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Pre-operative care includes exercises to prepare your baby for their tongue-tie release.
Why are these exercises important?
Why are these exercises important?
Baby
For your baby to get used to touching/stimulating in and around their mouth before their tongue-tie release.
Caregivers
To become familiar and comfortable with touching in and around your babies mouth before their tongue-tie release.
Hand Hygiene
Hand Hygiene
Wash hands thoroughly following the World Health Organisation (WHO) hand hygiene techniques for soap and water or use of hand sanitiser. See video demonstrations below.
You may choose to wear gloves after washing your hands for the exercises.
Hand Washing (Soap)
Hand Washing (Soap)
Hand Rubbing (Gel)
Hand Rubbing (Gel)
Positioning
Positioning
Position your baby in a comfortable position with their head supported in your lap, or on a soft supportive surface.
Make sure their head is in a neutral position and not tipped backwards.
See the photo as an example.
Exercise Outline & Duration
Exercise Outline & Duration
Outside of Mouth
Outside of Mouth
Cheeks (1 of 3): Outside of Mouth
Cheeks (1 of 3): Outside of Mouth
Why? To stimulate sensation and reduce tension in the cheek (buccinator) and jaw (masseter) muscles.
How often: 6 times, every 4 to 6 hours.
How long: 20 to 40 seconds
How to:
Gently apply pressure with your index finger and thumb on either side of your baby's cheek.
Massage in circular movements for 3 seconds on each side.
Repeat 5 times for each side.
Lips (2 of 3)
Lips (2 of 3)
Why? To improve flexibility of the lips and enhance sensation in the upper and lower lips.
How often: 6 times, every 4 to 6 hours.
How long: 20 to 40 seconds
How to:
Use your index fingers to gently pull up your baby’s upper lip.
Then move your index fingers around your baby's mouth to pull the bottom lip down.
Hold for 3 seconds on each side.
Repeat 5 times.
Rooting Reflex (3 of 3)
Rooting Reflex (3 of 3)
(Until 6 months)
Why? The rooting reflex is an innate response causing the head to turn when the cheek, mouth of face is stimulated with stroking. The head will turn to the side that is stimulated to find a nipple to feed.
How often: 2 to 3 times, every 4 to 6 hours.
How long: A total of 20 to 40 seconds
How to:
Stroke from the mid-cheek to the side of the lips.
Gently stroke the upper lip and lower lips using the thumb and index finger.
Repeat 1 to 2 times
Inside the Mouth
Inside the Mouth
Cheeks (1 of 5): Inside of Mouth
Cheeks (1 of 5): Inside of Mouth
Why? To lessen the tension in the cheek muscles inside the mouth.
How often: 6 times, every 4 to 6 hours.
How long: 20 to 40 seconds
How to:
Put your index finger on the inside of one of your baby's cheeks.
Move your finger around on the inside of your baby's cheek in a circular motion for 3 seconds.
Repeat 5 times
Repeat steps 1 to 3 for the opposite cheek.
Gums (2 of 5)
Gums (2 of 5)
Why? To enhance sensation on the gums and encourage passive movement of the tongue to follow the finger.
How often: 6 times, every 4 to 6 hours.
How long: 20 to 40 seconds
How to:
Position your finger between your baby's lips (they might start to suck).
Move your finger around your baby's upper gums from the back to the front and the other side.
Repeat on the bottom gums.
Repeat this 5 times on the top and bottom gums.
Roof of Mouth (3 of 5)
Roof of Mouth (3 of 5)
Why? To stimulate and provide sensation to the roof of the mouth and encourage tongue elevation against the finger.
How often: 6 times, every 4 to 6 hours.
How long: 20 to 40 seconds
How to:
Place your finger in the centre of your baby's mouth.
While your baby is sucking on your finger, position the pad of your index finger on the hard part on the roof of your baby's mouth behind the gums (see circled part on image on the right).
Move your index finger in a circular motion around the roof of the mouth (palate) for 3 seconds.
Repeat 5 times.
How much pressure? Apply pressure until fingers begin to blanch (appear white in colour).
Where: Place your finger in the centre approximately ⅔ along the roof of your baby's mouth (area indicated in the picture below).
Photo sourced from Baby Oral Health for Parents (2024)
Sucking (4 of 5)
Sucking (4 of 5)
Why? To stimulate your baby's sucking reflex using the mouth and tongue muscles. This exercise aims to increase your baby's oral strength and help them transfer milk more effectively.
How often: 6 times, every 4 to 6 hours.
How long: 20 to 40 seconds
How to:
Gently place 1/3 of your index finger in your baby's mouth with the pad down or pad up and allow them to suck on your finger.
Repeat 5 times.
This exercise was combined within the 'Roof of Mouth' exercise. See video above for sucking demonstration.
Where to place finger pad? Place your finger in the centre approximately ⅔ along the roof of your baby's mouth (circled area indicated in the picture below).
Photo sourced from Baby Oral Health for Parents (2024)
Tongue (5 of 5)
Tongue (5 of 5)
Why? To improve tongue elevation against the roof of the mouth or tongue-palate suction.
How often: 6 times, every 4 to 6 hours.
How long: 20 to 40 seconds
How to:
Insert one index finger into your baby's mouth and move it towards their cheek to stretch out the mouth, making space to insert your other index finger, on the other side.
Put your thumbs on baby’s forehead and middle fingers on their chin.
Then use both index fingers under the tongue to lift as high as possible towards the roof of mouth.
Hold and gently apply pressure on either side of the tissue under the tongue (frenum) for 1 to 2 seconds, then release.
Repeat 5 times
Encourage your baby to breast or bottle-feed immediately after completing these exercises.
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