Your goal is to have the area heal and give the most mobility possible. You should do the stretches with the baby lying down on a changing table, bed, or couch facing away from you, like during the exam. There is a video on website at www.TongueTieAL.com. A follow up visit will be planned 7-10 days after procedure. Begin doing the stretches the DAY AFTER the procedure. Gloves (preferred) or clean hands with nails trimmed should be used for stretches.

1.  If the lip or cheeks were also released, first put your fingers all the way in the fold of the lips and pull the lip or cheek up and out as high as possible so you can see the white diamond(s) open. Push right on the area(s), in and up gently but firmly. It may bleed slightly (occasionally), but if you notice concerning bleeding, call us.

2. For the tongue, use your non-dominant thumb to push down on the lower gum pad and hold the mouth open. With one index finger, push down right behind the gum pad in the floor of the mouth, and push slowly and firmly up and down the wound to put tension on the wound for a few seconds and repeat 3 times. It may bleed slightly the first day or two, but this is not a concern.

3. The main goal is to open and see the “diamond” on the lip and especially the tongue. If you notice it is becoming tight, then stretch/push a little more to open it back up.

4.  Repeat this 3 times a day for 4 weeks.

5.  Please do a “deeper stretch” and push twice as hard one time at 7 days to ensure it isn’t growing back together. You will notice some bleeding if it reopens or stretches out, which means it was growing back a little bit and now it’s reopened. Hold pressure with a gauze or a paper towel for 4-5min, and it will stop. Symptoms should improve after the stretch.

6.  Play in your child’s mouth a few times a day with clean fingers to avoid causing an oral aversion. Tickle the lips, the gums, or allow your child to suck your finger.

7.  Watch Michelle Emanuel’s YouTube channel for tummy time and guppy exercises. Do them daily.

8.  The released area will form a wet scab after the first day. It will appear white and soft. It may change color to yellow or even green. This is not an infection but is just a scab in the mouth. The white/yellow area will get smaller each day lengthwise, but HEALING IS STILL HAPPENING!  So even though the white scab is not as visible, you must continue stretching or the surgery may need to be repeated. If you have any concerns, please contact our office.

Follow-up with a lactation consultant is critical if nursing. Bottle-feeding babies will benefit from visiting a feeding therapist. A bodyworker (chiropractor, CST, etc.) is also very helpful, and tight babies may not see as many changes. You should expect one better feed a day (two better feeds the second day, etc.). Sometimes, there’s an immediate difference in feeding, and sometimes it takes a few days to weeks. Skin-to-skin, warm baths, and soothing music can be very beneficial to calm the baby.

For pain, give CHILDREN’S TYLENOL or GENEXA (organic) (160mg / 5mL) starting WHEN YOU GET HOME and for the next 2-3 days every 4-6 hours. For babies who weigh 6lbs give 40mg or 1.25mL, 7lb give 1.5mL, 8lb give 1.75mL, 9lb give 2mL, 10lb give 2.25, and 11lb give 2.25mL. Babies 12-14lb can have 80mg or 2.5mL, 15-17lb give 3mL. 18-23lbs give 3.75mL, 24lbs+ give 5mL. If your child is 6mo old and 12-17lbs, you can give INFANT’s Motrin (ibuprofen) at 1.25mL (50mg) or 1.875mL if 18lbs+. If your baby is refusing to nurse or seems to be in pain, please check the Tylenol dose is correct, and find an alternative way to get milk in the baby (bottle, syringe, cup).

Your child’s lip will swell up slightly for a few days, and the released areas will be sore for a few days. At one week, it will look much better, and at 2-3 weeks look much better and almost normal.