If you’re a breastfeeding mother, you might have heard other mothers talking about their babies having a lip or tongue tie. Tongue and upper lip tie in babies and toddlers is being discussed everywhere from breastfeeding support groups to online parent forums.
If you and your baby have been experiencing your own feeding challenges, it’s possible you’ve even wondered whether your own baby has a lip or tongue tie.
In the early days and weeks of breastfeeding, many mothers experience trouble breastfeeding. Before self diagnosing tongue and lip ties, it’s important to seek help from a lactation consultant. A lactation consultant can help if you are having trouble latching your baby to your breast, or show you ways to encourage your baby to get a deeper latch.
If you are concerned about lip ties or tongue ties in toddlers or older children, you can ask for advice from your child’s pediatrician.
Let’s explore ‘upper lip tie’ a little further, and answer many of the questions you are all asking.
What is an upper lip tie?
Under the top lip, there is a piece of tissue that connects the top lip to the gum.
It’s called the maxillary labial frenum.
It is normal to have this piece of tissue attaching the top lip to the gums. It’s not the presence of this tissue under a baby’s upper lip that constitutes a lip tie. A lip tie occurs when this tissue is so short or tight that it affects the functionality of the lip. In the case of breastfeeding, if there is restriction of movement in any structure of the mouth it can be challenging for a baby to get a proper seal on the breast.
If there is a severe lip tie – i.e. if the tissue happens to be extraordinarily short, thick, and tight – it can affect the upper lip’s movement and result in a poor latch. It’s interesting to note that a tongue tie is often present when there’s a lip tie, so it might be the restricted movement of the tongue that is causing any feeding difficulties.
You can read more about tongue tie in BellyBelly’s article Tongue Tie – 9 Facts You Need To Know.
It’s widely accepted that anything that affects your baby’s ability to get a good seal while breastfeeding can potentially affect your breast milk supply and that’s why a lip tie revision is sometimes suggested.
Does an upper lip tie need to be fixed?
A labial frenulum under the top lip is normal in babies. It isn’t considered a tie if there are no functional problems or breastfeeding concerns.
There’s no evidence to suggest releasing a lip tie will magically fix problems with breastfeeding or bottle-feeding, nipple pain, or poor weight gain in babies.
A decision about oral surgery for a baby or toddler isn’t one to make lightly.
Parents should do some research and find the right support to help them manage whatever difficulty is making them consider this procedure for their baby.
For breastfeeding problems, lip tie surgery is a last resort, suggested when a lactation consultant has ruled out other methods.
In this case, the benefits of continuing to breastfeed your baby would outweigh the possible risk of having the surgery done.
Are tongue ties and lip ties a fad?
It might seem as though tongue ties and lip ties are being increasingly blamed for almost every sort of breastfeeding or parenting worry.
Baby isn’t gaining weight?
Baby has reflux, or takes forever to finish a bottle?
Baby is making a clicking sound while breastfeeding?
Solution: check for ties.
Tongue-tie and lip tie treatment isn’t the answer to all feeding problems.
If you’re told lip tie surgery will fix your baby and any breastfeeding problems, it’s very important you first seek the guidance and advice of an IBCLC (International Board Certified Lactation Consultant).
Lactation consultants are breastfeeding experts and can help you work with your baby to figure out what the problems are and how to solve them.
Do your research, and find an experienced provider such as a pediatric ear, nose, and throat specialist (ENT). You can also work with your IBCLC for a thorough assessment of the full clinical picture.
What evidence supports surgical treatment of lip ties?
Health professionals vary in their opinions about detecting and treating tongue and lip ties.
To date, research hasn’t shown whether or not an upper lip tie has any effect on breastfeeding.
The Australian Collaboration for Infant Oral Research (ACIOR)has released a position statement on upper lip tie, buccal ties, and the role of frenotomy in infants. No intervention is recommended. The ACIOR states: ‘Maxillary labial and buccal frena are normal anatomic variants and do not ‘tie down’ the upper lip to impact on breastfeeding or feeding function’.
What are the risks of revising an upper lip tie?
Parents are often warned that not getting a diagnosis and having treatment for lip tie can have dire consequences, such as:
- Speech problems
- Problems swallowing
- Sleep disorders
- Increased risk of dental decay
- Other developmental difficulties in the future.
All these potential concerns are about the future; they do not address the immediate reasons relating to the lip tie.
In many cases, revision on babies with tongue and lip tie is a simple procedure. Surgery of any type, however, comes with risks.
The mouth has an extensive blood supply. Cutting or lasering procedures can cause blood loss and possible hemorrhaging.
Any open wound is vulnerable to bacteria entering, which creates a risk of infection.
Finally, the lip tie might not have been the problem and revision will not fix whatever was causing difficulties.
Which healthcare professional can fix a lip tie?
If you’re considering oral surgery for your baby or toddler, first seek the support of an IBCLC and ENT specialist, to assess whether or not a revision is the best option for your child.
It’s also important to consult with a pediatric surgeon to discuss any oral surgery. Your regular pediatric dentist might not have the training or experience to work with your baby.
Some GPs are also known to perform tongue tie and lip tie release.
The health professional you’re considering should have experience with newborn and older babies, toddlers, and older children.
The most important thing is to do your research and be as informed as possible before making your decision.
How much does lip tie surgery cost?
The range of costs for oral surgery is very broad and depends on each specialized practice.
Generally, the cost of surgery ranges from AUD$110-$1000. It can also depend on the type of treatment. Laser treatment tends to be much more costly than using scissors or a scalpel.
Some places might offer Medicare rebates. If you have private health insurance you can contact the provider to find out if your level of cover includes oral surgery for your baby.
What happens after lip tie release?
The type of aftercare treatment recommended will depend on where you have the procedure done.
Often, therapy techniques, such as stretches, are suggested to make sure the piece of released tissue doesn’t re-attach after the surgery.
Can babies successfully breastfeed with a lip tie?
Frenulums are normal. They give stability to the upper lip, lower lip, and tongue in the mouth.
Labial frenulums are normal. Many breastfed babies nurse successfully with varying degrees of lip tissue to gum line insertions.
Breastfeeding difficulties are caused by many things.
When a breastfeeding baby is well attached, it’s hard to see the top lip, let alone the bottom lip, which is usually buried in the underside of the breast. If the top lip tissue is causing a functional problem, it can be considered a lip tie.
Breastfeeding latch depends a lot on the individual anatomies of both mother and baby.
There are other treatments to solve breastfeeding problems. A lactation consultant can help with adjusting position and attachment.