A lip tie is a common condition affecting infants that relates to oral anatomy, potentially impacting various functions.
Defining a Lip Tie
A lip tie occurs when the labial frenulum, the band of tissue connecting the upper lip to the gum, is unusually tight, thick, or restrictive. A lip tie is diagnosed when this tissue limits the upper lip’s normal movement, preventing it from flanging out properly.
Lip ties are classified into different types or “grades” based on the frenulum’s attachment point and severity, ranging from Class 1 (mildest) to Class 4 (most severe, extending deeper into the palate). The classification primarily describes the anatomy, and the severity of restriction, rather than the class itself, determines the need for intervention.
Identifying the Symptoms
Parents may observe several signs indicating a baby has a lip tie, particularly related to feeding behaviors. Babies might struggle to latch onto the breast or bottle, often resulting in a shallow latch. Clicking sounds during feeding, dribbling milk, or frequent loss of suction are also common indicators. Babies may show frustration during feedings, fall asleep frequently, or appear fatigued due to inefficient milk transfer.
Visual cues can also suggest a lip tie. The upper lip might not be able to flange or curl outwards, or it may be pulled tightly to the gum. After feeding, a white line on the nipple can be present, indicating a shallow or improper latch. Mothers breastfeeding a baby with a lip tie may experience nipple pain, damage, or distortion. Mothers might have engorged breasts, blocked milk ducts, or mastitis due to inadequate milk removal.
Potential Challenges for Babies
If left unaddressed, a lip tie can lead to various difficulties and long-term consequences for a baby. Feeding difficulties are common, as inefficient milk transfer can result in poor weight gain or slow growth. Babies might have prolonged feeding sessions and experience excessive gassiness or colic symptoms from swallowing too much air. These feeding struggles can cause frustration for both the baby and the mother.
Dental issues can arise from a restrictive lip tie. There is a potential for a gap, known as a diastema, to form between the upper front teeth. The limited mobility of the upper lip can make oral hygiene challenging, increasing the risk of dental decay and plaque buildup on the upper front teeth due to trapped milk or food. As children grow, a lip tie may contribute to speech development issues, particularly affecting the articulation of sounds that require upper lip mobility, such as “p,” “b,” and “m.” Older children might also face challenges transitioning to solid foods, as a restricted lip can interfere with biting, chewing, and managing different textures.
Addressing a Lip Tie
Diagnosing a lip tie involves an assessment by a healthcare professional, such as a pediatrician, lactation consultant, pediatric dentist, or ENT. The assessment includes a visual inspection of the frenulum and a functional evaluation of the baby’s oral movements, especially during feeding. Not all lip ties require intervention; the decision to treat is based on the degree of functional impairment and the presence of symptoms.
The main intervention for a restrictive lip tie is a frenectomy, a procedure to release the frenulum. This can be performed using a scalpel, scissors, or laser. Laser frenectomies are preferred due to their precision, minimal bleeding, reduced discomfort, and faster healing times. Post-procedure care is important to prevent reattachment of the tissues and involves specific oral exercises or stretches. These stretches help maintain lip mobility and encourage proper healing.