AFTER CARE WOUND MANAGEMENT AFTER TONGUE TIE RELEASE

Please also see the following website for more explanation and a video on how to do the tongue stretches.

https://www.drghaheri.com/aftercare

HEALING: Please note that the wound under your baby’s tongue may heal white or yellow. This is normal and is likely not a sign of infection but of healing. Please see your doctor if you are concerned.

REGULAR BREASTFEEDING AND SKIN TO SKIN CONTACT IS IMPORTANT: Skin to skin contact is your baby’s best pain relief. Try to keep them skin to skin as much as possible. In the 5 days following the procedure it is especially important that the baby is breastfed. If you are able to avoid artificial nipples that would be ideal.

BODYWORK IS IMPORTANT: The tongue is made of several groups of muscles and these muscles have not been able to function optimally because the tie prevented adequate range of motion, lift, extension and cupping. Please see the list of bodywork practitioners on the GTA Bodywork Practioners page. We highly recommend you consider taking your baby to see one of these practitioners to help to improve the mobility of the tongue and jaw. Good bodywork may help reduce the risk of re-attachment.

STRETCHES TO REDUCE REATTACHMENT

The stretch, or lift, of the tongue helps to keep the wound flat and helps prevent the reattachment of fibers from lining up and being tight again. It is best if you attempt to do these stretches every 4-5 hours over the next 3 weeks. Some parents chose to do these stretches with every feed. It is most important to do these stretches for the first 7-10 days.

How to do the stretches (also see the following website - Dr Ghaheri’s After Care)

· Place your baby on a change table with their head closest to you (feet away from you)

· Place clean fingers under the tongue on the top of the diamond shape that has been created under the tongue. Do not place your fingers into the wound.

· Lift (pull towards you) and hold to stretch the diamond open for several seconds. Repeat 3 times.

· You should see the diamond wound elongate well when you lift.

EXERCISES TO REDUCE REATTACHMENT

Please also consider the following recommendations to reduce the risk of re-attachment and improve tongue mobility. It is best if you attempt to do these exercises every 4-5 hours over the next 3 weeks. Some parents chose to do these exercises with every feed. It is most important to do these stretches for the first 7-10 days. Each of these exercises we want to do for a total of 1-2 minutes.

· LATERAL RANGE OF MOTION - Slowly rub the lower gumline from side to side. Your baby's tongue should follow your finger. This will help strengthen the lateral movements of the tongue.

· SUCK TRAINING - Let your child suck your finger. While baby is suckling press down on the tongue and gently stroke outwards without moving your finger out of the mouth (think of stretching the tongue outwards).

· TUG OF WAR - Place a finger (index fingers works well), nail bed down and let your child suck on your finger while pushing down on the tongue away from the palate (we want to avoid stimulating the palate). Slowly try to pull your finger back, without removing it from their mouth, while they try to suck it back in. This should be a tug of war type action. Do this for 1-2 minutes. This strengthens the tongue itself

· With one index finger inside the baby's cheek, use your thumb outside the cheek to massage the cheeks on either side to help lessen the tension.

· If your baby is older you could also try sticking out your tongue to see if baby imitates your action