What to Expect
Our goal is to make your experience at our office as relaxing and comfortable as possible. In order to do so, we find it is helpful to go over what your child's visit will entail so there are no surprises along the way.
When you first call our office, our staff will get your basic information over the phone (baby's name, date of birth, your name, who referred you, etc.) We always recommend that you call your medical (and/or dental) insurance prior to your visit so you will know in advance if treatment will be covered. Unfortunately, we are unable to call on our patients' behalf, and every insurance company is different. Even different policies within the same insurance network can vary widely as to what is cover and what isn't. So the best way to be prepared for what treatment may cost out of pocket is to call your insurance company directly (be sure to let them know Dr. Aaronson is an out-of-network provider.)
You will be asked to fill out all the necessary paperwork online through our website, www.bostontonguetie.com. You can click here to go directly to the new patient paperwork. If you are unable to fill out the forms online, we can provide you with a hard copy when you come to our office - please arrive 15 minutes early if you need to fill out any forms.
Once you arrive and are checked in, an assistant will bring you and your child to Dr. Aaronson's operatory. Dr. Aaronson will then come in and chat with you for a bit about your child's symptoms, any issues you are having with nursing, and she will review your child's medical history. Certain things like traumatic births, long labors, a history of chiropractic treatment, etc. may be important factors to know in order to properly diagnose your child.
Dr. Aaronson will then examine your child. If you are seeing a lactation consultant, they are the best diagnostic tool for latch and nursing difficulties - Dr. Aaronson's assessment is an adjunct to the IBCLC's evaluation.
In order to properly diagnose a tie, the lip and tongue must be maneuvered in a way that can clearly expose any restrictions. This involves a lap-to-lap exam, in which a parent is seated across from the doctor, and the baby's head is placed in Dr. Aaronson's lap. Dr. Aaronson will then lift the baby's lip, move the cheeks, and lift under the tongue to look for any restrictions. It is important to note that the presence of a frenum (a band of tissue) connecting the lip or tongue to the rest of the mouth does not necessarily mean treatment is needed. Dr. Aaronson evaluates whether the frenum is inhibiting the baby's mouth from going through the necessary movements to properly latch and suck.
If Dr. Aaronson determines that your child has a tie (or multiple ties), then treatment options are discussed. In most cases, treatment would involve a laser frenectomy, which involves a laser cutting through the frenum until the restriction is removed. Risks and benefits are then reviewed, and parents have an opportunity to ask any questions. There is never any pressure to decide on the spot - parents are welcome to go home and think about their options before making the decision whether or not to treat. There is no charge for the consultation if parents opt not to treat.
If you decide to proceed with treatment that day, you are asked to sign the informed consent and then pay for the treatments. The charge is $699 per site (lip, tongue, cheek) for infants and children up to age 3. We ask that you pay in advance because insurance companies will send reimbursement checks directly to your home address, as we are out of network and cannot receive medical insurance payments.
Please note: Children over age 2 must be working with a speech pathologist, feeding therapist, myofunctional therapist, and/or bodyworker both prior to and after the procedure to ensure a successful outcome.
Your child is brought back to the treatment room by an assistant. We ask that parents stay in the waiting room during the treatment, which usually takes less than 5 minutes. The reason we ask parents to not be in the room is because Dr. Aaronson needs to focus 100% of her attention on your child, and having worried or anxious parents in the corner of the room is distracting. If you have an issue not being in the room during treatment, please discuss this with the doctor. Exceptions can be made in certain circumstances, but please be prepared to not be allowed in the room during treatment.
Once the baby is comfortably swaddled, we place protective glasses over your baby's eyes to prevent any damage from the laser. Pre-op photos will be taken for documentation/ insurance purposes. A numbing gel is applied to the area(s) being treated, if desired. The assistant holds your baby steady while Dr. Aaronson uses the laser to quickly release the frenum(s). Although the actual laser treatment takes about 5-10 seconds, Dr. Aaronson needs to access the mouth and get a good look at the lip and/or tongue prior to treatment. This is usually the part where babies scream and cry, because they simply don't like fingers in their mouths! We reassure the parents that any cries they might hear from the treatment room does not mean their baby is in pain. A post-op photo is then taken.
As soon as the release is done, your baby is picked up and comforted while the assistant goes to the waiting room to retrieve the parents. The parents are brought back to the room and you are free to feed your baby (breast or bottle) if you would like. Most parents prefer to feed immediately after treatment, both to comfort their child and also to see if the release has helped improve a painful latch. Many mothers notice an immediate difference, but this is not always the case.
Dr. Aaronson will review the stretching techniques and post-op care at this time. She will discuss pain management, what to expect with healing and pain, and any concerns you should be aware of that would warrant a phone call. She will then give you her personal cell phone number and encourage you to call/text her with any questions or concerns that may arise.
You are welcome to stay in our office and feed your child for as long as you need. We offer a My Brest Friend nursing pillow to those who need it.
FOLLOW UP CARE
We recommend returning to our office 1 to 2 weeks after the procedure to make sure the site is healing properly and to answer any questions you may have regarding your child's healing. You are welcome to return as often as needed - there is no charge for follow-up visits.