Lip Ties – When Are They a Problem?

By Kayla Shea

April 23, 2020

So you pictured your breastfeeding experience as a beautiful time of bonding with your baby. Is that picture not quite what you had hoped? Is breastfeeding painful? One potential cause could be an upper lip tie which can often be overlooked.

Successful breastfeeding is dependent on the infant’s ability to correctly latch onto the mother’s breast. Oral soft tissue abnormalities including lip and tongue ties can make breastfeeding very challenging for mom and baby. For the purpose of this article, let’s just talk about lip ties.

Most babies have a noticeable labial frenum, the connective tissue joining the gums and the upper lip, this is normal! When this tissue restricts the baby’s ability to latch correctly, we call it a lip tie. Lip ties can be described as the superior labial frenum, median labial frenum, or maxillary frenum depending on where the connective tissue inserts. This is not important for you to remember but just know that every baby is different so each mom and baby duo should be given care specifically for their needs.

My own son has a very noticeable labial frenum but it was never restrictive and never caused me any issues breastfeeding. When a lip tie restricts the movement of the upper lip, it may be difficult for the baby to latch effectively. I have seen this many times in my practice. If the baby can only grasp the nipple due to a restrictive tongue or lip tie, this can cause pain for mom and inadequate milk transfer. It may also cause milk pooling and dental caries for babies who have their upper incisors (Kotlow, 2013). Lip ties can also cause symptoms similar to reflux. Although there is no evidence by any scientific studies to show the swallowing of air with lip or tongue ties (Douglas, 2017), there are patient-reported studies to show improvement post oral surgery correction. A 2016 analysis of 1000 mom and baby pairs showed 71% of infants showing reflux improvement post-surgical correction (Siegel, 2016). Another study of 340 mom and baby pairs looked at reflux before, 2 days post-surgical correction and 2 weeks post-surgical correction, this study showed a 92% reduction of reflux signs (Kotlow, 2013). So it goes to show how big a difference it can make when mom and babies are assessed properly and corrections are made if need be.

You may be wondering what to look for? Watch for these signs and seek a professional’s guidance.

  • You can’t roll your baby’s upper lip to his/her nose
  • You noticed a skin crease between your baby’s nose and upper lip
  • Breastfeeding is painful during most of the feed
  • Cracked or bleeding nipples
  • Clicking sound when breastfeeding
  • Baby is unable to flange the upper lip at the breast
  • Shallow latch
  • Milk pooling around the breast
  • Difficulty transferring milk, slow weight gain
  • Colic
  • Engorgement blocked ducts and mastitis

It is important to seek professional guidance to determine the cause of any breastfeeding issues. Sometimes guidance in correcting position and latch can fix a lot of breastfeeding issues.

Who should you seek professional guidance?

    • Registered Nurse
    • Lactation consultant
    • Family Doctor
    • Dentist
    • Cranial Sacral Therapist
    • Of course…A Mama Coach!! All mama coaches are Registered Nurses and most are Lactation Consultants as well! We come with a wealth of knowledge and experience to give you the one on one support you need!

 

 

References
Douglas, P. (2017). Making Sense of Studies That Claim Benefits of Frenotomy in the Absence of Classic Tongue-Tie. Journal of Human Lactation, 33(3), 519-523. Doi: 10.1177/0890334417706694
Kotlow, L. A. (2013). Diagnosing and Understanding the Maxillary Lip-tie (Superior Labial, the Maxillary Labial Frenum) as it Relates to Breastfeeding. Journal of Human Lactation, 29(4), 458–464. doi: 10.1177/0890334413491325
Siegel, S. (2016). Aerophagia induced reflux in breastfeeding infants with ankyloglossia and shortened maxillary labial frenula (tongue and lip tie). International Journal of Clinical Pediatrics, 5(1), 6-8.

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