Newborn/Infants Aftercare
AFTERCARE FOR INFANTS/NEWBORNS
Instructions for performing stretches after a tongue tie/lip tie release procedure on an infant/newborn:
- Spotting or bleeding: It is common to experience a small amount of spotting or bleeding after the tongue tie or lip tie release procedure, particularly in the first few days. However, the use of a laser during the procedure helps minimize bleeding.
- Hand hygiene: Prior to performing the stretches, it is important to wash your hands thoroughly to maintain cleanliness and reduce the risk of infection. Gloves are not necessary for this process.
- Coconut oil: Having a small amount of coconut oil available during the exercises can be beneficial. It may help lubricate the area and make the stretching process more comfortable. Ensure that the coconut oil is used according to the instructions provided by healthcare professionals.
- Swaddling the arms: It is recommended to swaddle the baby's arms down during the stretching exercises. This helps to restrict arm movements and make the stretching process more efficient.
Instructions for performing stretches after a tongue tie/lip tie release procedure on an infant/newborn:
- Timing and frequency: Start the stretches on the evening of the procedure, and continue for three weeks. Perform six sessions per day, with five sessions spread throughout the day (such as during diaper changes) and one session in the middle of the night. This middle of night stretch should be halfway in between the last stretch before sleep and the first stretch of the morning. The middle of the night stretch is the most critical stretch as the area will have the longest time to heal and will try to reattach. During the fourth week, taper off by removing one session each day. Try not to exceed six hours between any two sessions.
- Positioning: Position your baby with their head in your lap or on the bed and have their feet facing away from you. Your baby's arms should be swaddled to the side so that the stretches can be done quickly and efficiently!
Upper lip stretch:
The upper lip is considered the easier site to stretch compared to the tongue. If you need to stretch both sites (upper lip and tongue), it is recommended to start with the upper lip. This is because babies typically do not enjoy either of the stretches and may cry, so beginning with the upper lip allows for easier access to the tongue in case the baby becomes upset (crying = mouth open!)
To perform the upper lip stretch:
Place your finger under the upper lip and move it up as high as it will go until you encounter resistance. Gently sweep your finger from side to side for one second. The goal is to prevent the raw surfaces of the lip and gum from sticking together, so avoid using force.
The upper lip is considered the easier site to stretch compared to the tongue. If you need to stretch both sites (upper lip and tongue), it is recommended to start with the upper lip. This is because babies typically do not enjoy either of the stretches and may cry, so beginning with the upper lip allows for easier access to the tongue in case the baby becomes upset (crying = mouth open!)
To perform the upper lip stretch:
- Place your finger under the baby's upper lip. Coconut Oil may be helpful.
- Gently move your finger up as high as it will go until you encounter resistance.
- Then, perform a gentle sweeping motion from side to side for approximately 1 second.
- The primary goal of this stretch is to insert your finger between the raw surfaces of the lip and the gum, preventing them from sticking together. It is important to avoid using force during the stretch.
Place your finger under the upper lip and move it up as high as it will go until you encounter resistance. Gently sweep your finger from side to side for one second. The goal is to prevent the raw surfaces of the lip and gum from sticking together, so avoid using force.
We have received training from the Alabama Tongue-Tie Academy, and the videos that follow are provided by them as a courtesy.
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Tongue stretch finger positioning:
- Insert both index fingers into the baby's mouth. Begin by inserting one finger into the mouth and moving it towards the cheek to stretch out the mouth, making room for the other index finger.
- Position your thumbs on the baby's forehead and your middle fingers on the chin. Approach the tongue from above, as demonstrated in the video.
- Use both index fingers to dive under the tongue and lift it towards the roof of the baby's mouth. This is the starting position for the three separate stretching motions for the tongue.
The three stretching motions for the tongue are as follows:
- Lift the tongue as high as it will go towards the roof of the baby's mouth. Hold it in this position for 1-2 seconds before releasing and allowing the tongue to relax. The goal of this stretch is to stretch the wound and create a new band under the tongue, which should be longer and no longer bind the muscle.
- Push your index fingers together to prevent them from separating. Then, using the top part of the diamond shape created by your fingers, push into the tongue in the direction of the tonsils. This motion should help lift the middle of the tongue along with your fingers. Avoid allowing your fingers to separate and go on either side of the diamond, as this may direct the lifting pressure at the sides of the tongue rather than at the diamond itself. It is important to use your middle fingers to prevent the jaw from being pulled up while lifting the tongue.
- With one finger propping up the tongue, place your other finger in the middle of the diamond shape, and turn your finger sideways. Use a lifting motion from the bottom to the top of the diamond-shaped area, sweeping through the wound. Be careful to perform this stretch without applying force or being rough within the wound.
- Massage: Outside of the diamond-shaped area under the tongue, massage on either side of the floor of the mouth to loosen up the musculature. Apply more pressure during these stretches since you are not in the wound area.
Remember, it's essential to follow the specific instructions and guidance provided by healthcare professionals or specialists who have assessed the situation and performed the procedure. These instructions are provided as a general overview and may not be suitable for everyone. If you have any concerns or questions, it's best to consult with the appropriate healthcare provider for personalized advice.
THE WRONG WAY TO STRETCH!
This is an example of an incorrect stretch technique
- Notice how the fingers are not positioned above the diamond-shaped area. When these fingers lift the tongue, too much force is directed towards the sides, while the middle portion remains pinned down. This can lead to reattachment.
- To perform the stretch correctly, focus on keeping your index fingers mentally glued together. This will ensure that your fingers stay in the middle, directly above the diamond-shaped area. As you push into the diamond and lift the tongue, aim to separate the top half of the diamond from the bottom half. The goal is to create a distinct separation across the diamond-shaped area.
- It is crucial to pay attention to separating the fold across the diamond to achieve a successful post-operative stretching regimen. By following this technique, you can help prevent reattachment and promote optimal healing.
Sucking Exercises
It is important to create a positive and reassuring environment when performing mouth exercises on your child. Remember that not all actions involving the mouth should be associated with annoyance or discomfort. Additionally, babies may benefit from exercises that improve their sucking patterns, especially if they have disorganized or weak sucking habits. Here are some simple sucking exercises that can be done to enhance suck quality:
- Slowly rub the lower gumline from side to side. As you do this, your baby's tongue will naturally follow your finger. This exercise helps strengthen the lateral movements of the tongue.
- Allow your child to suck on your finger and engage in a gentle tug-of-war. Slowly try to pull your finger out while they attempt to suck it back in. This exercise targets the strengthening of the tongue itself.
- While your child is sucking on your finger, apply gentle pressure to the roof of their mouth. Once the baby starts to suck, press down with the back of your nail into the tongue. This action usually interrupts the sucking motion momentarily as the baby pushes back against your finger. Listen for a seal break and then place your finger back up into the palate to stimulate sucking again. Repeat this sequence as tolerated.
- Place one index finger inside the baby's cheek and use your thumb outside the cheek to massage the cheeks on either side. This helps reduce tension in the cheek muscles.
Post Operative Healing Pictures
IT IS ESSENTIAL TO FOLLOW UP WITH YOUR LACTATION CONSULTANT AFTER THE PROCEDURE TO ENSURE OPTIMAL RESULTS!