Babies Breastfeeding What is a Lip Tie in Babies? By Wendy Wisner twitter linkedin Wendy Wisner is a lactation consultant and writer covering maternal/child health, parenting, general health and wellness, and mental health. Learn about our editorial process Wendy Wisner Reviewed by Reviewed by Rebecca Agi, MS, IBCLC on October 07, 2020 Rebecca Agi, MS, IBCLC is a board-certified lactation consultant and founder of Best Milk LA, a lactation consulting service. Learn about our Review Board Rebecca Agi, MS, IBCLC on October 07, 2020 Print Lauren Brown / EyeEm / Getty Images. 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. All of it can get a little confusing, to say the least. What is a new parent to believe? And if your child gets diagnosed with something like a lip tie, what—if anything—should you do about it? 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. Causes of Toddler Speech Delays 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. Lip ties present differently in different babies, so it’s best to get a diagnosis from your pediatrician, a pediatric dentist, a pediatric plastic surgeon, or a pediatric ENT rather than diagnosing one yourself. 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. Pediatric Ear, Nose, and Throat Disorders 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 latchLips don’t “flange out” while nursingUpper lip may looked tucked in or folded overDifficulty suckling at the breastMom may experience nipple pain, nipple creasing, and nipple abrasionsMom may experience plugged ducts and mastitisMom may have a decreased milk supply if baby can’t latch or suckle properlyBaby may get frustrated at the breastBaby may fall asleep breastfeedingBaby weight gain may be slowBaby 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 nippleThe bottle nipple may easily slip out of their mouthThey may take a long time to feedThey may be extra gassyThey may have trouble sucking on a pacifier Amount of Food to Feed Your Children by Age so They Can Stay Healthy 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 lipBaby may tire easily while feedingBaby may experience tactile sensitivityBaby may experience swallowing difficulties Toddler/Finger Food Feeding Difficulty chewing and swallowingFood challenges may lead to picky eatingLip ties may lead to “compensatory strategies” and additional feeding complications Dental Issues in Children Tooth decay due in upper teeth due to food becoming trappedGap between two front teeth, which may be significant depending on the severity of the lip tie Caring for Your Child's Teeth to Keep Them Cavity-Free 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. Research indicates that in some cases, releasing a tight lip or tongue frenulum can have a positive effect on breastfeeding. But it’s important to understand that all babies are different, and the call about whether or not to do this should be made in coordination with experts in the field. 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. The Pros and Cons of Breastfeeding 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. Top Tips for Preparing a Kid for Surgery 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… Many parents these days are also faced with the question about what to do about a lip or tongue tie in their baby. Especially as more mothers are breastfeeding, and more is being learned about how a baby’s oral structures affect their feeding abilities, lip ties have come to the forefront of the conversation. 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. 15 Self-Care Strategies for Busy Parents Was this page helpful? Thanks for your feedback! Track your baby’s most exciting moments with our milestone checklist. Get it free when you sign up for our newsletter. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit Article Sources Verywell Family uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Ghaheri BA, Cole M, Fausel SC, Chuop M, Mace JC. Breastfeeding improvement following tongue-tie and lip-tie release: A prospective cohort study. Laryngoscope. 2017;127(5):1217-1223. Additional Reading Ghaheri BA, Cole M, Fausel SC, Chuop M, Mace JC. Breastfeeding improvement following tongue-tie and lip-tie release: A prospective cohort study. Laryngoscope. 2017;127(5):1217‐1223. doi:10.1002/lary.26306. Potock M. Just flip the lip!: The upper lip-tie and feeding challenges. ASHA Wire website. Updated March 10, 2015. Tongue-tie in infants and young children. HealthyChildren.org website. Updated February 7, 2017. What is frenotomy? Stanford Medicine website. Updated May 30, 2020.