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Oral Exercises

 

If your baby is struggling to breastfeed, oral exercises will help with the following:

 

  • Improved time to finish feeds

  • Improved amount of milk baby takes per feed

  • Better seal on the breast

  • Better neuromotor development

 

When to do exercises:

 

  • When baby is quiet and alert

  • Make it playful

  • Stop when baby becomes agitated

  • Pressure should be firm but gentle

  • Don’t do all those exercises at the same time. Chose only 2 to 3, you can add some more later or change them. 

  • Aim to do them 3 times a day. 

  • Keep it fun, playful

  • Session length depends on baby’s tolerance, but usually takes only seconds to few minutes max

  • Discontinue if bay is agitated or showing stress cues

  • Consider re-evaluating, modifying after 1 week depending of progress

  • It will take some time to see an improvement

 

Jaws

 

Issue : Jaw tension, poor gape

 

Exercice : Jaw massage + chin tug

 

  • Use finger pads to massage both sides of the jaw (from TMJ to base of mandible), When you reach the chin, pause and gently `tug’ downward.

  • The `tug ‘is simply holding gentle pressure for a few seconds and waiting for the mouth to relax open. Repeat 2-4 times if baby is enjoying the work. 

 

Exercise: Magnet fingers 

 

  • Place fingers inside and outside the TMJ area, like they would be connected `magnetically`, gently massage. 

 

 

Exercise: “Beep Bop Boop Bip”

 

  • Use some silly sounds to associate touching chin, nose, philtrum, then chin tug.

  • This will help baby open wider and associate playful touch, especially teat/nipple near philtrum, with open wide. Repeat 2-4 times. 

 

 

Floor of the mouth

 

Issue: Floor of mouth tension, jaw tightness

Exercise: Floor of the mouth massage

 

  • Use finger pad, massage floor of mouth, circular movement work well. 

 

 

Lips

 

Issue: Suboptimal lip strength, frequent open mouth posturing due to lip tone/strength

Exercise: Lip pulses

 

  • Use finger pads to work around lips, giving input with a little ‘push’ side, middle, side of upper and lower lips. Repeat 2-4 times. 

 

Issue: Lip tension (lip blisters)

Exercise ‘Moustache, Beard’

 

  • Using index finger, massage over upper lip ‘moustache’ back and forth 2-4 times then rub under lower lip back and forth ‘beard’ 2-4 times 

  • Can add in some massage ‘circles’ to the moustache/beard exercise too. 

 

 

Cheeks

Issue: Suboptimal cheek strength

Exercise: Cheek pulses

 

  • With the pad of index finger (or pinkie finger if baby is very little) gently insert inside baby’s cheek, gently pulse up to 10 times, repeat on the other side.

 

Issue: Cheek tension

Exercise: Cheek stretch

 

  • Using thumb and index finger to form ‘magnet’ fingers, gently grasp cheek near TMJ are and slide to corner of lips. 

 

Tongue

 

Issue: Suboptimal lingual lateralization

Exercise: Gum rub side to side

 

  • With the pad of index finger, start in middle of lower gum, then travel/rub lower gum to back molar area. Repeat on both sides 2-4 times. 

 

Issue: Suboptimal lingual strength

Exercise: Side of tongue pushes.

 

  • With the pad of index finger, push against side of tongue, baby should try to `push back. Repeat 2-4 times each side. 

 

Issue: Suboptimal lingual cupping and extension

Exercise: Tug of war: 

 

  • Introduce finger to infant’s mouth. Elicit some lingual extension playfully. Encourage suckling on finger. With the pad of finger turned up toward palate, have infant suck and then start to tug to encourage cupping, extension, and maintenance of both. 

  • You can try to turn finger over for some stroking forward of the tongue periodically. Repeat for 2-4 times or to infant’s tolerance/enjoyment. 

 

Overall exercises

 

Issue: Overall development, healthy sensory input, nervous system regulation

Exercise: Baby and facial massage 

 

Tummy time (Method by Michelle Emanuel)

  • Every time you change baby’s nappy turn baby to her tummy

 

Suck training

 

Issue: Suboptimal sucking patterns, fatigue with feeds, poor seal​

 

Let baby invite finger in (pad side up)

Let baby initiate sucking.

 

Add in movement if baby allows

  • Tug of war

  • Rotate finger to pad side down, gentle pressure

  • Explore finger pressure to palate or pushing on tongue 

 

 

Post frenotomy exercises

 

Currently, there is no evidence that wound massage is effective. However, with clean fingers and short nails, there are some gentle fun exercises to encourage tongue mobility 

  1. Stick your tongue out for your baby to copy

  2. Run your fingers along your baby’s gums to encourage sideways movements

  3. Encourage sucking on your finger and attempt a tug of war game’

  4. If baby does not lift his tongue high enough when crying of playing for you to see the wound, you will have to lift the tongue all the way up in order to visualize the wound.  Please watch the following video for instructions. 

  5. https://www.youtube.com/watch?v=ZXFJHqgawNw

  6. https://www.youtube.com/watch?v=2JMcbF85ehs  (Melissa Cole)

  7. (4-6 times a day for 3 weeks)

  8. Massage under the chin when baby is sleeping to encourage the tongue to lift up. You can check if the tongue is up by lowering the chin and having a look where the tongue is resting.

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It is strongly recommended to visit a chiropractor or an osteopath who works with babies.

Here are some recommendations of trained osteopaths and chiropractors in oral ties and breastfeeding:

 

Marta Castelli

Osteopath who works with babies in Geneva, Eaux Vives at CAP (Cabinet d'accueil périnatal). Also does home visits. 

0041 22 736 24 40

CAP Route de Chêne 11, 1207, Genève

https://www.caperinatal.net/consultation-avec-une-ostopathe

 

Sophie Menghetti

Osteopath who works with tongue-tied and lip-tied babies in Geneva, Carouge at OstéOptimum

004122 300 67 09

54 Bis Route des Acacias – 1227 Carouge

https://www.onedoc.ch/fr/osteopathe/carouge/ph/sophie-menghetti

http://www.osteoptimum.ch/en/practice/

Philippe Lamy and Adel Aoun

Osteopaths who work with babies in Geneva and have a good knowledge about buccal ties, Les Acacias, Cabinet Lamy et Aoun

004122 301 64 23

0041 794747775

Rue du Grand-Bureau 28, Les Acacias, 1227

https://osteopathe-carouge.ch

Elodie Grandjean-Moche

Chiropractor who works with tongue-tied and lip-tied babies. 

Elodie is based in Bonneville, France, around 30 km from the centre of Geneva. 

+33 6 84 89 36 60

contact@chiropracteur-bonneville.fr

https://chiropracteur-bonneville.fr

Gaelle Dupin

Chiropractor who works with tongue-tied and lip-tied babies. Gaelle is based in Gex, France.

+33 4 50 40 28 17

chirogex@gmail.com

https://chiro-gex.fr

Noémie Durand
Osteopath 
Noémie has  done a training regarding tongue-tied babies. Noémie is based in Thonon-les-Bains, France. 35 km from the centre of Geneva

+33 7 66 21 21 31

durand.osteo.kine@gmail.com

https://vanillamilk.fr/1367-professionnel-allaitement-maternel/Osteopathe-Specialise-en-pediatrie/Durand/74200/Thonon-Les-Bains

https://www.facebook.com/noemiedurandosteo

Dr Coralie Garnesson
Chiropractor
Coralie is based in Geneva close to the HUG hospital. Coralie has lots of experience with babies with feeding difficulties and tongue-ties. Coralie is currently on a maternity leave. 

+41 22 570 11 57

dr.garnesson@gmail.com

https://www.onedoc.ch/fr/chiropraticien/geneve/pb5o5/dr-coralie-garnesson

https://www.facebook.com/Coralie-Garnesson-Chiropracteur-744156749286776/

Emmanuel Cormier
Osteopath
Paediatric osteopath at Cruseilles, Haute-Savoie. Specialises in restrictive oral ties.

+33 6 84 01 72 59

https://cormier-osteopathe-cruseilles.fr/content/le-cabinet-osteo-emmanuelle-cormier

Adresse : 31 Grand Rue, 74350, Cruseilles

Marion Prevot
Chiropractor and doula
Marion works with babies and has done 2 training courses for buccal ties and tongue-ties. She can visit you and baby at home. For adults she has a clinic at Chambéry.

+33 6 89 57 96 62

Eugénie Arrault

Chiropractor who works with babies and is trained in buccal ties. She practices in Annecy and in Saint Julien en Genevois

Centre Chiropratique du Genevois

15 Avenue de Genève, Saint Julien en Genevois

+33 6 47 52 00 98

+33 6 80 55 61 16

Héléna Souchon

Chiropractor who works with babies and speaks French and English.

37 Avenue Montaigne, Annecy-Seynod, 74600

+33 4 50 63 82 49

https://www.chiropratique-annecy-seynod.fr

Marie-Anne Bardel

Speech therapistMarie-Anne works with babies after frenotomy. 

+41 77 480 97 69

https://www.local.ch/fr/d/geneve/1201/cabinet-de-logopedie/cabinet-logopedie-orthophonie-du-leman-CE8vv7wOgbmncJorvKxgQA

https://zip.ch/en/cabinet-de-logopedie-rue-de-zurich-geneve-lE34YQLbD7/

Expat Midwife Geneva
 +41 78 307 1444

Lefko - Médecin Dentiste-Pédodontiste, Route de Pré-Bois 20, 1215, Bernex, Genève, Switzerland

Tram 14, 18 

Bus 10,23,28,53,57,Y

Parking available.

"When I contacted Mirka I had a really bad day coping with blocked ducts and a tongue-tied, hungry and crying baby. I felt that she got out of her way to call me back and arrange a next morning appointment. She was very helpful and relaxing, she gave me clear instructions on what to do and what i should expect. The process was quick and easy and she called me back in a week's time to see how things going. I would definitely recommend Mirka due to her ethos, professionalism and compassion."

Stella S.

Expat midwife Geneva
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