Lip Tie in Babies and Children
What is a lip tie?
A lip tie occurs when the small piece of tissue connecting the upper lip to the gum (known as the upper labial frenulum) is unusually tight, thick or attached lower down on the gum than usual. This can restrict the movement of the upper lip.
Many babies have a visible upper lip frenulum, and in most cases this is completely normal. A lip tie only becomes a concern if it causes symptoms such as feeding difficulties or problems with oral function.
At our clinic, we carefully assess both the appearance of the lip tie and, more importantly, whether it is affecting your child's feeding, growth or development before recommending any treatment.
What are the symptoms?
Not all lip ties cause symptoms. When they do, babies may experience:
- Difficulty latching during breastfeeding
- Frequent slipping off the breast
- Clicking noises while feeding
- Poor milk transfer
- Long or very frequent feeds
- Excess wind or reflux-like symptoms
- Poor weight gain in some babies
Breastfeeding mothers may also experience:
- Painful feeding
- Damaged or cracked nipples
- Recurrent blocked ducts or mastitis
- Difficulty establishing breastfeeding
In older children, a prominent lip tie may occasionally contribute to oral hygiene difficulties or, less commonly, a gap between the upper front teeth.
When should I seek medical advice?
You should consider an assessment if your baby has ongoing feeding difficulties despite support from a midwife, health visitor or lactation consultant.
It is particularly important to seek advice if your baby:
- Is struggling to gain weight
- Cannot maintain an effective latch
- Frequently becomes distressed during feeds
- Shows signs of dehydration
- Has persistent feeding difficulties despite expert breastfeeding support
Many feeding problems have causes other than a lip tie, so a thorough assessment is essential before deciding on treatment.
How is a lip tie diagnosed?
Diagnosis begins with a detailed discussion about your baby's feeding, growth and symptoms, followed by an examination of the upper lip and frenulum.
Rather than relying solely on how the lip tie looks, we assess how well the upper lip moves and whether the frenulum is genuinely contributing to feeding difficulties. We may also consider whether there is an associated tongue tie (ankyloglossia), as the two conditions can occur together.
In many cases, a multidisciplinary approach involving a lactation consultant or infant feeding specialist provides the best outcomes.
What treatment is available?
Many lip ties do not require any treatment and can simply be monitored.
If the lip tie is causing significant feeding difficulties and other causes have been excluded, a lip tie release (frenotomy or frenectomy) may be recommended.
The procedure is usually very quick. In young babies, it can often be performed in the outpatient setting without a general anaesthetic. Older children may require treatment under local or general anaesthetic depending on their age and individual circumstances.
Following the procedure, ongoing feeding support is often recommended to help babies adapt and establish effective feeding.
Recovery
Recovery after a lip tie release is usually rapid. Most babies are able to feed shortly after the procedure and often return to their normal feeding pattern on the same day.
Some babies may be unsettled for a short period, while mild discomfort or a small amount of bleeding is normal immediately after treatment.
Your clinician will explain any aftercare instructions and arrange follow-up if required to monitor feeding and healing.