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

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.

Read on to see if your little one may be a lip-tie baby and everything you need to know to fix 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 class 3 photo - 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 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.

How Common Are Lip Ties?

Some doctors estimate that 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
  • 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 looks slightly different, based on severity:

  • Class 1: No significant attachment
  • Class 2: Attachment mostly into the gum tissue
  • Class 3: Attachment where the future upper front teeth will be
  • Class 4: Attachment that extends to the palate of the mouth
Lip Tie photos chart - Diagnosis, Breastfeeding Complications & Treatment Options

Image by Dr. Lawrence Kotlow, DDS

How to Get Baby’s Lip Tie Diagnosed?

The two best ways to confirm your baby has a lip tie is to get a consult with:

  1. an International Board Certified Lactation Consultant who will have specific training in diagnosing lip and tongue ties. You can find one near you here.
  2. or, from 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. I’ve heard of several stories where the child’s pediatrician missed the tie and the baby (and mama!) suffered needlessly.

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!)

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.

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. 😱

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.

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.

Does a Lip Tie Affect Breastfeeding?

As you can see, yes, 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 ease some of the frustration and improve the breastfeeding experience, find an IBCLC lactation consultant.

You can also try these tips…

  • 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 positionAs if you needed another excuse to snuggle up to baby, he can generally get a better latch when he’s skin-to-skin with mom. Laid-back nursing is particularly helpful with a lip tie. 

Can a Lip Tie Cause Speech Problems?

Don’t worry, mama. A lip tie generally does not cause speech problems later in life. It is rare, but Dr. Ghaheri, an ENT at the Oregon Clinic, 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.

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. An untreated lip tie could cause a gap between the upper front teeth, but doctors suggest waiting until the teeth come in to consider a revision. 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)

The good news if baby does need a lip tie reversal? 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.

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.

What Happens During a Lip Tie Reversal?

Surprisingly, the entire process takes just a few minutes.

  • The mom lays on the dentist chair holding her child during procedure
  • The dentist applies a topical numbing agent (EMLA is safest for infants, though proceed with cautionto the area (general anesthesia should be avoided)  
  • 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
  • The baby is now free to nurse or be comforted by mom
  • The dentist will then review post-op instructions such as pain relief measures and post-procedure exercises (very important!)

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 are rare with a lip tie reversal. 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

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!

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 75,000,000 views, she helps mothers and moms-to-be lead healthier and more natural lives.

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4 Comments

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  1. 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.

  2. 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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