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

Let’s go over the ins and outs of lip ties, how they may affect your baby, and how to decide what course of action to take in terms of managing them.

What Is a Lip Tie?

We are all born with a little piece of skin in our mouths called the frenulum. Most of us can easily locate these thin membranes under our tongues and under our upper lips. Frenula are normal and we all have them, but in some cases the frenulum we are born with is too thick and tight, thus restricting the movement of our tongue and lips. 

When we have a tight, restrictive frenulum under our tongue, this 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 our upper lip is thick or restrictive, this is referred to as a lip tie. Most of us only have a very small, or almost non-existent frenulum under our upper lip. But when you have 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.

What Are the 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.

But it’s not just a visual thing. Most lip ties that are problematic also 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 moms may experience nipple pain as a result of 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.

Here are some signs that your baby may be struggling with breastfeeding due to a lip tie:

• 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
• Mom may experience nipple pain, nipple creasing, and nipple abrasions
• Mom may experience plugged ducts and mastitis
• Mom may have a decreased milk supply if baby can’t latch or suckle properly
• Baby may get frustrated at the breast
• Baby may fall asleep breastfeeding
• Baby weight gain may be slow
• Baby may experience gas from swallowing air

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
• The bottle nipple may easily slip out of their mouth
• They may take a long time to feed
• They may be extra gassy
• They may have trouble sucking on a pacifier

What Other Impacts Can Lip Ties Have on Your Baby?

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.

According to the American Speech-Language Hearing Association, lip ties can affect:

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 in Children

• 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.