Many times just “clipping” a tongue tie is not enough. Babies usually begin sucking inside the womb, so even a baby who has their ties released as a newborn may need therapy to relearn.
It is best to work with an International Board Certified Lactation Consultant (IBCLC) and/or Speech Language Pathologist (SLP), because they can assess your baby’s suck and show you exercises to specific to your baby. We have seen quite a few IBCLCs and SLPs now, so the information below is compiled from them, along with a few things I have come up with on my own.
Sucking, strength and mobility exercises (to be done as much as the baby enjoys):
Insert clean finger (nail down) or Soothie pacifier into baby’s mouth. Gently pull it back out – just until you feel resistance as the baby sucks harder, trying to hold on.
Insert clean finger (nail down) into mouth, gently stroke palate, then flip over and apply gentle pressure while stroking from the back of the tongue to the front of the tongue.
Insert clean finger (pad down) and stroke along the gum line.
Either hold onto a vibrating teeth or electric toothbrush or inset finger (pad down), or insert the electric toothbrush itself and stroke all over the tongue.
Older babies and children:
Offer a variety of safe objects for the baby to mouth and lick.
Offer Popsicles, lollypops, egg beaters etc. and encourage them to lick.
Spread something sticky (peanut butter/jelly etc) on the outside of their mouth to lick off.
Play imitation (silly face) games.
Practice a variety of sounds, especially ones that require complex tongue movements (“L” has been especially helpful for my children).
The orally defensive infant/child:
Take it slow! It is not uncommon for tongue tied babies to develop oral aversion, feeding can be stressful from birth, on top of surgeries, reflux or other issues that give them unpleasant oral experiences. We need to teach them that they can enjoy using their mouth!
Some children may not let you in their mouth at all. It took me several months just to touch my daughter’s face. I started with massaging her hands and feet, and progressed fairly quickly to her legs/arms and back, however, progress slowed down after that. I started each time on her hands and tried to work my way to her neck, then the top of her head, face, near her mouth and outside of her mouth. I always stopped as soon as she looked worried. After many months she let me fingers into her mouth but did not suck and quickly gagged. I discovered that if I put something tasty on my finger (such as jelly) she was more willing to accept it, slowly I worked up to doing sucking exercises, providing a lot of encouragement along the way. I have heard of other mothers finger feeding younger babies who were not interested in the sucking exercises.