Breastfeeding is a foundational process for both mother and infant, but it can be unexpectedly challenging when structural issues prevent a deep and effective latch. The thin, delicate tissues within the mouth, called frenulums, are sometimes restrictive, limiting the necessary mobility for feeding. These restrictions are commonly referred to as “ties.” Yes, a restriction of the upper lip frenulum, known as a lip tie, can interfere with a baby’s ability to breastfeed effectively.
Understanding the Anatomy of a Lip Tie
A lip tie is an anatomical variation where the maxillary labial frenulum, the band of tissue connecting the center of the upper lip to the gum line, is unusually tight, thick, or short. This restriction limits the natural upward movement and flanging of the upper lip. The presence of this frenulum is normal anatomy, but a lip tie is diagnosed when that tissue causes functional limitation.
Specialists often classify lip ties using scales like the Kotlow or Stanford classifications. These scales help describe the severity based on the frenulum’s thickness and where it inserts on the gum ridge. This classification standardizes the description of the attachment, which can range from a thin attachment high on the gum to a thicker, more restrictive attachment. A lip tie is distinct from a tongue tie, or ankyloglossia, which restricts the movement of the tongue; both, however, involve a restrictive frenulum that impairs the oral movements necessary for feeding.
How Lip Ties Disrupt Effective Breastfeeding
The primary way a lip tie interferes with feeding is by preventing the upper lip from being able to flange, or curl, outward over the breast tissue to create a wide, secure seal. For an infant to transfer milk efficiently, the upper lip must be able to move freely to help maintain the vacuum seal required for suction. When the lip is tethered, it often rolls inward, which results in a shallow latch where the baby takes in only the nipple and not enough surrounding breast tissue.
Impact on the Infant
This shallow latching mechanism leads to numerous symptoms for the infant. Without a secure seal, the baby may break suction frequently, which often produces a characteristic clicking sound during nursing. The constant swallowing of excess air from the poor seal can cause the baby to exhibit symptoms of gassiness or colic-like fussiness after feeds. Furthermore, inefficient milk transfer can lead to prolonged feeding sessions, yet the baby may still show signs of hunger or struggle with slow or poor weight gain.
Impact on the Mother
The consequences of this inefficient feeding are also felt by the mother. A shallow latch causes the nipple to rub against the baby’s hard palate instead of being protected deep within the mouth. This friction results in significant nipple pain, trauma, and even cracking. When the baby cannot effectively remove milk from the breast, the mother is at an increased risk for painful complications such as blocked ducts or mastitis. Over time, incomplete breast drainage can signal the body to reduce milk production, potentially leading to concerns about low milk supply.
Assessment, Correction, and Post-Procedure Care
The process of addressing a suspected lip tie begins with a comprehensive oral assessment by a healthcare professional experienced in infant feeding dynamics. This evaluation is often performed by an International Board Certified Lactation Consultant (IBCLC), a pediatric dentist, or an ear, nose, and throat (ENT) specialist. Diagnosis relies on both a visual examination of the frenulum’s attachment and a functional assessment of the infant’s ability to move their upper lip and latch.
Frenotomy Procedure
If the lip tie is determined to be the cause of the feeding difficulty, the common intervention is a frenotomy, which is a quick procedure to release the restrictive tissue. This release can be performed using sterile scissors or a soft-tissue laser. The primary goal is restoring full mobility to the upper lip. While the procedure itself is brief, the most important phase for a successful outcome is the diligent post-procedure care.
Post-Procedure Care and Stretching
Parents are instructed to perform specific stretching exercises to the release site several times a day, typically four to six times daily for three to four weeks. These stretches are designed to prevent the tissue from reattaching as it heals, which is a common risk due to the mouth’s rapid healing properties.
The stretching technique for the upper lip involves:
- Placing a finger under the lip.
- Gently lifting the lip high toward the nose.
- Holding the stretch briefly.
- Sweeping the finger side-to-side across the site.
It is expected to see a small, diamond-shaped wound that may develop a white or yellowish appearance as it heals, which is a normal fibrin scab. Pain management usually involves comfort measures like skin-to-skin contact and nursing immediately after the stretch. Follow-up with the treating provider is scheduled within the first week to monitor healing and ensure the exercises are being performed correctly. The infant needs follow-up care with a lactation consultant to help retrain the baby to use the newly mobile lip and achieve a deeper, more effective latch.