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aftercare instructions

Active Wound Management

Keeping the scab on the wound under the tongue (and/or lip/cheeks) from healing back together is the most important, yet for most people, the most challenging part of the aftercare.

You must be able to visualize the entire diamond when you are doing this stretch.  If you cannot see the entire wound there will be reattachment.  In order to do this properly you must place yourself behind baby's head (rather than in front or to the side).

Check out our video section for more stretch help. 
Two different ways to stretch the tongue

Two pointer fingers at the top of the diamond and thumbs holding chin for leverage

Bobby Ghaheri, MD

(2 weeks post-op)

One pointer finger at the top of the diamond and one at the bottom for extension

(Day of procedure)

How NOT to stretch

If you cannot see the full diamond when you are stretching, the part you cannot see with start to heal back together.  In both of these photos the diamonds are not fully visible - they are still folded in half

Bobby Ghaheri, MD

(3 days post-op)

Bobby Ghaheri, MD

(5 days post-op)

This video shows a great technique, for visualizing the wound, and also for re-training normal tongue resting posture, that you can do while your baby is sleeping!

Facial Massage

Baby needs sensory input for better healing
Massage is powerful medicine!
  • Promotes healing
  • Improves circulation and muscle tone
  • Regulates the nervous system
  • Promotes movement
  • Helps skin, fascia, and muscles to relax
  • Encourages growth and weight gain
  • Enhances the parent and baby connection
These are just some examples.  Do not be afraid to touch your baby! Find what your child likes best and do that!
Jennifer Flinn has an extensive collection of videos here where you can find help for all kinds of baby massage techniques!

Tummy Time

Change the world with tummy time
The days of plopping baby on their tummy and picking them up when they cry are over! Tummy time has changed, evolved, and improved thanks to Michelle Emmanuel.
  • Lay down with baby, sing, talk, play with toys, move around, encourage them to explore both sides of their body
  • Combine tummy time with sucking exercises
  • When baby is fussy, roll them out of tummy time, calm them, and then try again
  • Babies under 2 months old should be spending a minimum of 30 minutes a day in tummy time during waking hours
  • By 4 months, babies should be in awake tummy time for 45-90 minutes per day
  • Split tummy time into several 5-15+ minute sessions over the course of the day 
  • Supervised tummy time naps are great too!
If nothing else, think of tummy time as an integral post-release tongue workout. Every time baby lifts and moves (or tries to lift and move) their head, they lift and move their tongue.
Check out


Guppy can be for play time and for relaxation
Babies love guppy!
  • Choose how far the head tips back based on your baby's comfort level.
  • Great to do with baby while you're watching TV.
  • Can be done while baby is sleeping!
  • Search for red creases and air them out
  • Combine guppy with facial and/or body massage
  • Combine guppy with sucking excercises

Strengthening Exercises

  • Phasic Biting
    • Place pinky finger where baby’s molars would be and have them bite.  Alternate sides 3-5 times.
    • The bite should be strong, rhythmic, and equal on both sides.
  • Lateralization
    • Slowly rub the lower gum line from side to side and your baby's tongue will follow your finger.
    • You can also try tickling the corners of their mouth to see if they will try to catch your finger with their tongue.
  • Suck Training
    • While baby is sucking on your finger, flip your finger over to break the latch.  Repeat to make them practice the latching motion.
    • While baby is sucking on your finger (or pacifier or bottle) gently pull to play tug of war.

Additional Resources

Bobby Ghaheri, MD

Larry Kotlow, DDS

Michelle Emmanuel, OTR/L


Michelle Emmanuel's Youtube Channel

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