What Is a Lip Tie in Babies?

If you're expecting or have had a baby in the past few years, you’ve probably heard of lip ties. You may have heard that they can affect breastfeeding, and sometimes make it extremely challenging.

You may have also heard that lip ties can affect the spacing of your child’s teeth, and may even affect their speech. Or, you may have heard that lip ties have little impact on breastfeeding, and the whole thing is overblown.

What Is a Lip Tie?

We are all born with little pieces of skin in our mouths called frenula, thin membranes located under the tongue and under the upper lip. Frenula are normal and everyone has them, but in some cases the frenulum is too thick and tight, and it restricts the movement of the tongue and lips. 

A tight, restrictive frenulum under the tongue is often referred to as a tongue tie, or ankyloglossia. It’s estimated that about 10% of children are born with a tongue tie, though experts disagree on how accurate that number may be because the criteria as to what counts for a tongue tie varies from one healthcare provider to another.

When the frenulum under the upper lip is thick or restrictive, this is referred to as a lip tie. Most people only have a very small, or almost non-existent frenulum under the upper lip. But with a lip tie, that membrane may feel dense and may extend all the way to the gumline, or close to it.

Tight oral frenula are thought to be caused by genetic differences, and often run in families. So if your baby is diagnosed with a lip tie, take a look under your own upper lip—or your spouse’s lip—and you might find a lip tie as well.

Symptoms of Lip Tie

If you suspect that your baby has a lip tie, you may even be able to see it yourself. You can gently flip up your baby's upper lip and take a look. Most babies will have a very small, almost hard-to-see membrane at the very top of their gums. But if your baby has a clearly visible frenulum there, it feels thick, and/or it extends close to the gumline, you may be dealing with a lip tie.

Most lip ties that are problematic cause feeding issues for babies, both while they are breastfeeding, or while they are suckling on a bottle. Because their upper lip is tightly tethered to their gum, the mobility of their upper lip is restricted, making it difficult to form a tight seal around a breast or bottle nipple and properly extract milk. In addition, breastfeeding parents may experience nipple pain if their baby has a lip tie.

How Lip Ties Affect Breastfeeding

In order for your baby to nurse well, they need to form a good latch on your breast, maintain that latch, and be able to use their lips and tongue in coordination to suckle. Some babies can do this well, despite a restriction in their lip or tongue frenulum; others have more trouble.

Signs that your baby may be struggling with breastfeeding due to a lip tie include:

• Trouble latching and maintaining a latch
• Lips don’t “flange out” while nursing
• Upper lip may looked tucked in or folded over
• Difficulty suckling at the breast
• Becoming frustrated at the breast
• Falling asleep while breastfeeding
• Slow weight gain
• Gas from swallowing air

Signs in the breastfeeding parent include nipple pain, nipple creasing, and nipple abrasions; plugged ducts and mastitis; and a decreased milk supply if baby can’t latch or suckle properly.

How Lip Ties Affect Bottle Feeding

It’s not just breastfeeding that can be impacted by a lip tie. Lip ties can affect bottle feeding as well. For example, if your bottle-fed baby has a lip tie, they may:

• Suck shallowly on the bottle nipple.
• Lose their grip on the nipple so that it easily slips out of their mouth
• Take a long time to feed
• Be extra gassy
• Have trouble sucking on a pacifier

Other Effects of Lip Ties

Most of us think of how lip ties affect infant feeding, but severe lip ties can have an affect on your baby as they grow older as well.

Solid Food Feeding

• Baby not be able to clean their spoon with their upper lip
• Baby may tire easily while feeding
• Baby may experience tactile sensitivity
• Baby may experience swallowing difficulties

Toddler/Finger Food Feeding

• Difficulty chewing and swallowing
• Food challenges may lead to picky eating
• Lip ties may lead to “compensatory strategies” and additional feeding complications

Dental Issues

• Tooth decay due in upper teeth due to food becoming trapped
• Gap between two front teeth, which may be significant depending on the severity of the lip tie

What to Do If Your Baby Has a Lip Tie

So here’s the million dollar question: What should you do if your baby has a lip tie?

First of all, don’t diagnose a lip tie yourself. Make sure you consult a specialist such as a lactation consultant, pediatric dentist, or pediatric ENT for diagnosis as well as advice for how to manage the lip tie.

If you are having a breastfeeding or other feeding issue, you may be stressed out about the idea of doing something like having the lip tie released. Again, this something for you and your healthcare provider to discuss.

If you are breastfeeding and concerned about a lip tie, you should consult with a lactation consultant. Most breastfeeding issues have more than one cause, and a lactation consultant can help you figure out where your baby’s lip tie fits in here, whether fixing it will help, and what else needs to be focused on to remedy your breastfeeding issues, such as latching and increasing milk supply.

Lip Tie Release

If you do end up getting your baby’s lip tie released (a procedure called a frenotomy), you will need to find a provider you trust and who is experienced in lip tie releases. Usually, pediatric dentists or pediatric surgeons do this. The procedure is typically done on an out-patient basis and your baby can remain awake. Your provider may use laser technology or sterile surgical scissors.

The procedure is normally quick and almost painless for babies—it’s usually the parents who are most stressed out about the procedure! The membranes that are being cut (frenula) are very thin and don’t usually bleed much.

Your healthcare provider will provide after-care instructions for your baby, including possible painkillers to soothe any soreness your baby may experience. Soreness is usually minimal for this procedure. Always make sure to check with your healthcare provider for administration of painkillers for infants, as certain painkillers are not appropriate for babies under six months.

A Word from Verywell

There are so many decisions we have to make for our babies when they are little. To stay home or go back to work? To breastfeed or bottle feed? To use cloth diapers or disposables. The list goes on…

It’s very common to come across conflicting information about something like lip ties. You may have even been told different things by different healthcare providers. This can get confusing and overwhelming.

Remember that you are the parent here and you get to decide what is best for you and your baby. Make sure to seek out different opinions, stay informed and educated, sort out of what seems sensible and smart for you and your family—and then try to leave all the rest behind. Keep in mind that ultimately, whatever decision you make and whatever path you choose, you are doing what feels right for you and your baby in the end.