POST-OPERATIVE INSTRUCTIONS FOR INFANT TONGUE-TIE RELEASE
Learn More About Post-Operative Instructions Learn More About Infant Eating Assessment Tool (InfantEAT) Learn More About The FLIP
Healing & Preventing Reattachment
The mouth heals quickly, which may cause the tongue or lip sites to reattach too early, leading to reduced mobility and symptom recurrence. To prevent this, follow the stretching exercises below.
- Perform stretches with your baby sitting on your lap or lying on a bed, feet pointing away from you. Swaddle the baby's arms to prevent interference.
- Stretches should be gentle, firm, and brief (5-10 seconds) with quick, precise movements.
- Begin stretches within 3-6 hours post-procedure using gloves (preferred) or clean hands with trimmed nails.
- Follow-up within 7 days in person (recommended) or virtually.
Stretching Routine
- Frequency: Minimum 4-6 times daily for 4 weeks. Stretching before each feeding may help calm your baby after the stretching is complete.
- Goal: Open and visualize the “diamond” shape on the lip and tongue. If it becomes tight, stretch/push slightly more to reopen.
- Alternative for Virtual Follow-Up: If an in-person visit isn’t possible, perform a deeper stretch once on day 7 by pushing twice as hard. Slight bleeding indicates minor reattachment, which can be reopened. Apply pressure with gauze or a paper towel for 4-5 minutes to stop bleeding.
- Tummy Time & Exercises: Watch Michelle Emanuel’s YouTube channel for tummy time and guppy exercises.
Healing Process
- The released area will develop a wet scab, appearing white, yellow, or green. This is not an infection but a normal healing process.
- The scab will shrink daily, but stretching must continue to prevent reattachment.
Feeding & Therapy Support
- It is important to maintain your baby’s hydration after treatment! Monitor wet diapers and if necessary, bottle or syringe feed to make sure baby stays hydrated.
- Breastfeeding: Follow up with a lactation consultant is required!.
- Bottle-Feeding: A feeding therapist or lactation consultant
- Other Support: Occupational therapy (OT), physical therapy (PT), craniosacral therapy (CST), or bodywork may help babies improve strength, suction, mobility, and overall wellness.
- Expect gradual improvement in feeding: One better feed per day (e.g., two better feeds on the second day, etc.). Some babies improve immediately, while others take days to weeks.
- Use skin-to-skin contact, warm baths, and soothing music to calm your baby.
Post-Procedure Expectations
- Bleeding: Slight spotting is normal in the first few days.
- Swelling: The lip may swell slightly for a few days.
- Healing Appearance: White/yellow scabbing is normal; it does not indicate infection.
- Concerns: Contact our office (see contact information below!)
Pain Management
-
Children’s Tylenol (Genexa organic option) 160mg/5mL: Administer every 4-6
hours for 2-3 days based on weight.
- 6lbs give 40mg or 1.25mL 7lb give 1.5mL 8lb give 1.75mL 9lb give 2mL 10lb give 2.25mL 11lb give 2.25mL
- 12-14lb give 80mg or 2.5mL 15-17lb give 3mL 18-23lbs give 3.75mL
- 24lbs+ give 5mL
-
FOR CHILDREN OVER 6 MONTHS ONLY: Infant’s Motrin (ibuprofen): Administer
every 4-6 hours for 2-3 days based on weight.
- 12-17 lbs:25mL (50mg)
- 18+ lbs:875mL
- If your baby refuses to nurse or seems in pain, check the Tylenol dose and try bottle, syringe, or cup feeding. Coconut oil or Breastmilk ice chips can also be soothing.
- Discomfort usually lasts 36-48 hours, at latest one week and appearing nearly normal by 2-3 week.
Stretching Techniques
Demonstration Video: Dr. Amar’s video will be sent to you via text message
Upper Lip Stretch
- Start with the lip stretch first
- Insert a finger on each side at the corners of the mouth, move towards the center and lift lip upwards until resistance. The lip should cover the nostrils when fully stretched!
- Sweep side to side for 1 second to prevent reattachment.
Tongue Stretch
- Place both index fingers underneath the tongue as close to the apex (top) of the diamond.
- Hand Positioning: Thumbs on the forehead, middle fingers on the chin.
- Vertical Stretch: Lift tongue towards the roof of the mouth for ~3-5 seconds (put pressure towards tonsils).
- Side-to-Side Stretch: Sweep up from the bottom of the diamond wound.
- You must be able to visualize the entire diamond in order to do a proper stretch!
Sucking Exercises
These exercises prevent negative associations with stretches and strengthen tongue movement:
- Lateral Tongue Movement: Rub baby’s lower gumline side to side to encourage tongue motion.
- Suck-and-Tug: Let baby suck on your finger, then slowly pull it out while they resist.
- Pressure Against Palate: While baby sucks your finger, gently press against the roof of their mouth to improve coordination.
- Cheek Massage: Place a finger inside the baby’s cheek and massage from the outside.