Lip Tie: How to Check Your Baby (And How to Fix it)

Though it can affect breastfeeding, most conventional doctor’s can’t recognize a lip tie. Here’s how to identify a lip tie and fix this common issue.

A lip tie may be to blame for your baby's trouble breastfeeding or fussiness from eating. And most conventional doctor's can't recognize one. Read on to see if your little one may be a lip tied baby and everything you need to know to fix this increasingly common issue.

Those first few moments after birth, when baby is placed on your chest and instinctively goes to latch, are nothing short of magical. But if you’re hoping to breastfeed right away (that colostrum has major benefits for baby!), a lip tie can cause a frustrating breastfeeding experience for both baby and mom.

If you’re struggling, read on to see if your little one may have a lip tie and learn everything you need to know about fixing this increasingly common issue.

What Is a Lip Tie?

A lip tie is when the piece of muscleless tissue connecting the upper lip to the upper gum restricts the mouth’s mobility, because it’s too thick, too tight, or both. (source)

Newborn baby with lip tie – Mama Natural

Photo of Mama Natural’s daughter Paloma with a lip tie at 11 days old.

What Causes a Lip Tie?

Though there isn’t concrete data to explain why a lip tie happens, multiple studies suggest that a similar condition, tongue tie, is hereditary. In fact, Autumn Read Henning, a speech language pathologist, estimates that approximately 70 percent of her own patients with a tongue tie have a known relative with the condition, too.

There is also emerging evidence that the MTHFR gene plays a role in the formation of the mouth, including the lips. This study reported that those with certain MTHFR mutations have a sevenfold risk of developing a cleft palate.

It’s important to note there is still much to be learned about MTHFR mutations, but researchers do believe this specific genetic mutation is more common in Caucasian and Asian populations. It appears to be slightly rarer in Amerindian populations, and significantly lower in Black populations.

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How Common Are Lip Ties?

Dr. Ghaheri, an ENT at the Oregon Clinic, says a lip tie is much less common than a tongue tie, a condition where a short, tight piece of tissue below the tongue restricts its range of motion.

A tongue tie is also more likely to affect breastfeeding, because the tongue is unable to move up. That said, a lip-tied baby can have trouble breastfeeding, because it’s harder to flange the upper lip. 

If Your Baby Has a Lip Tie Does That Mean He/She Has a Tongue Tie?

If baby has a lip tie, it does not mean he/she has a tongue tie. In the womb, the area under the tongue and the area between the upper lip and the gum line develop at different times and by different processes, according to Breastfeeding Today.

The belief that most babies have both a lip tie and a tongue tie probably stems from a reflex that links the tongue and the lip, making it difficult for a baby to move one independent of the other. The two conditions should be evaluated separately—once a lip tie is treated, any problems with the tongue will likely correct itself (and vice versa).

How to Tell If Your Baby Has a Lip Tie?

If your baby hasn’t been evaluated for a lip tie, talk to a healthcare provider if you notice the following signs of a lip tie:

If baby has a lip tie, they may

  • Be unable to latch deeply, if at all, causing nipple pain and damage
  • Have difficulties staying on the breast
  • Make a clicking sound
  • Splutter or choke on milk
  • Cluster feed
  • Exhibit poor weight gain
  • Be at risk for bottle rot
  • Develop jaundice
  • Be excessively fussy or develop colic

If baby has a lip tie, mama may

  • Experience pain during feedings
  • Have damaged or distorted nipples (often they’ll notice a wedge shape)
  • Develop engorgement, blocked, ducts, or mastitis
  • Have milk supply issues (low supply due to ineffective removal; oversupply due to a demanding nursing schedule)

What Does a Lip Tie Look Like?

There are four different classifications of lip ties and each class looks slightly different, based on severity:

  • 1: No significant attachment
  • 2: Attachment mostly into the gum tissue
  • 3: Attachment where the future upper front teeth will be
  • 4: Attachment that extends to the palate of the mouth
Classes of Lip Tie Baby Chart by Mama Natural

Image by Dr. Lawrence Kotlow, DDS

How to Get Baby’s Lip Tie Diagnosed?

To confirm whether your baby has a lip tie, get a consult with:

  1. An International Board Certified Lactation Consultant who will have specific training in diagnosing lip and tongue ties. Here’s how to find one near you.
  2. A Holistic Dentist who has experience with diagnosing and treating lip ties. You can find one here.

Of course, you can have your child’s pediatrician look at your child’s mouth, but be aware that some doctors are not trained at diagnosing a lip tie (or its severity) in babies.

Does a Lip Tie Affect Breastfeeding?

A lip tie can affect breastfeeding. It really depends on the severity of the lip tie, as well as the child and mother dynamic. (If you think about it, there are countless things that could impact nursing: nipple shape, child’s palate formation, alertness of child, etc.)

Depending on the severity of the lip tie, breastfeeding a baby with this condition can be a painful and frustrating experience for mama and baby—so be sure to seek help if you suspect a lip tie. 

To improve the breastfeeding experience:

  • Find an IBCLC lactation consultant
  • Soften breasts: Engorgement may make it especially difficult for baby to latch. If your breasts are too full, hand express or pump a bit of milk before continuing to feed baby.
  • Try another breastfeeding position: Baby can generally get a better latch when skin-to-skin with mom. Laid-back nursing is particularly helpful with a lip tie.

Can a Lip Tie Cause Speech Problems?

A lip tie generally does not cause speech problems later in life. It is rare, but Dr. Ghaheri says:

“In some severe cases if the lip tie is causing the child some discomfort with mouth opening, because of tension, they may alter their oral anatomy to minimize pain, which could impact speech.”

If you suspect a lip tie is affecting your child’s speech development, talk to your doctor. He/she may recommend your child see a speech language pathologist, or a speech therapist.

Can a Lip Tie Cause Tooth Decay?

In breastfed babies, an uncorrected lip tie can cause significant tooth decay, particularly in a baby’s upper front teeth.

According to Dr. Lawrence Kotlow, a lip tie prevents any residual milk from draining from the area between the upper lip and the gum, eventually causing bottle rot.

To prevent tooth decay, Dr. Kotlow recommends parents pay extra attention to oral hygiene once the upper front teeth erupt, making sure there’s no residual milk in the baby’s mouth after feedings.

If your child shows signs of enamel wear—white spots or discoloration—visit a dentist to determine a plan of action for better oral hygiene and whether any corrective care is needed. You can find a holistic dentist here.

Can a Lip Tie Cause a Gap in Teeth?

According to Dr. Ghaheri, a lip tie can cause a gap in between the two front teeth. 

  • If the lip tie is so severe that there’s notching at the gum line, a lip tie revision may be necessary to prevent gapped teeth.
  • If the lip tie is less severe, the gap may be temporary, closing as other teeth come in and shift the teeth. In this case, if there are no issues with breastfeeding, he recommends holding off on a lip tie revision until all teeth come in.

Dr. Ghaheri says it’s important to note that dental spacing is complex—a lip tie revision does not guarantee that there won’t be a gap between the front teeth (or that an existing gap will close).

Lip Tie Surgery

  • If baby has a lip tie, but breastfeeding is not affected (no difficulties for baby and no pain for mama), doctors say no lip tie reversal is needed. 
  • If a lip tie is interfering with breastfeeding, it may be wise to consider a revision, no matter what class of lip tie a baby has. (source)

If you decide to go ahead with a lip tie reversal, you’ll need to find a holistic dentist who specializes in these lip tie procedures. Find a holistic dentist near you here. Or, ask your child’s pediatrician for a referral.

Baby Faith before and after lip tie surgery frenectomy Mama Natural

Mama Natural’s third child, Faith, before and immediately after a “frenectomy” at 13 weeks of age.

What Happens During a Lip Tie Reversal (Frenectomy)?

New technology has made the treatment less painful and more accurate. In the past, a lip tie was snipped with scissors; now, most healthcare professionals use a laser treatment that reduces the chance of excessive bleeding and is less traumatic for baby.

Surprisingly, the entire process takes just a few minutes.

  1. The mom lays on the dentist chair holding her child during procedure
  2. The dentist applies a topical numbing agent (EMLA is safest for infants, though proceed with cautionto the area (general anesthesia should be avoided)  
  3. About 30 seconds later, the dentist uses a small handheld laser to precisely “cut” the lip tie. For those who don’t know, laser—or a strong-beamed light—can cut tissue quickly and relatively painlessly
  4. The baby is now free to nurse or be comforted by mom
  5. The dentist will then review post-op instructions such as pain relief measures and post-procedure exercises (very important!)
woman holds baby during lip tie surgery frenectomy

Mama Natural holds baby Faith during her lip tie reversal or “frenectomy.” It’s not a pleasant process, but it’s over in a minute.

How to Help Baby Heal Naturally Post-Procedure

Healing time is generally only a few days—the mouth heals quickly!

Some babies will seem largely unfazed by the procedure; others may display signs of discomfort and need a little extra care. Either way, it’s a good idea to use this time to give your baby a little extra love and attention.

Here are some ideas to help manage baby’s pain after lip tie surgery:

  • Do skin-to-skin immediately following the procedure.
  • Breastfeed immediately before and after the lip tie reversal. This is usually all babies need for comfort and pain relief.
  • With doctor’s approval, you can use Arnica Montana before and after procedure for pain relief. (where to buy)
  • Ice the area to reduce inflammation and pain.
  • Gently rub organic coconut oil on the area.
  • Have baby wear an amber teething necklace to promote a healthy inflammatory response.
  • In cases of extreme discomfort, infant Tylenol or ibuprofen may be necessary. Talk to your child’s dentist/doctor if you think baby needs additional pain relief.

The Importance of Oral Exercises Post-Procedure

The mouth heals so quickly that it may prematurely reattach at either the tongue site or the lip site, causing a new limitation in mobility and the persistence or return of symptoms, says Dr. Ghaheri.

To prevent this, proper aftercare is crucial. Your doctor/dentist will have a series of lip exercises to keep the tissue from reattaching and promote blood flow/healing.

Upper Lip Stretch

  • Wash hands thoroughly
  • Lay baby in your lap, with his/her feet away from you.
  • Apply coconut oil to your finger, then place your finger under baby’s lip. Move it as high as it will go, then gently sweep from side to side for 1 to 2 seconds.

When to Call Your Doctor

When done correctly, complications with a lip tie reversal are rare. You may notice some minor bleeding for a few days post-procedure and baby may be fussier than usual.

Call your doctor if:

  • Baby is extremely upset and normal pain relief methods (arnica, breastfeeding, skin-to-skin, etc.) don’t help.
  • There are signs of infection, like fever, swelling around the revised area, excessive sleepiness, or restlessness.
  • Excessive bleeding

 

My Daughter Had a Lip Tie. Here’s What Happened.

My daughter, Paloma, had a shallow latch from day one. Unfortunately, I didn’t notice this until my nipple turned black and blue ?. (BTW, the hospital lactation consultant didn’t check my baby for any tongue or lip tie post-birth. IMHO, this should be mandatory!)

Something wasn’t right…

About four days later, when we were back home recovering, I started experiencing tremendous pain with each feeding and noticed my discolored nipples. I created a DIY nipple cream that did help take away some of the pain, but I knew that something was wrong with her latch.

…So I called a lactation consultant

I called an IBCLC lactation consultant who diagnosed Paloma with a Class 3 lip tie. (Thankfully, she didn’t have a tongue tie!) Interesting to note: my father and his siblings all had lip ties, which the midwife “treated” by snipping with scissors after birth. ?

We decided to treat the lip tie

I found a local holistic dentist who used laser to treat lip ties. We made an appointment right away and Paloma had the procedure a few days later. She did cry momentarily during the actual laser treatment and for a few moments afterward (see picture below ?), but I sensed that it was more about some strange man holding up her lip versus any pain. She nursed immediately after the procedure and never showed signs of discomfort after that. I didn’t use any pain relievers—just extra cuddles and nursing.

Here’s what happened…

Did our nursing relationship magically change overnight? NO. A breastfeeding latch is a form of muscle memory and Paloma had to re-learn how to nurse. The good news: It only took a few days of practice and we were good to go. (And my nipples returned to their regular flesh color. ?)

Overall, the lip tie procedure was simple, easy, and effective. Definitely worth it!

Newborn baby with lip tie correction surgery – Mama Natural

Photo of Mama Natural’s daughter Paloma immediately after her lip tie laser treatment. She calmed down quickly and didn’t seem to be in pain.

How About You?

Did or does your baby have a lip tie? What issues does/did it cause? Did you opt for a lip tie reversal? Share your experiences with us!

Genevieve Howland

About the Author

Genevieve Howland is a childbirth educator and breastfeeding advocate. She is the bestselling author of The Mama Natural Week-by-Week Guide to Pregnancy and Childbirth and creator of the Mama Natural Birth Course. A mother of three, graduate of the University of Colorado, and YouTuber with over 85,000,000 views, she helps mothers and moms-to-be lead healthier and more natural lives.

18 Comments

  1. Just to express an alternate opinion from a pediatric surgeon. She said surgery with stitches was more likely the less painful option than laser and didn’t require all the post-op “exercises”. She expressed how with laser you are burning the skin, which then re-heals to an extent and the “exercises” are us re-tearing it away each time to keep it from going back. Thus, more painful experience for child in long-term. As stitches are one time cut and then leave alone to heal. She went over all the options and pro’s and con’s, was very well informed and left it up to me. Just wanted to share another perspective.

    • The exercises are to prevent the tissue from relying. They have to be stretched in order to elongate and retain a functional length. I am a nurse. Peace.

  2. Hello Momma Bears

    I have a 19 month old son who underwent the surgery just two months ago . I went a full year and half in the dark not knowing he was a lip tied baby. In fact he had a case that I was told “ doesn’t get much worse then this” as per our doctor . I feel horrible that we never picked up on this . BFing was not the same as my first but I wouldn’t call it hard or difficult. If only I knew then perhaps I would of been more attentive to some of his needs 🙁
    Not so much functional but mechanically my boy is struggling. I can see that after two months post surgery he is still favoring his mouth to not move . He won’t smile with teeth … still scrunching his nose when he laughs and is not using his words . I have started the process for early intervention as I need to get to the bottom of this 🙁 . 10 months old we had 7 words . As my boys teeth grew in the more words he lost . I think he needs PT.
    PS I was told by my dentist to hold off and to allow nature to run its course ( … that the baby will fall and naturally detach) . Our Dr said to not allow that to happen as it would turn into an urgent situation and the bleeding would be bad .

    I hope you all follow your guts and mommas intuition 🙂

  3. I knew before my daughter was born that she may have an upper lip tie because I had one. Mine required a frenectomy when I was 14 years old to correct the gap in my teeth, so I didn’t want the same issue for my daughter. However, once my pediatrician diagnosed her with a lip tie at 4 days old, the only instruction I was given is that it doesn’t need to be corrected unless she isn’t gaining weight. I struggled with painful breastfeeding for about 4 weeks, but the lactation consultants seemed reluctant to encourage me to have the correction and the pediatrician insisted that the correction wasn’t necessary. There is very little peer-reviewed research done on the benefits/consequences of lip tie correction, so I was left largely with anecdotal evidence, which is difficult for me to trust. My daughter is now 5 months old, and I finally decided to schedule the surgery because I believe it will be best for us. I wish I had trusted myself and done it right away. Mamas, you know your babies. Listen to your healthcare providers, but trust your instincts on this. If it’s right for you, do it. If it’s not right, don’t. Whatever you do, though, decide for yourself because the confidence you will build is worth it!

    • Thank you for this!

  4. hello 🙂 my daughter just turned 2 and ive noticed her lip tie is worse than we originally thought. its Level IV. it never affected breastfeeding, thankfully, or anything else, but i dont want it to affect her teeth or anything in the future. our pediatrician said at her 18 month checkup that it will likely bust on its own if she falls and hits her face. they also said that without looking at it and never saw what level it was until i did some digging online. not sure if i should find a different ped, see if a local dentist will do it, consult with ent at childrens. what… not sure of my next steps. thoughts? comments? thanks!!

    • For anyone reading this our daughter did tear hers naturally by hitting her face at 11 months in a tumble. It bled excessively and was a traumatic experience for the whole family. We never really had latch issues with breastfeeding so opted not to do surgery because it was a mid-grade lip tie. We had to have two ER visits for the bleeding to finally stop. If I knew this was a risk I would have got the surgery. So if you get advice for it to correct itself naturally this is what may happen and it was terrible for all involved.

  5. My toddler is 19months and I never knew she had a class 4 lip tie her 18 month check up! We struggled with breastfeeding A LOT! With pinched and bleeding nipples I never thought to check and none of the lactation consultants checked either. Strange right?! But I am one persevering mamma and just tried every nursing position possible. In the end she latched best in the football hold and we are still breastfeeding 19months later. The issue we have now is that her teeth are separated and have decided to fix it ASAP, even if chances are her teeth won’t move i to correct position. We found a great Dentist who does laser with sedation. I’m not so keen on the sedation part but feel its better than GA. Praying it will go well as we have her tie fixed this week. Thanks again for the cool post and advice on post procedure management!

  6. Hiii really love u channel! God bless u..I am from Lebankn the middle east

    After watching ur videos.. I discovered my baby has an upper lip tie.. doctor is clueless hehe..ddnt treat it coz I worked hard to work on latch..now baby is 6 weeks but still got pain while bf..I’m thinking if it is worth it to do the surgery? Or shall I just handle it.. did u feel any pain with faith? Coz I remember u said she had it too but ddnt affect her bf?!
    Sorry typos..typing while bf hehe

  7. I SO agree that lactation consultants, OBs, and pediatricians need to know this. Eventually, I figured it out with a little help from the internet and helpful articles like this one. I highly recommend nipple shields (to protect yourself) and pacifiers (practice sucking can stretch the tissue over time). After about 3 months, latch improved significantly without surgery.

  8. Hi Genevieve,
    My son was born with both lip and tongue ties and it was extremely painful for me to breastfeed though it wasn’t an issue for him (he was gaining weight and all). At first I thought that maybe it takes me a while to get used to breastfeeding and waited some time and it did not get better at all. Finally, when he was about 2 months old, we decided to get him checked at the pediatric dentist and it was confirmed he had both. We got it done the same day, did all the stretching exercises but it didn’t really help with the pain. It became less painful eventually but wasn’t completely painless as he got older (maybe at about 5-6 months). I don’t know if he was too old to re-learn to latch correctly or needed some bodywork which we decided not to do to a baby. When I got pregnant with our second, I was told that most likely this baby will be lip/tongue tied or both as well. I prepared for this. Again, painful breastfeeding for me and she was swallowing air and was uncomfortable later but gaining weight just fine. Sure enough she had both and also cheek ties. We got it done today, she is 2 weeks. Wanted to ask you, did you do bodywork with either of your daughters or they just got adjusted and re-learned to latch correctly on their own? From your experience how soon should I expect to feel improvement and less pain and see if additional work is needed?

  9. My son was born with a lip tie and I checked with my midwife at our 6-week postpartum check up. She told me we didn’t need to treat it if there was no pain during breastfeeding. My son gains weight normally (he’s quite chunky!) and other than some cluster feeding and occasional spluttering and gas, our breastfeeding relationship is great! For us, it’s something to just be aware of for now. I know it could’ve been a lot worse, but I’m so thankful for a smooth breastfeeding journey so far.

  10. Excellent article! Thank you for compiling this information in such a thorough, organized way. I feel much more prepared to have an educated conversation with my healthcare providers after reading this.

  11. My 2nd son had a lip tie that I never actually noticed until his teeth started coming in. He has the class 3 lip tie but we never had any nursing issues so the doctor said we don’t have to correct it. He does have a little gap between his front teeth because of it though.

    My 3rd son who is 9 days old currently also has the same class 3 lip tie. Though I don’t have any nipple soreness, he has a poor latch and makes a lot of slurping noises while nurses, he also “chokes” when my milk lets down. I’ve noticed that he’s a “messy” eater so there ends up being breast milk running out of his mouth as he is nursing. He’s also a very sleepy baby, I’m concerned that all the extra effort he puts into nursing has him exhausted. His urine and stool output is good though and he weighs more than his birth weight.

    Thank you for this article, I will bring this up with our pediatrician. Hopefully we can have this corrected.

    • There is any problem with speech
      My daughter have and am afraid if it cause speech problems?

  12. My daughter has a class IV lip tie, which caused a notch in her gum. However, I never had any pain with breastfeeding and my daughter didn’t have any issues latching. My pediatrician and midwife said there was no need to correct it if there were no issues. It’s important to note that not all lip ties require surgery.

    • For sure! Just like we say in the post: “If baby has a lip tie, but breastfeeding is not affected (no difficulties for baby and no pain for mama), doctors say no lip tie reversal is needed.” Glad you’re doing well and best wishes to you!

    • Hi Kimberly,
      I believe my son has the same class IV with a cleft gum, or notch in the center. Won’t the notch cause major dental issues? have you come across any information on this from your Dr?

      Thanks.


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