Frenulotomy (tongue-tie division) can bring significant improvements in feeding and comfort for many babies. But just like any physical change, it takes time and sometimes a bit of support for your baby’s to adapt.
In this blog, we’ll walk you through the role of oral exercises, what to expect before and after the procedure, and why we do not recommend stretching or massaging the wound site.
If your baby has had a frenulotomy elsewhere, we recommend asking your provider about their aftercare guidance. If you’d like additional support with oral function before or after the procedure, we’re here to help, please don’t hesitate to get in touch.
Why Exercises May Be Recommended Before a Frenulotomy
In some cases, gentle oral exercises may be recommended in the lead-up to a tongue-tie release. While research in this area is still emerging, the aim of these exercises is to:
- Reduce muscle tension
- Improve oral tone and mobility
- Prepare your baby to use their tongue more effectively post-procedure
- Promote optimal healing
Babies with tongue restrictions often develop compensatory muscle habits—ways of feeding that work around the tongue-tie. These habits can persist after the tie is released if the surrounding muscles and fascia are still tight. Although there is limited high-quality evidence to confirm the extent to which the benefits are, clinical experience suggests that some babies may find it easier to adapt functionally after a frenulotomy if they’ve had some support with oral movement beforehand.
How pre- frenulotomy and post frenulotomy exercises may help optimise healing
It’s important to understand that movement is believed to play a key role in how tissues heal, particularly when it comes to maintaining flexibility and function. While high-quality research focused specifically on post-frenulotomy healing is limited, what we know from broader wound healing literature and from clinical experience can offer helpful insight. There are 2 ways in which movements impact healing.
Proliferation Stage of Healing
In the case of frenulotomy, the wound typically heals very quickly—often within 1 to 2 weeks. During this early phase, how your baby uses their tongue plays a key role in how the tissue comes back together.
If a baby continues to feed using the same compensatory patterns they relied on before the release, there’s a chance the wound may close along those same lines of tension. This is known as primary intention healing, where the edges of the wound come together directly. While this kind of healing is fast, it may reinforce the same tight or limited movements the baby had before.
Ideally, we want the wound to heal by secondary intention. This means the tissue heals from the base up, rather than simply pulling closed from the edges. Secondary healing allows more space for new, flexible tissue to grow and is more likely to support long-term improvements in tongue mobility. This process is more likely when the edges of the wound aren’t held tightly together for long periods—which is where movement and varied tongue use can help.
Remodelling Stage of Healing
After a frenulotomy (tongue-tie release), a small wound forms under your baby’s tongue. As this area heals, the body produces collagen—a strong, stretchy protein that helps rebuild and strengthen tissue.
This longer-term phase is called remodelling, and it plays a crucial role in how well the tissue functions after healing.
Now, here’s the important bit:
If the tongue moves gently and regularly during this stage, the collagen tends to be laid down in a way that follows those movements. This supports healing that is more flexible and more likely to restore normal tongue function.
But if the tongue stays still—or only moves in the same restricted patterns it did before the release—the collagen may form in a tighter, less flexible way. This can limit how freely the tongue moves in the future.
This is what professionals mean when they talk about “remodelling collagen fibres in a more functional alignment.” In simple terms, it means that movement during healing helps the tissue form in a way that works better for feeding and oral function.
Here’s the good news:
The remodelling stage doesn’t end when the wound closes. It can continue for up to two years after the procedure. This means that encouraging regular tongue movement—through functional therapy, oral exercises, or scar remodelling techniques—can continue to support improved tongue function long after the initial healing.
Why Exercises May Be Recommended After a Frenulotomy
Rather than relying on aggressive manipulation, we support functional healing—where the baby’s own tongue movement plays a central role in guiding recovery and integration. While a practitioner may introduce gentle exercises to encourage tongue elevation and promote healing by secondary intention (natural healing from the base upward), no activity should apply forceful pressure through the wound. Parents are always encouraged to follow their baby’s cues and only proceed with techniques that their infant comfortably tolerates.
Our aftercare model is rooted in developmental support, functional use, and relationship-based care, empowering families to support healing through connection, responsiveness, and trust—not coercion or distress.
We emphasise that babies learn best by actively using their own bodies. Tongue function improves when babies practice movements like:
- Sucking
- Swallowing
- Playing with their tongue
- Mimicking facial expressions
- Optimising resting tongue posture
Why We Do Not Recommend Disruptive Wound Stretching
Some care providers may suggest a technique known as disruptive wound massage or stretching, which involves pulling, with considerable force, or massaging the healing wound site multiple times a day to prevent reattachment. These are not functional strategies but manipulation of the wound during healing. We do not recommend this approach, and here’s why:
Why We Do Not Support Disruptive Wound Massage
- Distress for Babies and Parents: This method is often upsetting for infants and caregivers alike, leading to low compliance with aftercare routines.
- Increased Inflammation and Scarring: Frequent interference with the healing site can trigger inflammation, encouraging the development of fibrous tissue that may actually reduce tongue mobility over time.
- Feeding Aversion: Families have reported that babies begin to associate oral contact with pain, resulting in reluctance or refusal to feed.
Most importantly, there is no robust evidence that disruptive wound healing or stretching reduces reattachment or improves long-term outcomes. In the absence of proven benefits—and with clear risks—we do not believe this practice is ethically justifiable.
Key differences between disruptive wound massage/stretches and functional exercises
| Feature | Wound massage/ Stretches | Functional Healing Approach |
| Force Applied | Moderate to strong | Minimal to none |
| Focus of Intervention | Wound management | Functional use and mobility |
| Baby’s Comfort | Often distressed | Tolerance-guided and calming |
| Primary Activity | Manual manipulation | Feeding, play, posture, and light touch |
| Evidence Support | Weak to limited | Supported by developmental theory |
| Parental Experience | High stress, low adherence | Empowering, relationship-based |
Baby led approach
It’s important to remember that every baby is unique, and not all exercises will suit every baby in the same way. Our approach is always grounded in:
- Respecting your baby’s cues
- Stopping any activity that causes distress
- Keeping exercises playful, soothing, and developmentally appropriate
If your baby becomes fussy or resists a particular movement, it’s okay to pause and try again later—or not at all. Most exercises and games can be adapted to suit your baby’s needs, so if you’re finding it difficult or uncertain, please don’t hesitate to get back in touch for support or alternatives. As always, the guiding principle is to do no harm, and your baby’s comfort and wellbeing come first.
What Does the Research Say?
It’s important to acknowledge that high-quality research on oral exercises in babies is limited, especially regarding which techniques work best and when. This is partly due to the natural differences in baby age, anatomy, and technique. However, current clinical experience and early research suggest:
- Exercises are well tolerated when done gently and respectfully.
- They may improve post-frenulotomy outcomes, especially when combined with feeding support.
- No evidence suggests they cause harm when approached with a baby-led, gentle method.
We also draw on knowledge from related fields—such as muscle rehabilitation, fascial therapy, and infant feeding development—to help guide safe and effective recommendations.
