Tongue Tie Release: Why It's a Process, Not a Procedure
Tongue Tie Release: Why It's a Process, Not a Procedure
If your baby has been assessed and a tongue tie release has been recommended, you may be feeling a mix of relief and apprehension. Relief that there is an answer. Apprehension about what comes next.
One of the most important things I want parents to understand — and something that often isn't explained clearly enough — is that the frenotomy itself is just one part of the picture. What happens before and after the release matters just as much as the procedure. In many cases, it matters more.
What actually happens during a frenotomy?
A frenotomy (sometimes called a frenulotomy) is the division of the frenulum — the tight band of tissue under the tongue that is restricting movement. Depending on the practitioner, this is done with scissors or a laser. It is a quick procedure, usually taking only a matter of seconds.
After the release, there will be an open diamond-shaped wound under the tongue. This wound will look white or yellowish — sometimes even a neon yellow-green, particularly in jaundiced babies — and that is completely normal. It is not infected. It is granulation tissue, which is simply the body's natural healing response.
Why the wound needs active management
Here is something that surprises many parents: the mouth heals very quickly. So quickly, in fact, that without active management, the released tissue can begin to reattach — sometimes within days.
Any open wound in the mouth naturally contracts towards its centre as it heals, and if two raw surfaces are in close proximity, they will stick back together. This is not a failure. It is simply how the body works. What we are aiming for is a healed frenulum that is longer, softer, and more flexible than the one that was there before — not one that simply closes back the way it was.
Published estimates suggest that reattachment after frenotomy occurs in approximately 2.6–13% of cases. Active wound management — gentle stretches and massage of the wound site — is widely recommended to reduce this risk, and emerging research suggests that when exercises are performed consistently and correctly, both reattachment rates and overall breastfeeding outcomes improve.
Stretches are typically recommended from the day after the procedure, usually three times daily for around four weeks. Your practitioner should show you exactly how to do these, and it is absolutely fine to ask for a demonstration and to have the technique checked at follow-up. Many parents find it daunting at first — that is normal, and it does get easier.
The wound healing timeline is also worth knowing. The first five to seven days are usually the most comfortable, with good mobility in the wound. Between days ten and twenty-one, the scar tissue begins to firm up — this is the most critical window and when reattachment is most likely. After day twenty-one, the tissue begins to soften again, though full maturation can take several months.
Why exercises matter beyond wound healing
There are two distinct reasons for tongue exercises after a release, and understanding both makes a real difference to how you approach the weeks ahead.
The first, as described above, is wound management — keeping the healing tissue open and preventing premature reattachment.
The second is neuromuscular re-education, which simply means helping the tongue learn to move in ways it never has before.
A baby with a tongue tie has been compensating since birth. They have learned to feed with a restricted range of motion, often developing compensatory patterns just to get by. After a release, the tongue is physically freer — but the baby does not automatically know how to use it differently. Freedom of movement does not instantly translate into function.
Think of it this way: if you had worn a tight cast on your arm for weeks and it was then removed, the arm would be free, but the muscles would still need to relearn how to move properly. The tongue is no different.
Exercises and continued feeding support in the weeks after a release help to stimulate new tongue movement — lifting, extending, cupping — and encourage the baby to begin using those movements during feeding. This does not always happen immediately, and it is important that parents know this. Some babies take to feeding differently within days of a release. Others take longer, and that is normal too.
What a well-supported release actually looks like
A good outcome after tongue tie release is rarely down to the procedure alone. The research increasingly supports a multidisciplinary, supported approach — and a 2025 study found that prioritising lactation and feeding assessments before surgical referral actually reduced the number of procedures needed, while improving breastfeeding outcomes overall.
In practice, a well-supported process involves:
Assessment before any release by an IBCLC, who can evaluate tongue function in the context of feeding and optimise positioning and latch in the meantime
Referral to a skilled practitioner who will carry out a full functional assessment and, where appropriate, perform a complete release
Active wound management at home — gentle stretches and massage, guided by your practitioner, for approximately four weeks
Tongue exercises to encourage neuromuscular re-education and help the baby use their new range of motion during feeding
Continued lactation support in the days and weeks after the release — this is often where the real work happens, as the baby learns to transfer their new tongue freedom into feeding at the breast
Bodywork — many families find that craniosacral therapy or infant physiotherapy supports their baby's comfort and function after a release, particularly where there is tension in the jaw, neck, or body. The evidence base for bodywork in this context is limited, but it is commonly recommended as part of a holistic approach and many parents report it helpful
A note on the evidence
I always want to be honest with families about where the evidence is strong and where it is less certain. Tongue tie is a genuinely contested area in infant feeding research. There is ongoing professional debate about how to assess it, when to treat it, and what outcomes to expect.
What most practitioners do agree on is this: where a release is recommended and carried out, a supported, holistic approach — with skilled lactation care before and after — gives the best possible chance of a good outcome for mother and baby. The procedure itself is a small part of a much bigger picture.
Moving Forward
Tongue tie is one of the more complex areas of infant feeding — not because it is rare, but because no two babies are the same, and the impact on breastfeeding varies enormously from family to family. What matters most is not the diagnosis itself, but understanding how it is affecting your baby's feeding and what, if anything, needs to be done about it.
If you are struggling with breastfeeding and suspect tongue tie may be a factor, the most important first step is a thorough assessment — one that looks at how your baby feeds, not just how their tongue looks.
I have extensive experience assessing tongue function in the context of breastfeeding, working with families through the process of diagnosis, referral, and recovery, and supporting mothers to reach their feeding goals on the other side of a release. Whether you are in the early days of feeding and something does not feel right, or you are further down the road and not seeing the improvement you hoped for after a release, I am here to help.
A Breastfeeding Consultation is a good place to start. We will take time to look at the full picture — your history, your baby's feeding, and what support or next steps might be right for you.
You do not have to figure this out on your own.
