We recommend starting pre-frenectomy exercises as soon as you are considering the procedure as we believe this will help your baby get familiar with having your fingers in their mouth several times a day. We also want you to be confident and comfortable with doing these exercises. Building trust with your baby is very important. Some babies can experience an oral aversion after having a procedure in the mouth.
These pleasant exercises will encourage resuming normal tongue movements and we recommend doing these exercises 3-5 times a day. It is important to make oral work fun and playful. Make sure you are smiling at your child and using a pleasant voice when doing these exercises. Singing, laughing, along with skin to skin contact also helps to keep your baby happy while you're encouraging them to use their tongue in a new way. Be sure to always start with clean hands.
Bip Bop Boop Game (Desensitize the palate including gag reflex)
Begin with touching the baby’s chin saying “BIP”
Touch baby’s nose saying “BOP”
Touch baby’s upper lip saying “BOOP” (touching the upper lip will tell the baby to open mouth)
Press down on the center of baby’s tongue saying “BEEP” (if the baby does not open mouth when the upper lip is touched, tickling the lower lip may help)
(Catherine Watson Genna: Supporting Sucking Skills in Breastfeeding Infants)
Follow The Finger (Functional exercise)
Slide your finger along the baby's lower gums from one side to the other starting in the back of the gums while encouraging the baby to chase your finger from side to side with his tongue. Also, rub the upper gums area to teach elevation skills.
Tug-O-War (Strengthening exercise)
This is best done by getting your baby used to take a Mam orthodontic pacifier. This specific pacifier allows your baby to create suction with the posterior tongue. The Soothe or Nuk pacifier encourages biting and holding with the lips which we are trying to discourage and break the habit. You will need to hold the pacifier in until your baby uses the tongue to suck, then play Tug-O-War. It is not unusual for your baby to push the pacifier out with a swallow until enough suction is created by the posterior part of the tongue to hold the pacifier in. Remember, this is a workout. Try for a few minutes 3 times a day to start and offer other times as desired.
Another way to perform this exercise is to touch your baby's upper lip to encourage the opening of the mouth wide. When your child does, slide your finger in their mouth, pad up, on top of their tongue, and allow them to suck. While your baby sucks and you press down on their tongue slightly, gently play tug-o-war, pulling your finger out slightly and letting them work to suck you back in. This can be especially helpful just before your baby breastfeeds since it helps the baby learn proper tongue movement for breastfeeding.
On the procedure day, it is recommended to give a dose of Tylenol for babies under 6 months one hour prior to the appointment and bring your baby a little hungry so plan to feed about 60-90 minutes prior to the appointment. We like babies hungry but not hangry so they will nurse post procedure. We have My Breast Friend nursing pillows in our office for you to use for feeding, but you may bring your own if you would like. We recommend your baby wear light weight clothing for the day of the procedure since we do our weighted feeds in clothes and a clean diaper to keep our babies comfortable.
Older children and adults
Start massaging the areas to stretch out tight muscles and get your child used to your hands in the mouth. You may use clean hands and coconut oil to massage or just clean hands. A good time to do this is when you are brushing teeth.
Check out the Myo exercises PDF below and start trying to strengthen the tongue muscle as much as possible.
On the procedure day, for any baby over 6 months that is eating solids through adulthood, feed a meal or snack, and give a dose of ibuprofen an hour prior to the appointment.