Lip Tie in Babies: What Parents Need to Know
While infant lip ties are usually harmless, they can lead to challenges with feeding and weight gain. Learn more about how to diagnose and treat lip ties.
Cara Dolan / Stocksy
You may have heard of being "tongue-tied," but have you ever heard of a lip tie? For some babies—and toddlers—lip ties can present breastfeeding challenges. Others may experience problems gaining weight, particularly in/with severe cases. The good news is that, in most instances, lip ties are not dangerous. They are pretty straightforward: to diagnose and treat. However, if you are worried about your child, it's important you learn everything you can about this condition.
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Read on to learn more about lip ties in babies and toddlers.
What Is a Lip Tie?
"Lip ties occur when the tissue (frenulum) that connects the upper lip to the gums is too short or tight," says Leah Alexander, M.D. FAAP, a board-certified pediatrician in New Jersey. "This makes it difficult for a baby to move their lip up and down, which can cause problems with feeding, speaking, oral hygiene, and even dental health. Lip ties are more common in newborns than in older children."
According to the Cochran Library, lip ties occur in 4 to 11% of newborns, making them relatively common. Although lip ties are not as well-studied as tongue ties, it is thought that the cause of lip ties may be hereditary.
"What happens is at about 12 weeks gestation, the soft tissue in this area begins to recede," explains Christine Miroddi Yoder, MA, CCCSLP, CLSE, a speech language pathologist and certified lactation supporter and educator. "With lip and tongue ties, that soft tissue remains. It's not anything the parent did wrong, and we don't yet know why that, in some cases, the tissue recedes and others it does not."
What Are the Signs and Symptoms of a Lip Tie?
Most infant lip ties are discovered if/when baby struggles to latch while nursing, but there are other signs, too.
Difficulty latching to the breast
Difficulty breathing while trying to feed
Becoming worn out or tired from the exertion of trying to feed
Slow or no weight gain
Gassiness, fussiness, and/or colic
Parents who breastfeed may notice that their breasts still feel engorged after feeding because their infant can't latch or suck properly. Unfortunately, engorgement can lead to blocked ducts and mastitis, which can be chronic when a baby cannot empty the breast of milk. Sometimes, bottle feeding can help alleviate symptoms, but parents should have their child evaluated if the lip tie prevents them from feeding.
Do Lip Ties Affect Language?
While some believe lip and tongue ties impact language, the truth is no one really knows for sure. Since articulation disorders and lip and tongue ties are common in children, it's not surprising to see them frequently co-occur. But correlation isn't the same as causation.
"This is a hot-button topic amongst speech-language pathologists," says Jessica Austin, MA, CCC-SLP speech-language pathologist at Waldo County General Hospital in Belfast, Maine. "There is evidence that a tongue tie (with or without a lip tie) can cause or contribute to feeding and swallowing issues, but there is no evidence that a tongue tie (with or without a lip tie) causes articulation or speech sound disorders."
Austin explains that speech sounds require little movement of the tongue tip. "You can try it out at home; /t/, /d/, and /n/ require that you touch the top of your tongue tip to the roof of your mouth," she says. "This can be done with very little movement of the tongue. /S/ and /z/ also require elevation of the tongue tip, but the elevation required is pretty minimal."
Diagnosis and Treatment
If you've noticed latching, sucking, and feeding issues, especially if weight gain is slow, you should consult a pediatrician. They can refer you to a pediatric dentist for an oral exam. At the pediatric dentist, you will likely be asked how frequently your child feeds, if they spit up or choke while feeding, and what kinds of sounds your baby when suckling or swallowing, such as clicking.
Unfortunately, not all children will be properly diagnosed. According to the American Speech-Language-Hearing Association (ASHA), lip ties often go undetected because most infant exams not include an examination of the upper lip or frenulum.
"Lip and tongue ties are often missed or dismissed," says Dr. Yoder. "But they can result in an incorrect swallow called the tongue thrusting swallow. This can throw off the pressure in the mouth and cause oral concerns. It may also require individuals to need orthodontic work."
If left untreated, lip ties can negatively impact one's dental health, causing a gap between the front teeth, cavities, and other issues. Lip ties can also lead to future health problems in adulthood, like sleep apnea. The sooner a child is diagnosed, the better their chances of avoiding dental and health challenges.
That said, having a lip tie isn't a guarantee that a child will experience related health problems. "Ties don't affect everyone the same," says Dr. Yoder. "Just because two people have ties doesn't mean their issues will be the same. One can have severe reflux and feeding issues, and the other may not have any problem with feeding but they may develop sleep apnea as an adult." When in doubt, consult a pediatrician an/or pediatric care specialist.
Correcting a Lip Tie
Thankfully, correcting a lip or tongue tie is relatively simple. Children can have the procedure done at any age, including infancy. A trained professional, usually a pediatric dentist or surgeon, completse the correction by cutting the tie with a laser or scissors. It takes under a minute to complete and is pain-free, thanks to numbing the soft tissue before the doctor begins.
When To Call a Doctor
If you think your baby has a lip or tongue tie, reach out to a pediatrician for a screening. For those who feel anxious about ties, especially if you are experiencing difficulty feeding, remember that ties can be easily diagnosed and treated.
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"Social media has led many parents to worry about lip and tongue ties, but if you are worried, rather than trying to self-assess or self-diagnose, seek out a provider who has been trained in the assessment and care of a child with tethered oral tissues," says Kelly Fradin, M.D., director of pediatrics at Atria Institute in New York City and author of Advanced Parenting: Helping Children Through Diagnoses, Differences, and Mental Health Challenges. "Specifically, looking at photos online will not help you to diagnose your child because what matters is the dynamic function and movement of the tongue and lip rather than the appearance of the tissues."
