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Exercises post division


Press-down exercise (for infants still using excessive posterior tongue elevation after division) - Touch the chin then nose then philtrum ( the finger sized dip above between the nose and the lips), when the baby opens his mouth a brief fingertip pressure is applied to the humped area of the tongue then released. With each touch make a noise (one noise for chin, a different one for nose etc.) and keep it playful. Keep doing it until baby stops playing. After a few repeats baby should begin to drop the posterior tongue in anticipation. Do it before feeds or between feeds.

Tongue massage (for infants with severe tongue retraction) Touch the philtrum, when baby opens his mouth begin massage with a finger pad on the tongue just behind the tip. Rotate the finger in a small circle without loss of contact. Infant should improve shape and extension of tongue. If baby attempts to suck the finger, turn it over so it is pad up and continue the massage with the nail side of the finger as baby sucks. Forward traction can be achieved by accentuating the part of the circular stroke closest to the front of the tongue.

Tongue lateralisation - for those who need to improve extension and lateralisation. Touch philtrum to open mouth, trace fingertip around lower gum ridge, starting from the front and going first one side then the other. Repeat 3 times in the first quadrant and then 3 times in each of the other quadrants (upper left, upper right, lower left, lower right).

Desensitising the palate - for babies who have high palatal arches who are resistant to a deep latch. Fingertip touches the palate at the front in midline, gradually work your way back, stopping at the point where the baby gagged last time. The point is to have a positive experience, not to reinforce negative by causing a gag. Over several sessions / days the finger can be gradually put further back on the palate.

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