If you’re a breastfeeding mother, you might have heard other mothers talking about their babies having a lip or tongue tie. Tongue and lip ties in babies and toddlers are being discussed everywhere – from breastfeeding support groups to online parent forums, and even by social media influencers.
If you and your baby are having trouble breastfeeding, or you’re struggling to get a good latch, you may be wondering whether your own baby has an upper lip tie or tongue tie.
In the early days and weeks of breastfeeding, many mothers experience feeding challenges. 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 experiencing breastfeeding pain, 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 should ask for advice from your child’s paediatrician.
Let’s explore lip ties a little further, and answer many of the questions you are all asking.
What Is an Upper Lip Tie?
An upper lip tie refers to a condition where the frenulum – the band of tissue that connects the upper lip to the gum – is too short or tight. This can restrict the mobility of the upper lip and cause issues with breastfeeding, speech, and tooth or jaw development.
With an upper lip tie, the frenulum attaches too closely to the gum, limiting how far your baby can flare or elevate their upper lip. This can make it difficult for them to latch properly during breastfeeding or bottle feeding. An upper lip tie may also impact dental health and cause issues like tooth decay or misalignment.
How are lip ties diagnosed?
Under the top lip, there’s 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 in babies occurs when this tissue is so short or tight that it affects the functionality of the lip.
During breastfeeding, if there is a 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 – that is, if the tissue happens to be extraordinarily short, thick, and tight – it can affect the upper lip’s movement and result in trouble latching deeply to the breast.
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 the poor latch.
You can read more about tongue tie in BellyBelly’s article What Is Tongue Tie – 8 Facts To Be Aware Of.
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 corrected?
A labial frenulum under the top lip is normal in babies. As babies grow, so does the mouth and the functional tissues inside it. The mere presence of a labial frenulum under your baby’s upper lip does not suggest a correction is needed, if there are no functional problems or breastfeeding concerns.
Even if you are experiencing problems breastfeeding, there’s no evidence to suggest releasing a lip tie will magically fix feeding difficulties, 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; it might be suggested when a lactation consultant has ruled out other methods to help you continue breastfeeding. In this case, the benefits of continuing to breastfeed your baby would outweigh the possible risk of having the surgery done.
It’s important to understand that tongue tie or lip tie treatment isn’t the answer to all feeding problems.
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 and are becoming something of a fad.
This might be due the increased awareness amongst health care providers and parents about the potential impacts that a tongue or lip tie can have on breastfeeding outcomes.
In a small prospective cohort study in 2015, surgical lip tie release resulted in significantly improved breastfeeding outcomes when combined with tongue tie revision. In a Cochrane Systematic Review of five randomized controlled trials, comparing the outcomes of surgically treated ties, all studies were found to be limited by several key factors, including lack of standardized diagnosis and treatment method, consistently small sample sizes and a lack of long-term follow up.
If you’re told lip tie surgery will fix your baby and any breastfeeding problems you have, 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 paediatric 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’.
In the position statement from the Academy of Breastfeeding Medicine on ankyloglossia (tongue tie) in infants, it is stated that ‘the upper labial frenulum is a normal structure with poor evidence for intervention for improving breastfeeding and therefore cannot be recommended’.
What happens if I don’t revise a 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.
What are the risks of revising a 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 haemorrhaging.
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 result in breastfeeding improvement.
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 surgical procedure is the best option for your child.
It’s also important to consult with a paediatric surgeon to discuss any oral surgery. Your regular paediatric 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 releases.
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 whether your level of cover includes oral surgery for your baby.
Will my babies lip tie go away?
A baby’s upper lip tie can sometimes resolves on its own during the first few months of life as the upper lip lengthens and the frenulum loosens. However, if severe enough to cause issues like difficulty breastfeeding, an inability to flange lips, or poor weight gain will typically require treatment.
What happens after lip tie release?
The type of aftercare treatment recommended will depend on where you have the procedure done.
The good news is, a release – a simple procedure to clip the frenulum under the lip – has a high success rate for improving both breastfeeding and bottle feeding. Your baby’s paediatrician, or a lactation consultant can properly assess if the tie is significant enough to warrant clipping, and can perform the procedure if necessary.
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?
Frenulum’s are normal. They give stability to the upper lip, lower lip and tongue in the mouth.
Labial frenulum’s 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 treatment options to solve breastfeeding problems. Many mothers find that baby led attachment helps their baby get a deeper latch.
For more information on this topic, you can read BellyBelly’s article Baby Led Attachment – The Big Benefits And How To Do It.