Could lip tie be the cause of your baby’s discomfort?

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LIP TIE - what lip tie baby means and whether they need a frenulotomy

There is now much more awareness of tongue tie in babies, and the difficulties it can cause when breastfeeding. 

Lip tie, however, is not often talked about and is often surrounded in confusion and conflicting accounts.

What is lip tie?

If you look or feel inside your mouth you will see a little bit of skin that joins your top lip to your gums. This is your lip tie (its scientific word is the labial frenulum). 

Everyone has one and it is perfectly normal. Babies have gummy mouths and so it can be hard to know what to look for and what’s normal.

If the lip tie is too tight and the frenulum is too short and thick, then it can limit the movement of the lip. This can possibly cause problems with feeding and, later with speech. 

Some babies will have prominent frenulum on their lips and have no problems. 

It’s hard to diagnose a problematic lip tie just by looking at your baby’s mouth. Their lip frenulum can change a lot and recede as they grow and you may not notice any issues with breast, bottle or solid feeding whatsoever.

On the other hand, you may have difficulties with breast or bottle feeding and/or notice your baby is colicky and windy. You might also notice that your baby has a large flap of skin joining their lip to their gums.

In this case, could a lip tie be why they are having problems feeding?

There is very little research done so far into the condition and how much it affects babies feeding or speech or dental problems as they grow up. 

We lay out the research done so far along with personal accounts from mothers who believe their babies suffered from lip tie.

How do I know if my baby has a lip tie?

Here are some of the signs and symptoms associated with lip tie in babies:

  1. Difficulty feeding. As there is no research or evidence that lip tie can affect feeding, it is hard to be confident that problems are down to a lip tie, specifically. If your baby has trouble feeding it is worth checking if a lip tie could be affecting them.  
  2. Shallow latch. A lip tie can make it difficult for baby to flange their upper lip or open their mouths widely. This can result in a shallow or poor latch.
  3. Pain breastfeeding. As the baby cannot open its mouth widely enough to create a good latch, it can result in tension. This can result in baby trying to suck strongly to get milk, which can lead to pain when breastfeeding. 
  4. Clicking sound. You may notice a clicking sound as they drink or they may cough, choke or gulp. They might also chew or bite your nipple. 
  5. Fussy at feeding times. Your baby might be fussy with either breast or bottle feeds and suffer from gas, reflux or colic. 
  6. Lip blister. Baby might also have a lip blister that doesn’t go away. 

It’s worth noting that many of these symptoms of a possible lip tie are also symptoms of tongue tie in babies. Not every baby with lip tie also has tongue tie but there is always a chance they could have both. You can find out more about tongue tie with our article How to know if your baby needs a tongue tie release.

It’s worth getting both tongue and lip tie checked out by your midwife, health visitor or GP if you are having problems breast or bottle feeding. If in doubt, always talk to a health specialist to get advice.

Some breastfeeding issues might happen if your baby is not latched on correctly and may have nothing at all to do with either a tongue tie or lip tie.

A midwife, lactation specialist or health visitor can give you advice and support to reposition your baby while feeding and encourage your baby to get a better latch. So even if they don’t have a tongue or lip tie, by seeing someone you can get advice and practical support to make breastfeeding easier. 

If you’re finding breastfeeding hard then don’t suffer alone and always get help early one to make both yours and your baby’s life happier and easier.

Lip tie - what lip tie baby means and whether they need a frenulotomy

Does lip tie really affect breastfeeding?

Currently there is no conclusive evidence that a lip tie can affect breastfeeding but anecdotally many mums believe that there is a connection. 

One mum said:

My daughter had a pretty significant lip tie that her doctors didn’t seem concerned with. We had lots nursing problems from the start, she had terrible reflux as an infant, and she couldn’t even latch until she was 12+ weeks old.

Other mums report that their children have lip ties, which don’t affect their feeding or speech in any way:

Both of mine have (lip) ties…My 14 month old obviously I’m not sure if it will affect her speech etc but my eldest has incredible speech, absolutely no issues at all and I bf her until she was 21 months.

Can lip tie cause problems with latching during breastfeeding?

Breastfeeding literature in the past often talked about how both the upper and lower lips need to flange (turn outwards) to latch onto the nipple during breastfeeding. 

The ideal latch was thought to be when both the upper and lower lips turned out, like fish lips. If a baby has a lip tie then they will find it harder to turn out their upper lip when breastfeeding.

Now, however, ideas about the position of the upper lip in breastfeeding have changed. For a good latch the lower lip should flange but the upper lip can rest in a neutral or very slightly outward-turning position. 

The role of your baby’s top lip is to rest on your breast and make a seal. 

So for a good breastfeeding latch the lower lip turns outwards and flanges, but the top tip can be fairly straight. If this is the case then a lip tie wouldn’t affect your baby’s latch so much.

Lactation expert Cathy Watson-Genna also advises that a very tight lip frenulum (lip tie) could produce a sucking blister on the underside of the upper lip which might make it more difficult for a baby to stay attached.

What could make feeding easier if my baby has a lip tie?

Many mums share advice on parenting forums and social media about what made feeding their lip tied babies easier. Here’s what they suggest:

A baby with a lip tie may have an easier time drinking from a bottle. If you’re breastfeeding then expressing milk might give you some relief until you get further advice or help. Some mums say that their babies found bottles with narrow teats easier. 

Healthline offers this advice:

To breastfeed a baby with a lip tie, you may have to be a little strategic. Try softening your breast with your baby’s saliva before attempting to latch, and practice proper latching technique so that your baby can connect more fully to your breast. 

A lactation consultant may be able to help you brainstorm more ways to make nursing more comfortable and efficient for you and your baby.

Lip tie - what lip tie baby means and whether they need a frenulotomy

Can a lip tie cause colic?

One thing that mothers talk about a lot on parenting forums, is that they feel a lip tie can affect their babies seal around a nipple or teat. They feel that their baby may take in more air when they feed because of this. 

This, mums swear, can lead to wind or colic. 

La Leche believes that a poor breastfeeding latch can cause colic, saying:

Colic-type symptoms can appear if a baby is having problems latching onto the breast. A shallow latch can lead to babies taking in a lot of air which then causes discomfort.

A tongue tied or lip tied baby might have a poor latch and this could mean that they are more prone to gas or colic. 

If your baby struggles to either breast or bottle feed and seems to be very gassy or colicky it’s worth asking your midwife or GP about tongue or lip tie, even if it’s just to eliminate this from the equation.

What’s the position in the UK, regarding lip ties and their treatment?

In the UK lip ties are not regularly checked, diagnosed or treated after birth. 

Some dentists carry out frenectomies but, more often on older children, when a severe lip tie might affect either speech or dental care. 

There is no conclusive evidence to suggest that lip ties ties cause problems with either feeding or speech. 

The ATP (Association of Tongue-tie Practtioners) released this statement about lip tie:

The National Institute for Health and Care Excellence (NICE) have not issued any guidance on this issue and therefore training is not available in the UK in lip tie division for practitioners. 

This situation may change in the future if new research and evidence influences best practice guidelines. Currently nurse/midwife tongue-tie practitioners working in the UK cannot offer lip tie division.

…On the rare occasions that lip ties are divided by surgeons in the NHS it is usually done in relation to concerns about dental issues, not breastfeeding. If you have concerns about lip ties we suggest you discuss this with your dentist.

What can I do if I think my baby has a lip tie?

If you think your baby has a tip tie and it is affecting their feeding and later, their speech then seek advice from your doctor. If you are still concerned then you might think about seeing a specialist privately, who may be able to carry out treatment. 

Always get advice and support for any issues with breast or bottle feeding and try different methods, like as the ideas we outlined above.

Seek support online. There is a Facebook group called the Lip Tie Support Group set up by a UK mum, whose baby had a lip tie. Here parents can share their experiences and get further advice and information on how and where to get treatment.