The upper lip frenulum is a small band of tissue connecting the center of the upper lip to the gum area, just above the front teeth. While present in everyone, sometimes this tissue is unusually tight, thick, or restrictive, a condition known as a lip tie. A lip tie restricts the movement of the upper lip, potentially interfering with a baby’s ability to create a proper seal during feeding. Identifying the difference between a normal frenulum and a restrictive lip tie helps parents address infant feeding challenges.
The Appearance of a Normal Frenulum
A normal upper labial frenulum is thin, translucent, and flexible. This healthy tissue insertion is positioned high on the gum line, often near where the gum meets the cheek lining. The function of a normal frenulum is to allow the upper lip a full, uninhibited range of motion.
When an infant’s lip is gently lifted toward the nose, the normal frenulum stretches easily without causing the tissue to visibly whiten or blanch. This flexibility permits the upper lip to flange, or roll outward, which is necessary for a deep, effective latch during feeding. A normal frenulum does not impede the lip’s mobility or anchor it tightly to the gum tissue.
Identifying a Restricted Lip Tie
A lip tie appears thicker, denser, or shorter than normal tissue. Instead of inserting high on the gum, the restrictive frenulum often extends down the gum line, sometimes attaching between the front teeth or toward the hard palate. When the upper lip is raised, a tight lip tie prevents the lip from rolling outward fully, creating a visible limitation of movement.
A key visual sign of restriction is blanching, the temporary whitening of the tissue or gum when the lip is gently elevated. This blanching indicates significant tension on the frenulum, confirming a functional limitation. Professionals use a classification system for the anatomical attachment point, but the inability of the lip to move freely defines a clinically significant lip tie.
Functional Impact on Feeding
The limited mobility caused by a lip tie directly affects an infant’s ability to feed efficiently. The restricted upper lip cannot create the wide, cup-like seal required for a deep latch. This poor seal forces the baby to use a shallow, compensatory latch, leading to inefficient milk transfer.
The shallow latch results in the baby taking in excessive air, evidenced by clicking sounds during feeding, increased gassiness, and symptoms of colic. This struggle causes infant fatigue, leading to frequent, short nursing sessions and sometimes insufficient weight gain. Breastfeeding parents may experience discomfort, including nipple pain, cracking, or trauma, because the baby gums or bites the nipple to maintain suction.
Diagnosis and Treatment Options
Diagnosing a lip tie requires more than just a visual inspection of the tissue structure. A healthcare provider, such as a pediatrician, pediatric dentist, or lactation consultant, performs a physical examination combined with a functional assessment. The functional assessment observes lip movement and determines whether the restriction is actively causing feeding or other oral health issues.
If the lip tie is determined to be the cause of functional problems, the most common treatment is a frenotomy, or revision. This procedure releases the tight band of tissue, allowing the lip to move more freely. The release can be performed using sterile surgical scissors or a specialized soft-tissue laser. Treatment is recommended only when the restricted frenulum is causing clear, observable symptoms and functional limitations.