What to Expect:

• A diamond-shaped area will be visible under the tongue.

• A whitish-yellow scab will form over the diamond.

• A photo of YOUR child's diamond will be emailed to you for reference.

• Baby may be fussier than usual for 2-3 days after the procedure.

• Stretches begin the MORNING after the procedure and continue for 6 weeks.

• ALL stretches are done from BEHIND baby's head.

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DAY 1: Procedure Day

✅ No stretches today.

Focus on comfort:

• Extra hugs and cuddles

• Skin-to-skin time

• Feed your baby on demand

   

Your baby has had a big day, so focus on rest and bonding.

 

DAY 2: Start Stretching the Diamond Tall

✅ Begin stretches every 4 hours, including overnight.

• Place baby on a firm surface.

• Always approach from BEHIND baby’s head.

• Use 2 index fingers to gently lift the tongue from the CENTER of the diamond.

• Stretch the diamond as tall as possible for 2 seconds, and repeat twice.

   

If an upper lip tie was released:

• Roll under the upper lip with your index finger.

• Make gentle circles over the area where the lip meets the gums.

• Then gently massage vertically and horizontally to keep the area open.

• This process should only take 2 seconds in total.

   

DAY 3: Add Gentle Massage

✅ Continue lifting the tongue as before.

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From BEHIND baby's head:

• Sweep your index finger under the tongue and INTO the diamond area.

• With the pad of your index finger, glide it up and down, then side to side (corner to corner in both directions) to prevent central attachments from forming.

• This is a QUICK process intended to keep the diamond fully open and prevent contraction of the wound.

• Do NOT aggressively rub the wound.

• The entire stretch should take no more than 2 seconds.

   

This keeps the diamond wide open to prevent closure/reattachment.

 

Recommended Stretch Schedule

• Weeks 1 & 2: Every 4 hours (including overnight)

• Weeks 3 & 4: Every 6 hours

• Weeks 5 & 6: Twice daily

   

Helpful Tips for Stretches

• Use coconut or olive oil on your fingertip as a gentle lubricant.

• Roll up a receiving blanket like a paper towel tube and place it across and beneath baby's shoulders (not under the neck). This will cause their head to tilt back and should help to open baby's mouth wider.

• Go in from the sides. This way you can anchor your fingers against baby's jaws as you do the stretch so baby doesn't clamp down. 

• Avoid numbing gels with benzocaine (like regular Orajel).

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Timing Suggestions:

• For newborns (under about 3 weeks of age): Try stretching before feedings. Most newborns will settle quickly once they are sucking. (If your baby gets too upset to feed well after stretches, we recommend switching the stretches to after feedings instead.)

• For older babies (more than about 3 weeks): Try stretching after or between feedings to avoid associating stretching with feedings.

   

Comfort Measures

Infant Tylenol can be used as needed (for 48 hours after procedure):

• The dose is based on your baby's weight.

• Please give the dose written on the bottom of your aftercare instruction sheet. It may be different than the instructions on your bottle.

• Do not exceed 5 doses in 24 hours.

• The correct dose will be reviewed at your visit.

   

*For babies over 6 months, ibuprofen (Motrin) is preferred.

Don’t wait for baby to become uncomfortable between doses.

 

What’s Normal?

• A white, yellow, or orange diamond-shaped scab is expected.

• Minor bleeding with stretches is normal and may happen at ANY time as the area heals.

• Baby may have darker stools from tiny amounts of blood swallowed during the procedure.