What to do when you suspect your baby has a tongue and/or lip tie?
You may have heard your baby is tongue or lip tied. Don't go run and book an appointment to get it revised too quickly. It's important for us to look at three things together: tongue function/mobility, presence of a tie, symptoms that are unwanted when it comes to feeding and/or breathing, etc. Please check out the following list to see how many symptoms your baby has and we can chat together when you see me next. The website below has some great information to read through as well so I hope it's helpful!
https://airwaymatters.blog/2019/01/29/baby-lip-tongue-tie-planning-made-easy/
You may have heard your baby is tongue or lip tied. Don't go run and book an appointment to get it revised too quickly. It's important for us to look at three things together: tongue function/mobility, presence of a tie, symptoms that are unwanted when it comes to feeding and/or breathing, etc. Please check out the following list to see how many symptoms your baby has and we can chat together when you see me next. The website below has some great information to read through as well so I hope it's helpful!
https://airwaymatters.blog/2019/01/29/baby-lip-tongue-tie-planning-made-easy/
Positive oral stimulation
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This is a video of Jodi the LC doing some positive oral stimulation exercises on a baby who had his lip and tongue released approximately 7-10 days prior.
A written summary of these exercises can be seen below. If you have any questions please don't hesitate to contact Jodi at any time! |
These exercises are not meant to be done with the negative exercises (if post revision). They should be tolerable, even enjoyable for the infant. You can make them into a game, sing songs, make noises, etc. to distract them. If your infant is under 6 weeks of age you might be able to do these positive exercises mixed in with the negative rubs/stretches post revision. If your baby is older than 6 weeks and more alert, I encourage you to keep the positive and negative exercises separate from each other and keep negative ones completely separate from feeds.
Not shown in this video are the tongue stretches. This can be done by using your index fingers and scooping the tongue up and pushing back and up on either side of the top of the diamond (revision site). Your fingers should almost be touching as you do this. The intention of this is to stretch the site without actually touching it.
One more thing you can do is best done when your baby is nice and relaxed/calm or asleep. Close their mouth and then slowly pull down on their chin to see inside their mouth. You want their tongue to suction to the roof of their mouth. If it's not, gently close their jaw and hold it there for a minute then check again. Hopefully it will learn to lift and once it does, you can gently pull open their lower jaw with their chin until the tongue pops/clicks off their hard palate. Close their mouth and repeat a few times. This again, stretches the revision site without touching it.
Of course if you have any questions or concerns please don't hesitate to contact Jodi the LC or your lactation consultant if followed by another one.
- Rub your baby’s gums (both sides back and forth) with your finger. This encourages their tongue to lateralize side to side.
- While your finger is on their gums, turn your finger tip towards the tongue and bounce on the side/back of the tongue by where their molars will come in.
- Stretch both cheeks. To do this you use your index finger inside the cheek and gently pull outwards while going from the top (inside top gum line) to the bottom (inside bottom gum line) in a rolling pin type motion. Do this a few times on each side. This can help relax the band muscles (orbicularis oris muscle) that are commonly tight from their tongue not moving/sucking properly. You can also massage the cheek muscles by using your index finger inside the mouth and thumb outside on the cheek and with gentle pressure go from the back of the cheek (index finger between back molar space/gums) and move towards the top lip. Repeat a few times.
- Hard palate rubs. Your baby’s palate is malleable so it may have changed shape over the last weeks/months. Their gag reflex may have also come forward off the soft palate onto the hard palate (or even onto their gums where their molars will come in later on) so it’s important to stimulate it so it goes back to where it came from. Rubbing your baby’s hard palate softly can stimulate areas of it the palate that their tongue hasn’t been reaching. Do circles and then wipers side to side while moving front to back. The baby’s tongue will follow your finger. If you find they gag on your finger before you get to their soft palate, simply touch the gag area briefly and move away; repeat a few times.
- Suck training. If your baby is willing to suck on your finger (nail bed down on their tongue), while you’re moving it around their mouth, you can let them do so. While they’re sucking, your goal is for your finger tip to reach their soft palate and for their tongue to be out over their gum line (and stay there; not sliding in and out) while they’re sucking. You can let them suck on your finger in between doing the other above exercises.
- Stick their tongue out at you. Babies can mimic your facial expressions so if your baby is old enough to have quiet alert time you can stick your tongue out at them and they’ll mimic you. This shows their tongue muscle they can extend it further than they could before the release. While doing this you can make a noise as it stimulates more of their senses to learn how to do the action. You can even make clicking noises and see if they'll give it a try. The older the infant, the more likely they are to mimic these additional noises.
- Put your finger under your baby's tongue on one side and let it sit there for 5-10 seconds. Repeat on the other side under the tongue. You might notice prior to bodywork and/or prior to tongue revision you might not be able to get your finger under their tongue very easily. Don't force it, but if you can get a finger under there, it can be helpful to encourage those muscles to relax and stretch them a bit.
Not shown in this video are the tongue stretches. This can be done by using your index fingers and scooping the tongue up and pushing back and up on either side of the top of the diamond (revision site). Your fingers should almost be touching as you do this. The intention of this is to stretch the site without actually touching it.
One more thing you can do is best done when your baby is nice and relaxed/calm or asleep. Close their mouth and then slowly pull down on their chin to see inside their mouth. You want their tongue to suction to the roof of their mouth. If it's not, gently close their jaw and hold it there for a minute then check again. Hopefully it will learn to lift and once it does, you can gently pull open their lower jaw with their chin until the tongue pops/clicks off their hard palate. Close their mouth and repeat a few times. This again, stretches the revision site without touching it.
Of course if you have any questions or concerns please don't hesitate to contact Jodi the LC or your lactation consultant if followed by another one.
Tongue release site stretches/rubs (as per Dr. Jimmy Chan in N.Vancouver & Dr. Singh in Chilliwack). Please note other dentists instructions may vary so please don't take this as the only option.
The site under your baby’s tongue will be the shape of a diamond and after a few days a white scab will form. It’s important to understand this is not a flat surface you will be rubbing. In order to keep it open you can rub it in a skateboard ramp fashion by sweeping through the middle from the floor of their mouth down and back up towards the tip of their tongue. Then in the same sweeping motion go to the corners of the diamond towards their gums on either side. Be sure to switch fingers/hands to get either side or at least turn your wrist to ensure your finger goes all the way to the side corners of the site. If you can keep the crease and the corners open the chances of the site reattaching is low. This should only take 3-5 seconds. Be sure to ask the dentist how wide the site under the tongue is so you’re aware what you’re looking for moving forward. It’s common to only see a small white diamond form, however the site can be quite wide on some infants. Knowing this can help you know whether you’re keeping the whole site open successfully or not. It can bleed a bit in the first few days, or if it's left for very long periods of time and parts reattach. Allow the infant to suckle afterwards and the bleeding typically stops quickly (if not, please contact your dental provider). Other coping strategies that can help infants deal with discomfort are: swaddling/bundling, bouncing, shushing, sweet solutions (breastmilk), and sucking (@ the breast, on a soother, finger, or bottle). You can also use numerous natural options to support their nervous system and help them with any discomfort they may be feeling. Typically if your baby is going to have a rough day/night we find it is around day 3-4 post release. During this time be extra patient and give them lots of skin-to-skin/cuddles and utilize your pain relief/coping strategies. Your baby might seem to get worse before they get better and it may be hard to notice any improvements in the first week at all. Be sure to chat with your lactation consultant to ensure what you're experiencing is normal and they can help point out areas where baby may be doing better and those they're needing a bit more support in.
Feel free to call/text me anytime to chat about this further if you have questions.
The site under your baby’s tongue will be the shape of a diamond and after a few days a white scab will form. It’s important to understand this is not a flat surface you will be rubbing. In order to keep it open you can rub it in a skateboard ramp fashion by sweeping through the middle from the floor of their mouth down and back up towards the tip of their tongue. Then in the same sweeping motion go to the corners of the diamond towards their gums on either side. Be sure to switch fingers/hands to get either side or at least turn your wrist to ensure your finger goes all the way to the side corners of the site. If you can keep the crease and the corners open the chances of the site reattaching is low. This should only take 3-5 seconds. Be sure to ask the dentist how wide the site under the tongue is so you’re aware what you’re looking for moving forward. It’s common to only see a small white diamond form, however the site can be quite wide on some infants. Knowing this can help you know whether you’re keeping the whole site open successfully or not. It can bleed a bit in the first few days, or if it's left for very long periods of time and parts reattach. Allow the infant to suckle afterwards and the bleeding typically stops quickly (if not, please contact your dental provider). Other coping strategies that can help infants deal with discomfort are: swaddling/bundling, bouncing, shushing, sweet solutions (breastmilk), and sucking (@ the breast, on a soother, finger, or bottle). You can also use numerous natural options to support their nervous system and help them with any discomfort they may be feeling. Typically if your baby is going to have a rough day/night we find it is around day 3-4 post release. During this time be extra patient and give them lots of skin-to-skin/cuddles and utilize your pain relief/coping strategies. Your baby might seem to get worse before they get better and it may be hard to notice any improvements in the first week at all. Be sure to chat with your lactation consultant to ensure what you're experiencing is normal and they can help point out areas where baby may be doing better and those they're needing a bit more support in.
Feel free to call/text me anytime to chat about this further if you have questions.
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Dr Ghaheri's (Dentist in the USA who has done tonnes of studies and tie releases in his practice) page with info & videos on aftercare: www.drghaheri.com/aftercare/
Post tongue and lip tie revision exercises & stretches - by Luna Lactation - link I will also review the exercises & stretches with you and your baby. It is ideal if we can meet within 1-3 days after your baby has the revision done. If you have any questions please don't hesitate to message me. |
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Disclaimer: this information should be used in conjunction with an assessment and ongoing support from a certified body worker, dentist, or myofunctional therapist. Liquid Gold holds no responsibility for any damage/injury these exercises listed may result in if done incorrectly or without correct instruction & support.