A lip-tie is an extra short or tight piece of tissue attaching your baby’s upper lip to their gum. While doctors used to be concerned about a lip-tie causing breastfeeding problems, recent research shows that it’s not likely to cause issues. Lip-ties often improve on their own as a child gets older, and there’s no good evidence that surgery to correct lip-ties is needed. Ask your baby’s doctor to weigh in if you’re concerned, and talk to a lactation consultant if you’re having trouble breastfeeding.
IN THIS ARTICLE
- What is a lip-tie?
- What causes lip-ties in babies?
- How can I tell if my baby has a lip-tie?
- Should lip-ties in babies be corrected?
What is a lip-tie?
A lip-tie is an extra short or tight labial (maxillary) frenulum – that’s the triangle-shaped piece of connective tissue that attaches your baby’s upper lip to their gum.
All babies have some tissue there, and the definition of normal and “too tight” isn’t well defined medically. A lip-tie shrinks as a baby grows, often correcting itself by the time a child’s canine teeth come in.
There’s another frenulum under your baby’s tongue. When this is too tight (tethering your baby’s tongue to the floor of their mouth), it’s called a tongue-tie. There’s some evidence that a tongue-tie may (in some cases) make it harder for your baby to latch onto your breast and nurse and make breastfeeding more painful for you.
Some experts have concluded that a lip-tie might cause similar breastfeeding difficulties, because it may prevent a baby from flanging their upper lip to get a good latch, but others say this isn’t necessary. In any case, there’s no evidence that lip-ties cause breastfeeding problems.
What causes lip-ties in babies?
There are seven different frenula in a baby’s mouth. These pieces of soft tissue give stability to an infant’s upper lip, lower lip, and tongue.
A lip-tie or labial frenulum formed while your baby was still developing in the womb. Normally, the frenula get thinner and recede before a baby is born, separating their lip from their gums. No one knows why some babies still have a lip-tie at birth.
Genes might be at least partly responsible for lip-ties. They often run in families. Tongue-ties are more common in boys than in girls. There’s been some assumption that tongue-ties and lip-ties often occur together in the same baby, but there’s no good data to support that claim. In fact, one study of 100 newborns with lip-tie found no correlation.
How can I tell if my baby has a lip-tie?
Some lip-ties are obvious – a baby’s upper lip may be pulled tightly to their gum. But it’s usually not something that you’ll be able to recognize, because, again, every baby has an upper lip frenulum. Even healthcare providers and pediatric dentists don’t have a good system for measuring lip-ties.
If you’re concerned that your baby may have a lip-tie that might be interfering with their latch or causing you discomfort during breastfeeding, talk with a lactation consultant.
A lactation consultant can help evaluate your baby’s latch and provide solutions. Sometimes a simple change in position or technique will be helpful.
Should lip-ties in babies be corrected?
There’s no good evidence that surgery for lip-ties (called a frenotomy) is necessary or useful.
Most research to date has focused on tongue-ties rather than lip-ties. Or the research combines tongue-ties and lip-ties together. More research is needed on lip-ties specifically.
We also don’t have good data on the success rate of frenotomies for breastfeeding problems, and the procedure – even for tongue-ties – is now controversial. At this point, we don’t know for sure if there’s any relationship between a lip-tie and breastfeeding problems, but recent research suggests not.
The procedure to correct a lip-tie or tongue-tie is called a frenotomy. During the procedure, the doctor makes one small cut in the frenulum to separate it from the baby’s upper lip. Pediatric dentists also perform frenotomies and sometimes use a laser for the procedure.
Occasionally both lip-tie and tongue-tie frenotomies (when the frenulum under the tongue is cut) are done at the same time, though there’s no good evidence to support this practice.
Doctors have been performing frenotomy procedures since the 1600s, and the practice has grown significantly in recent years, sometimes to address (or avoid) breastfeeding problems, and sometimes for appearance. It’s a quick and low-risk procedure, but it’s still a surgical procedure.
If you’re considering a frenotomy, be sure to discuss the risks and desired benefits with your healthcare provider. One thing to consider: Some babies have something called “oral aversion” after a painful oral procedure. Because their mouth or tongue hurts, they may have trouble breastfeeding.
If your baby has a tie and you’re having breastfeeding pain or think your baby is having trouble nursing, talk with your healthcare provider and a lactation consultant about other options before going the surgical route.
If your baby’s appearance is your main concern, there’s probably no reason to do a procedure. Again, the frenulum should shrink on its own as your child gets older.
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