Bodywork. It’s a term that seems to be gaining more and more attention, especially in the realm of infant care, but why is that? Why are providers that work in the lactation space advocating for the importance of incorporating this as well as additional modalities of treatment when a frenotomy procedure is being considered for an infant? Frenotomy, otherwise known as a tongue-tie, lip-tie, or cheek-tie release, is a delicate surgical procedure performed to release a restricted frenulum because it is negatively impacting function. However, many may not realize the crucial role that preparation as well as rehabilitation play in ensuring optimal outcomes for infants undergoing this procedure. Like with any surgical procedure (even one that may seem “minor”), understanding the importance of individualized therapeutic treatment before and after a frenotomy can significantly contribute to the holistic well-being and development of the child as well as the breastfeeding relationship.
Pre-Frenotomy Preparation:
We know from research that infant massage (one specific type of bodywork) has positive impacts on an infant’s growth and development, including:
- Improved weight gain, immune function, and sleep
- Decreased stress and pain
- Enhanced feeding outcomes
- Increased elimination of waste (number of bowel movements)
It is reasonable to understand that these are all positive outcomes we would want an infant to have, especially before undergoing any type of procedure.
Some additional specialized bodywork techniques, including craniosacral therapy and myofascial release, aim to address any underlying tensions or restrictions within the infant’s body (mouth, neck, trunk, pelvis, etc.) By releasing these tensions, a more favorable environment can then be created for the frenotomy procedure, working to ensure smoother post-operative healing, reducing the likelihood of complications, and increasing the chances of optimal and desired outcomes.
Post-Frenotomy Rehabilitation:
After the frenotomy procedure, specialized rehabilitation continues to play a pivotal role in supporting the infant’s recovery and development. Post-frenotomy rehabilitation modalities focus on aiding the body’s natural healing process and promoting optimal function of the newly released tissues. Additionally, post-frenotomy bodywork can assist in preventing the reformation of adhesions or scar tissue, which can hinder the full range of motion of the tissues released. Consistent rehabilitation sessions continue to contribute to the gradual improvement of breastfeeding, bottle feeding, oral motor skills, nervous system regulation, and overall motor development, allowing the infant to adapt and thrive in their environment more effectively.
Holistic Benefits for Infant Development:
The holistic benefits of skilled therapeutic modalities also extend to the emotional and psychological well-being of both the infant and the caregiver. Creating a nurturing and supportive environment through gentle touch and mindful interaction can enhance the parent-child bond and foster a sense of security and trust for the infant, laying a solid foundation for healthy emotional development and attachment.
Conclusion:
By incorporating skilled and individualized therapeutic techniques into the care plan of infants undergoing a frenotomy, caregivers and providers can ensure a more comprehensive and holistic approach to the infant’s well-being. From addressing pre-existing tensions to supporting post-operative healing and promoting healthy development, pre- and post-rehabilitation serve as a valuable complement to this medical intervention, fostering optimal growth and nurturing the bond between infants and their caregivers.
As a lactation-informed infant physical therapist trained in these specialized techniques, I recommend each infant be assessed individually to determine the best care plan for that infant’s unique presentation, ideally before a frenotomy is scheduled, to help ensure optimal timing and outcomes of the release procedure. As therapists, our focus is always to incorporate caregivers into treatment sessions and provide the necessary education so they feel empowered to continue care at home for more long-term benefits.
If you have questions about this topic, infant physical therapy, or just want to connect, I would love to hear from you. You can reach out directly at claire@arkansaslactation.com. I am always looking to listen and learn from this community, as you know your baby and yourself best.
Warmly,
Dr. Claire Stone
Resources:
- Ang JY, Lua JL, Mathur A, Thomas R, Asmar BI, Savasan S, Buck S, Long M, Shankaran S. A randomized placebo-controlled trial of massage therapy on the immune system of preterm infants. Pediatrics. 2012 Dec;130(6):e1549-58. doi: 10.1542/peds.2012-0196. Epub 2012 Nov 12. PMID: 23147978; PMCID: PMC3507248. https://pubmed.ncbi.nlm.nih.gov/23147978/
2. Badr LK, Abdallah B, Kahale L. A Meta-Analysis of Preterm Infant Massage: An Ancient Practice With Contemporary Applications. MCN Am J Matern Child Nurs. 2015 Nov-Dec;40(6):344-58. doi: 10.1097/NMC.0000000000000177. PMID: 26302088. https://pubmed.ncbi.nlm.nih.gov/26302088/
3. Field T. New Born Massage Therapy. International Journal of Neonatal Health. 2017. 1(2), 54-64. doi : 10.25141/2572-4355-2017-2.0054. https://www.biocoreopen.org/ijpn/Newborn-Massage-Therapy.pdf