Lip Tie

By Krista Gray, IBCLC. Last updated March 5, 2013.

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What is lip tie?

Lip tie before the procedure.

Lip tie before the procedure.

A labial frenulum, or lip tie, is found when the thin membrane attaching from the top gumline to the upper lip, is tight.  Though breastfeeding problems are much more commonly caused from tongue tie, severe cases of lip tie can interfere with a baby’s ability to maintain a latch at the breast and make breastfeeding difficult.

Symptoms

A very tight lip tie can keep a baby from maintaining a latch while nursing.  If you notice the labial frenulum attached to the bottom of the gum line, as well as have problems with him maintaining latch even while trying various positions, lip tie may be the cause.

Does lip tie affect anything in addition to breastfeeding?

Though some cases will need revision for breastfeeding concerns, a tight labial frenulum can be more of a concern because it can cause a gap between a child’s two front teeth or the rotting of the front teeth.

Treatment

Same baby following laser release of lip tie.

Same baby following laser release of lip tie.

Increasing a baby’s head extension will usually allow a baby to grasp the breast sufficiently for breastfeeding.

As with tongue tie, a frenotomy can also be performed on lip ties.  By clipping the labial frenulum, the lip will immediately have more movement range, allowing the breastfeeding issues to be improved if not resolved.  However, unlike with tongue tie, lip tie revisions with scissors are subject to bleeding and most surgeons require a baby be put to sleep for the procedure.  Therefore, a preferred method by parents is usually to revise a lip tie with laser.  In this case, the procedure is quick and easy, with little to no bleeding.  Babies do not need anesthesia for the procedure and many times don’t feel a thing.  Typically being swaddled and held is much more alarming than the procedure itself.

Having a session of cranio-sacral therapy along with the lip tie revision can maximize results – the gentle manipulation of the head, neck, and back can help relax tension and thereby restrictions that were caused by a tight labial frenulum.

When should it be corrected?

If there are breastfeeding issues and your baby is diagnosed with lip tie, the sooner you have it revised the better.  It is safe to do the procedure on a newborn and, the sooner it is performed, the less relearning the baby has to do at the breast.  Even if the baby is a few months old (or older) when a frenotomy is performed, improvement should immediately be seen.

Post-Procedure

After a frenotomy, it is good to work with your baby to help her learn (or relearn) how to breastfeed properly.  This may include shaping the breast and holding the teat in the baby’s mouth for the duration of the breastfeed for the first few days to two weeks (depending on how much relearning the baby needs).  Be proactive to ensure good positioning and latch so she will learn to latch correctly.  It is also a good idea to perform some simple exercises on your baby for the first two weeks.  With clean fingers, gently sweep across the revision area.  Then place gentle pressure on either side of the revision lifting the top lip so scar tissue does not form.  Do these several times a day for two weeks.

You can read here about my experience breastfeeding a child with lip tie.

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