A lip tie is a condition where the small band of tissue connecting your baby’s upper lip to their upper gum is unusually thick, tight, or extends too far down toward the teeth. This tissue, called the maxillary labial frenulum, exists in every baby. It becomes a “tie” when it restricts the upper lip’s movement enough to interfere with feeding or, later, dental health. Lip ties are closely related to tongue ties, which affect a similar band of tissue under the tongue and occur in roughly 5 to 10 percent of newborns.
What the Frenulum Actually Is
The maxillary labial frenulum is a small, somewhat triangular fold of connective tissue (not muscle) that runs from the midline of the upper gum into the inner upper lip. It forms during embryonic development and is essentially a leftover structure from the tissue bands that helped shape the face before birth. Every baby has one, and in most cases it’s thin, flexible, and stays out of the way.
When this tissue is shorter, thicker, or attaches closer to the gum ridge than typical, it can tether the upper lip in place. That tethering prevents the lip from flanging outward the way it needs to during breastfeeding, when a baby’s lips should splay wide around the areola to form a proper seal.
How a Lip Tie Affects Feeding
The most common reason parents learn about lip ties is breastfeeding difficulty. When a baby’s upper lip can’t flange outward fully, they latch onto less breast tissue than they should. This creates a shallow, inefficient latch that causes problems for both baby and mother.
For the baby, a restricted latch can mean:
- Poor milk transfer, leading to slow weight gain or prolonged feeding sessions
- Clicking sounds during nursing, caused by the seal breaking repeatedly
- Excessive gassiness or reflux, because the broken seal allows the baby to swallow more air
- Frustration or fatigue at the breast, with the baby pulling off frequently or falling asleep before finishing
For the mother, the shallow latch often causes significant nipple pain, cracking, or blistering. Many mothers notice their nipple looks flattened or creased after feeds rather than round, which is a sign the baby is compressing rather than drawing the nipple properly. Persistent pain and inefficient milk removal can also raise the risk of blocked ducts and mastitis. Some mothers end up switching to bottles, pumping exclusively, or supplementing with formula not because of low supply, but because nursing has become too painful or the baby isn’t gaining weight adequately.
How Lip Ties Are Identified
There’s no single blood test or scan for a lip tie. Diagnosis is based on a physical exam and how the tissue behaves when the lip is lifted. A provider will gently flip the baby’s upper lip upward to see where the frenulum attaches, how thick it is, and how much it restricts movement. The key question isn’t just what the tissue looks like but whether it’s causing a functional problem.
Lactation consultants (IBCLCs) are often the first to spot a potential lip tie during a breastfeeding evaluation. Pediatric dentists and ear, nose, and throat specialists also assess and treat lip ties. Your pediatrician may notice it during a routine exam, though lip ties get less consistent attention than tongue ties in general pediatric practice.
One classification system, developed by Dr. Lawrence Kotlow, grades lip ties from mild to severe based on where the frenulum inserts. A mild tie attaches high on the gum with minimal restriction, while a severe tie extends over the gum ridge and between the front teeth. But the grade alone doesn’t determine whether treatment is needed. A tie that looks significant on exam might not bother the baby at all, while a moderate-looking tie in a different baby could make breastfeeding miserable.
Beyond Breastfeeding: Teeth and Speech
Lip ties don’t only matter during infancy. When the upper lip can’t move freely, food particles and milk tend to pool between the gums and upper front teeth. That trapped residue feeds bacteria, which raises the risk of early childhood cavities and gum irritation once teeth come in. If your toddler has a lip tie, wiping their upper gums and teeth after feedings becomes especially important.
As children get older, an untreated lip tie can contribute to difficulty forming certain speech sounds, trouble with lip closure (keeping the lips sealed when chewing or at rest), and a slower transition to solid foods. Some children develop picky eating habits partly because the restricted lip movement makes managing new textures harder. A gap between the two upper front teeth is another common sign in older children, though that gap sometimes closes on its own as the permanent teeth come in.
When and How Lip Ties Are Treated
Not every lip tie needs treatment. If your baby is breastfeeding comfortably, gaining weight well, and you aren’t in pain, the tissue itself isn’t a problem regardless of how it looks. Treatment is considered when the tie is causing functional issues: persistent latch problems, poor weight gain, or significant maternal pain that doesn’t improve with positioning adjustments and lactation support.
The procedure to release a lip tie is called a frenectomy. It involves cutting or releasing the restrictive tissue so the lip can move freely. The two main approaches are surgical scissors and laser. With scissors, the provider typically gives the baby sugar water for pain relief, then snips the tissue quickly. With a laser, the tissue is vaporized rather than cut. Despite the popularity of laser frenectomies in private practices, there is no evidence that laser procedures produce better outcomes than the standard scissor technique. Babies who undergo the standard snip typically have fewer complications.
Laser procedures carry their own risks worth knowing about. The pain from laser surgery and the stretching exercises required afterward can cause some babies to develop feeding aversions, which is a serious concern during the early months when steady growth matters most. In severe cases, infants have required feeding tubes after complications from laser procedures. This doesn’t mean laser is always harmful, but the assumption that “laser equals gentler” isn’t supported by current evidence.
Recovery and Aftercare
After a frenectomy, the wound in the mouth heals quickly in young infants, typically within a couple of weeks. The most important part of recovery is preventing the tissue from reattaching as it heals, which requires gentle stretching exercises at home.
A typical protocol involves lifting the baby’s upper lip up and back toward the nose, holding for about three seconds, then using the pad of your index finger to massage along the gum ridge. Think of it like brushing imaginary teeth: rub gently side to side and up and down about five times, making sure to reach high into the fold under the lip. The whole process takes under ten seconds per session. Most providers recommend stretching six times a day for the first three weeks, then gradually tapering off during the fourth week by dropping one session per day.
Babies are often fussy during stretches, which is normal. Doing them quickly, consistently, and with clean hands is what matters. Many parents find that nursing or offering a bottle immediately after helps soothe the baby and reinforces the connection between mouth movement and comfort rather than pain.
What Improvement Looks Like
When a frenectomy successfully addresses the problem, most parents notice changes within the first week or two. The baby’s latch deepens, nipple pain decreases, and feeding sessions become shorter because the baby is transferring milk more efficiently. Some improvement is immediate; other changes develop gradually as the baby learns to use their newly mobile lip.
Working with a lactation consultant after the procedure helps, because a baby who has been compensating for a restricted lip may need some guided practice to adjust their latch. The release alone gives them the physical ability, but relearning the mechanics of feeding can take a bit of time and support.