Tongue-Tie Post-Revision Exercises and Pain Management

To Keep a Clipped Tongue-Tie Open

Baby Paige Before Clipping

Baby Paige After Clipping

The Side Swipe

Insert your finger under the child’s tongue, as far back as you can reach.

Sweep side to side.

The Tongue Lift

Insert your finger, pad down, under the infant’s tongue.

Push it as far back as you can. Then lift up, as far as you can.

Hold for a few seconds.

 

Below is a video from Dr. Kotlow showing how to do the exercises for a tongue tie and lip tie.

 

To Teach them to Use the Tongue Properly and Potentially Stretch the Tie

When a tongue is restricted due to a tie, the infant cannot extend the tongue forward. This causes the back of the tongue to stay “bunched up.” This leads to dental problems, a misshapen soft palate, and problems breast-feeding. Because the back of the tongue does not drop down, the baby has difficult swallowing and often spills milk out the sides of the mouth. This is true of breastfeeding and bottle-feeding.

Bunched Tongue

After a tie is clipped, it is important that the infant learn to use the tongue properly. This includes the ability, knowledge, and consistent practice of extending the tongue forward, thus releasing the “bunch.”

Tug-of-War

This can be done several different ways. The basic idea is to have the infant suck on something, then slowly pull out, forcing the infant to extend his/her tongue in an attempt to draw the item back into his/her throat. Don’t pull out all the way, just until the infant extends the tongue and draws it back into the throat. Allow them to suck for a little while and then repeat.

This can be done with your finger, a bottle, or a pacifier.

I do this exercise with Ruby each time I feed her. I still finger feed her with an SNS. I continuously apply downward pressure on the back of her tongue. Then I pull out slowly, as described above.

I really encourage finger feeding an infant whose tongue was clipped while he/she was older (although, not necessarily full-time finger feeding). By having the baby suck on you finger, you can judge improvement or digression.

Josiah, my third child, had is tongue-tie revised at 6 weeks old. I learned so exercises and stretches from Ruby’s speech therapist and another friend who took her daughter to a speech therapist also. I do all these exercises on Josiah to make sure I leave no stone unturned.

If no improvement or only limited improvement is acquired from these exercises, I highly suggest having your baby evaluated by a speech pathologist to see if there are other areas that may need work that I may not have personal experience with.

Here is a short video of all the exercises I did with Joey after his tongue-tie was released.

These exercises should be done at least twice a day for 2-3 weeks. You want to continue them until the underside of the tongue is healed up completely. So babies make take longer to heal.

Video of Exercises to do After a Tongue-Tie Release

As you can image, your baby will be in a considerable amount of pain from the procedure. To have success in nursing, you should give him/her homeopathic remedies to reduce pain.

I use arnica and hypericum. Hyland’s brand of remedies is great because it dissolves quickly and easily. I give a double dose ever few hours for the first few days after the procedure. Then back off slowly from there. If the infant appears to have a difficult time nursing or transferring milk, give an extra dose if remedies.

I was advised that Josiah wouldn’t be in much pain after a few hours. However he basically stopped nursing for a few days. He even refused the lact-aid. I was terrified that I was going to lose my nursing relationship with him like I did Ruby.

I gave him some pain medication on a whim. BOOM! He nursed like a dream! I have worked with another mother who reported the same thing.

I had to give the remedies for about six weeks.

Doctors advise that the tongue heals quickly and so pain meds should not be needed pasted a few days. This may be true if we left the tongue alone. However, because we are stretching it, more pain will occur. This is because each time you stretch it, you are reopening any attached tissue. Ouch!

It can be difficult to give remedies to an infant because they have a reflex to prevent them from chocking. This reflex causes them to push any foreign objects out if their mouths using the tongue. So every time you stick a tablet in, the tongue pushes it right back out. And because the tongue is moist and the tablet dissolves quickly… Well… You can see how well that ends.

I have a video below that explains my method for giving babies the remedies. Hopefully it will be helpful.

 

There are different strengths of remedies to choose from. The most common are 6x and 30x. The smaller the number, the more potent the remedy. The larger the number, the more diluted the remedy. More isn’t always better when it come to homeopathic remedies. Homeopathic remedies not only help with physical symptoms, but also emotional trauma as well. The diluted remedy will help with emotional trauma while the more concentrated remedy will mainly help with physical symptoms.

So if you are taking arnica for a black eye that was caused from running into a door, 6x would be best because you are only dealing with a physical pain. However, if the black eye was caused from a fight and you were punched in the face, you also will be suffering from emotional trauma, 30x would be best because the diluted remedy will help with emotional trauma.

During a frenectomy, the baby is held down during the procedure. If that isn’t tramatic enough, a care-giver is exercising a very sore wound. Because of this, I chose 30x remedies to reduce the likelihood of an oral aversion occurring.

Oral aversions are common with a tongue-tie release. It happens when the baby associates your finger going into their mouth with pain. So they develop an aversion to fingers, so sometimes anything, going into their mouths. Some babies have had problems with tooth brushes and such as a result. I am happy to say that Josiah has no aversions!

If you would like to read more about my personal experience with pain management post-revision with my own children, click here to read this post.

56 responses

  1. my daughter is 9 months old and doesnt have teeth… her tongue was tied underneath and i finally found a dr to clip it for me. im starting to worry now that its healing back together.

    • I have sent you a private email about this. I am so sorry about the delay. My laptop died in Dec and so I haven’t been as on top of things as I should have been. I hope I can still help and answer any questions you may have.

  2. I had my 11 month old girls posterior tongue and lip tie lasered on June 21st. I did the stretches religiously three to four times a day only for one week as it completely destroyed her trust in me. I also read several articles stating that the stretches weren’t needed as it was unlikely to reattach. It is now growing back and I am beside myself sick. Please, if you have any advice!!

    • I am so sorry to hear that! I was told that exercises were not needed for Ruby. As a result, she had to have her tongue clipped 3xs. However, doing the exercises kept it free. A frenulum normally does regrow. However, it typically is not nearly as restrictive if exercises are done frequently and properly.

      It is important to use homeopathy to reduce pain. Arnica and Hypericum are really good. This reduces pain and allows you to do more exercises without the severe pain.

      I’m sorry you feel that doing the stretches completely destroyed her trust in you. She may not like you sticking your finger in her mouth now, but hopefully that is the extent of it. That is what it was for Ruby and this is natural. However, I feel that being a good parent means doing things our kids don’t like and are mad at us for becuase it is best for them. WE aren’t there to be their bestie, we are there to give them the best we can-even if it means temporary pain. Pain is a necessarily and beneficial part of life.

      • I prefer the Hylands brand of homeopathy for infants becasue they dissolve instantly. I use 30x because it helps with the emotional trama that can result from the experience of having the tongue lasered. I doubled the dosage the first two weeks of Josiah’s revision and then lowered it slowly. If he ever acted like he was in pain, I gave another dose.

        Homeopathy is different than traditional medicine. It is from plants and is extremely diluted. If baby seems to still be in pain 15 minutes after you give the first dose, continue giving doses every 15 minutes until elievated. My daughter once ate an entire bottle of homeopathy. I called poison control and they laughed at me. So there’s not much, if any risk with overdosing.

        With Joey’s revision, I prefered to give more remedies to make sure he wasn’t in pain than to risk him being in pain. My thought process on this, is that if he is in pain, he will avoid moving his tongue. This will cause much greater risk of reattachment than if he is willing to freely and constantly move his tongue. I gave remedies for a total of 6 weeks I think. It seemed to work because his tongue has no reattachment.

      • Its homeopathic like teething tablets buy different remedies. Its also by the same company (Hyland’s) and dissolvable.

  3. Pingback: August Beach Bumps - 23 Girls, 27 boys, & 2 team yellow! 33 babies born! - Page 1445 - BabyandBump

  4. I have been looking for exercises like these, my 14 week old is 2 weeks post revision and needs this kind of help to further improve. Do you mind if I share your site with a couple tongue and lip tie support groups I am in? They are closed groups so there shouldn’t be anyone but them having access.

  5. Pingback: Tongue-Tie Release and Pain Management | Nursing Ruby Sue

  6. Hello. We had our 11 week old son’s tongue and lip released three days ago. The doctor told us that he would be able to latch on no problem right away, but he’s been having trouble still (popping off after two.minutes, screaming, refusing to go back on..) Do you think this is due to pain from the procedure?

    Also, I am scared to death of having them reattach! I’ve been pulling his top lip to his nose four times repeatedly, and lifting the tongue up the same amount of times, but it’s so hard to grab hold of either one due to saliva that I’m not sure I’m able to get it enough! I didn’t know about all of the little exercises you did in the video with your son..am I too late to start them now? Thank you for any help you can offer 🙂

    • It is most likely from pain. It is extremely painful to move the tongue and lip after the procedure. I would start remedies for pain immediately. Give them every 15 minutes until the baby shows no signs of pain. This will also help greatly in reducing the possibility for reattachment. I know Jennifer Tow has a more detailed protocol to avoid reattachment. If the remedies you find on my blog are not helping, you may want to consider contacting her and becoming one of her clients.

  7. I am going to buy the pain remedies you used….

    Also I have rescue remedy…I think that is the name. Flower extracts that are to give some relief. Do you know if I can give them at the same time?

    Thank you SO much for your blog. It is of the Lord that I found it! Hannah will have an upper lip tie and posterior tongue tie laser revision done next Thursday. I am dreading it, but know it is the right thing to do! Thankful that God is in control of everything.

    Your videos have been so helpful! I am doing the exercises with Hannah this week so that she gets used to them and to having my finger in her mouth.

    Thanks again,
    Beth

      • So do you think I should use all three things…or just do the two you used?

        Also, I was wondering about giving a double dose before the procedure…what do you think! They do not use anything to numb the area…crazy I think!

      • It depends on the age. If its an infant, they will not be able to acurately judge the releasement of the tether because the baby wont move their tongue in response to stimuli. Also, nursing immediately after the proceedure helps to close up the wound and stop bleeding. The infant will not be able to nurse if numbed. Neither Ruby or Joey were numbed for their frenctomy.

      • It is homeopathic. Its very diluted plant particles. Very safe. Works very efficiently, I think because God gave us in the Earth things to heal ourselves. I am a Pastors wife and I feel that God is glorified when we use what he created to bless us. .

  8. Sorry, one more question…

    You only did the exercises in the video twice a day? And no reattachment?

    Thanks again, so wonderful to talk with another mom who has travelled this road!

    • Keeping baby pain is free is the biggest component. If he/she is without pain, they will willingly and freely move their at all times. So even if you dont think the baby to be in pain, GIVE THEM ANYWAY. Homeopathy is not like trafitional meds. You cannot OD from them, they will not damage the liver. As a matter of fact, my oldest once downed an entire bottle. I called poison control and the laughed at me. The bottle will usually say, “give another dose every 15 minutes until symptoms resolve.” Do exactly that.

      There is no guarantee that there wont be attachment. I have seen a few experts post infornation linking reattachment to certain defieincies in amino acids and such. I personally dont have access to that info. If you are extremely concerned about it if it does become an issue, i recommend you become a client of Jennifer Tow’s. She has a much more indepth pre- and post- proceedure routine she now gives her clients to significantly reduce reattachment.

  9. Hi Samantha,

    We had a posterior tongue tie release for our son when he was 9.5 weeks old. I was told to manage the frenulum (up and down) for one week after every feeding. While I did not do this after every feeding I think it was at least 5 times a day for a week. I felt improvement 2-3 days after the procedure but now we are almost two weeks after in couple of days and I think he is regressing. Before I had pain on one side (pinched nipple) and the past two days it seems to start happening again. I am concerned about reattaching. I can feel restriction under the tongue but not sure if this is normal. Once the tongue heals and does not reattach should you still feel that frenulum under the tongue or not and if I feel it does it mean this is a scar/reattachment? Since it has not been two weeks if I continue with the exercises would this improve or is it now over? I would hate to have to redo the procedure again…

    • Sounds like reattachment to me. Exercises should have been dont at least 2-3 weeks. You should continue them until the wound heals open. Also, remedies for pain and to promote effective healing should have been given frequently. Im sorry thst you were bot properly informed. Its sad how many mamas and babys go through the right procedure but are not given the right information post revision to see lasting results. I recommend having a consult with Jennifer Tow. She can tell exactly what remedies to give and also exercises and stretches that are extremely effective in keeping the wound open. You can email her at iparentllc@aol.com

    • Also forgot to say that he cries a lot and refuses to take the breast quite often. When he is obviously hungry when I put him to breast he starts screaming. Sometimes he takes the breast and starts screaming within seconds. I do have forceful letdown. Do you think this is why? How can I feed him when he seems to start screaming as soon as he sees the breast ? This does not happen every time but quite a few times a day. I am so tied of all the screaming.

      • Sounds like a tongue tie. Either it wasnt fullu released or it reattached. I would consult with Jennifer Tow.

  10. My son had a lip and tongue revision at 12 weeks. For so long I had nipple pain. I would cry at almost every feed. I was ready to give up until I finally found someone that told me he was tongue tied. I drove 6 hours to get it taken care of the next day. It’s been four days. The first time he latched after the procedure, it was heaven. I could feel his tongue. However, now I feel like he is going back to old habits. I’m doing the exercises but could he still be reattaching if latch is becoming uncomfortable again? He also sees a chiropractor weekly. Another concern is the smacking and clicking noises he still makes. Those noises have gotten any better since the revision. Any advice would be greatly appreciated.

    • Are you giving anything for pain? They will compensate and use old habits to avoid using the tongue to its full extent bc when doing so it hurts. This is a very painful procedure and the recovery is very painful. Imagine the worst bluster youve ever had in your mouth under your tongue times 10. Its very painful to move. So they avoid moving it by sucking the same way they did when it is tied. Watch the video on remedies and pain management.

      • Hi my son def has ties. Here it is

        He has acid reflux since birth, he only will be held all day long! With maybe 20 min putting down. He has to be held upright! He spits up alot he chokes alot when I have a let down. He only has good feeds in his sleep. So now that he’s getting bigger he wakes often at night. He cries and cries and cries tries to eat pushes off and cries some more. I jus want a happy baby. But I’m all for natural. .. I don’t vaccines I don’t circumcision I don’t give medicines unless it’s homepathic. … he also has an upper lip blister where the lip tie is. Is it the right choice to do this surgery? When I’m so against interventions? I had no pain meds no epidural no IV no eye stuff no k shot no vaccines etc… pleas let me know. I dealt with my daughter and weaned her at a year cuz I couldn’t take the sleepless nights anymore I learned she has ties too. It’s like he’s constantly eating during day and he gets so fussy all the time.I jus want a happy baby..
        I’m jus really confused. 😦

      • Im all natural myself. No vaccines, homeopathic meds, gut healing, gluten free, cloth diaper, baby wearing. Home birth. This is a no brainer. The reason for TT is that it is a midline defect caused by malnutrition and/or toxicity in our environment. It is unnatural to have the tie in the first place. By releasing the ties, the child has full mobility of tongue. This allows the child to swallow appropriately. When my husband had his TT released he shocked at how easy it was to swallow and even talk! His sleep apnea completely went away so he had much more energy. Muscle tension was released so neck and back pain dramatically decreased. I havent even started on its pact on the vagus nerve -I have a post about that too.

  11. Where can you buy this? At cvs or Walmart? I found Arnica on Amazon and it gets here in two days. The Hypericum I would like to buy locally, but not sure where to look. Any advice?

    • Usually health food store have them (whole foods, native sun). If baby is a newborn then 30c strength should work. If baby is a fee months old or older, the more potent 200c would be better

      • He is 6 weeks and he was clipped today. I got the 30x of the arnica – three bottles of it. Will make some calls tomorrow to some health food stores, whole foods is more than an hour from me… Thank you for all of this info!

      • 30x is not the same as 30c. It is significantly less potent. X is the roman numeral for 10. C is for 100. You need 30c.

      • No one has 30c locally and I called everywhere – only 30x – and no one knows about the hypericum. I got the Amazon 30x in the mail today, was going to return it. But do you think I should just use that? Is it worth it to try?

      • Use it so that baby has something to help with pain. Give it liberally. But I would recommend ordering all the remedies bc you will need to give it to the baby for a couple of weeks at least.

  12. Hi – my bottle-fed 8 month old had both lip and tongue released on Thursday 2/25 (so today, 3/2 is day 6). It is not going well AT ALL. She screams bloody murder at the exercises we were prescribed to do 6 times a day, and even once at night. She now refuses her bottle after only drinking 20ml-1 ounce. We have had to finish her feedings with an additional 2 ounces via syringe. She has no suck reflex when I try tug-of-war kind of games. We administered Tylenol and Motrin every 3 hours around the clock for the first several days, and we still have this many problems. Do you think the combination of Arnica/Hypericum would be effective? If so, what type and dosage of each? I looked on Amazon for Hypericum 200C as you stated in a previous comment and didn’t find much. I already have Arnica, but it’s 30C. Thanks for your help!

    • Tylenol will be of no use. You are only damaging the liver. However, homeopathy has been used effectively for all my kids and Ive seen it benefit many others. I also made a salve using coconut oil and lavender hydrosol to rub on the wound. This numbs it. Get the highest dosage of remedy you can find. Most health stores sell 30c. But if you can find 200c, that may be better.

      • 200c of both, or just the hypericum? Thank you!

        Also, in the video, it looks like your bottles are 30x. How does that affect your dosage recommendation?

        For Arnica, the office who did ours suggested 10 tablets of 30c dissolved in 2 Tbsp of breastmilk or formula, and give 10 drops every 3-4 hours as needed.

        Thank you again, I’m a stranger to homeopathic remedies.

      • I used 30x on my son before I was better educated on homeopathy. Now that I understand the dosages and have more experience, I know to use 30c for newborns but 200c for older babies.

      • Good news! My local Sprouts has Hypericum 200c. I will pick it up today. So I will have Hypericum 200c and Arnica 30c. For my 8 month old, what dosage/method of application do you suggest?

      • I use 200c for both since the baby is older. It may be best if we continue this conversation via text. My number is list on the contact me page

  13. My son will be 1-2 weeks old when he has his tongue and lip revised. Exactly what dosage of arnica and hypericum should I purchace (30c for each?) and what quantity and frequency would I administer). You mentioned highlands products but is there a specific one you would recommend? I have used the teething tablets and gel but have not seen any product specifically for infant pain management by highlands

    Thank you

  14. I’m really sorry to bother you again – my sons revision is tomorrow and I’m just trying to prepare. I bought the hypericum and arnica tablets. Our lactation consultant said to dissolve the recommended dosage in 1 oz of water and then put drops on baby’s temples, soft spot and feet. It sounds like you gave them orally though. I obviously don’t want to be giving a two week old an ounce of fluid every 15 minutes as his stomach won’t be able to handle that. Do you have any experience with administering to small infants? Do you do it oraly? Do you make s very concentrated liquid so as to give them less?

    • I always gave it orally. I should have a video of how I gave them on the pain management page. Text me please if you need further help as I dont always get comments in a timely manner. My phone number is on the Contact page. Praying for you and your baby tomorrow.

  15. My son has a class five lip and tongue tie that we lasered. It has been almost 4 weeks (if not 4 already) and I was told that it partially reattached but that it is not at the point where revision is needed. I’m super upset about this. I feel like a horrible mother!

    Anywho, I am wondering if I should get the tongue tie laser peocedure done again premptively to release the tongue fully again. Thoughts?

    Also his mouth is so small that it is hard to get my index finger in his mouth sideways… Is it ok to use my thumbs instead (they’re thicker but more stumpy then a long index finger). I tried to look it up on the internet but no luck on finding an answer.

    Lastly, is there any way to reverse finger aversions?

    • This sounds pretty complex. Its very hard to determine the best course of action based on just a few sentences. It would be irresponsible for me or anyone to do so. I think it would best to talk to your IBCLC about this. If You dont have one yet, I know Jennifer Tow will not disappoint. I have only the limited experience of my kids, but she has 20+ years of experience. This can be a very tramatic and painful experience for the baby. You want to make sure you get it tight, even if it means paying money to hire a qualified professional.

  16. My son is 3 weeks old and just got his lip and tongue procedures done. How long should I expect him to be in pain/discomfort? I do the stretches every 4 hours with kids orajel and give him tynenol as well. Planning on visiting family out of town before my brother gets deployed. Not sure if my boy will be comfortable enough to go. Thank you in advance.

  17. PLEASE PLEASE USE PAIN MEDS FOR YOUR BABIES AFTER PROCEDURE.

    My 4 year old just had her tongue and lip tie lasered off & we were Not prepared for the amount of pain she was/is in. Normally shes a very strong tough girl but this procedure has made her cry for days. The first two days she couldnt drink from a spoon or straw. The stretching exercises ate nothing short of torture literally.

    I am apalled that some suregeons claim the procedure is painless and babies are pain free after. Some parents dont even give babies pain meds & wonder why they wont nurse, or blame the crying from stretches on discomfort of hands in mouth. I tried all kinds of homeopathic stuff the first two days and my daughter was in severe pain. We went with ibuprofen & bam she could talk & sip soup. I urge everyone, please give your babies actual pain meds the first few days, and homeopathic after. Please dont forgo it, its barbaric not to esse this kind of pain.

    I would repeat the surgery I feel its completely necessary, but I was not prepared for the pain involved. Thinking of babies with same pain makes me so sad.

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s