Post Frenulotomy Exercises

Following your baby's tongue tie division I will have shown you some exercises. This information is to help you to remember them.

It is important to start when your baby is most likely to be receptive to the exercises, during a quiet, alert state or early in an active, alert state. By making the sequence of events predictable, the exercises can be turned into a game for you both to enjoy. It is very important to respect your baby's wishes. If your baby turns their head away, clamps their mouth shut or puts their hands up as if to block you, stop the exercises and try again at another time. Face your baby, making eye contact and talk to them throughout letting them know what is coming next and giving gentle encouragement. 

To encourage your baby to open their mouth the following sequence can be employed: 
Touch their chin, then their nose and lastly touch the philtrum (the space between the nose and the top lip)

Mirroring
To help with tongue extension.
Ask "can you poke your tongue out?" and then poke YOUR tongue out. Waiting, smiling and then repeating.

'Gummys'
These help the side to side (lateral) movement of the tongue.
Verbal cue: "Do you want to play gummys?"
 Once their mouth is open, place your finger in front of the lower gum. Slowly slide your finger along the gum to the right and then back to the centre, pause and then repeat 3 times. Then repeat sliding your finger along the gum to the left.

Sucking exercise
Verbal cue: say "down" during the down and forward action.
Place your smallest finger against your baby's lips with the nail facing away from you. This will encourage your baby to open their mouth wide. Allow them to draw your finger tip into their mouth, your nail will be against their tongue. As they start sucking, gently press down and forward (towards their lips) drawing their tongue forward over their lower gum. 

Desensitising the gag reflex
Some babies with a tongue-tie or a high palette can have a very active gag reflex. This can make them slip down the nipple or choose a shallow latch to avoid activating the gag. To help desensitise this overactive gag the following exercise can help. Encourage your baby to open their mouth wide with the sequence described above.  Then place your finger (nail down) on the roof of the mouth (hard palate) close to the gums. Slide the finger back, applying firm pressure along the hard palate, stopping just before the gag is stimulated. Over time your baby will learn to tolerate normal touch to the palate. It is important to take this exercise very slowly to avoid reinforcing the discomfort. 

I hope you are able to enjoy these exercises with your baby 


Further reading: 
Watson- Genna, C. (2013) Supporting Sucking Skills in Breastfeeding Infants, 2nd Ed. Jones and Bartlett Learning: MA


Laura Spitzfaden IBCLC, Sucking Skills, http://feedthebabyllc.com/suckling-exercises/ accessed 11.01.2015