2 days)
• White healing pseudo-membrane (normal)
• Rarely, adhesions if exercises are not done

Serious complications are exceptional when performed by a trained professional. The benefits far outweigh the minimal risks.