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
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.
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.
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.
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.
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
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
Stick your tongue out for your baby to copy
Run your fingers along your baby’s gums to encourage sideways movements
Encourage sucking on your finger and attempt a tug of war game’
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.
https://www.youtube.com/watch?v=2JMcbF85ehs (Melissa Cole)
(4-6 times a day for 3 weeks)
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.
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:
Osteopath who works with babies in Geneva, Eaux Vives at CAP (Cabinet d'accueil périnatal). Also does home visits.
CAP Route de Chêne 11, 1207, Genève
Osteopath who works with tongue-tied and lip-tied babies in Geneva, Carouge at OstéOptimum
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
Rue du Grand-Bureau 28, Les Acacias, 1227
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
Chiropractor who works with tongue-tied and lip-tied babies. Gaelle is based in Gex, France.
Noémie has done a training regarding tongue-tied babies. Noémie is based in Thonon-les-Bains, France. 35 km from the centre of Geneva
Dr Coralie Garnesson
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.
Paediatric osteopath at Cruseilles, Haute-Savoie. Specialises in restrictive oral ties.
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.
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
Chiropractor who works with babies and speaks French and English.
37 Avenue Montaigne, Annecy-Seynod, 74600
Speech therapistMarie-Anne works with babies after frenotomy.
+41 78 307 1444
Lefko - Médecin Dentiste-Pédodontiste, Route de Pré-Bois 20, 1215, Bernex, Genève, Switzerland
Tram 14, 18