A lip tie is a congenital condition where a baby’s upper lip is tethered too tightly to the gum by a short or thick frenulum (the small band of tissue under the lip). This can restrict the upper lip’s mobility and affect feeding, weight gain, and comfort. Lip ties are often genetic and can occur alone or alongside a tongue tie. In this guide, we explain what a lip tie is, how to spot it in newborns, infants, and toddlers, the potential problems it can cause, and all current treatment options – from simple stretching exercises to a minor surgical procedure called a frenectomy. We’ll also share tips to improve nursing and solid-food feeding when a lip tie is present. By the end, you’ll know when to seek professional help for your baby’s lip tie, backed by the latest pediatric and lactation guidelines.

What Is an Upper Lip Tie?

A lip tie (also called an upper lip tie or maxillary lip tie) occurs when the maxillary labial frenulum – the piece of tissue connecting the upper lip to the gums – is unusually short, thick, or tight. Normally, this frenulum holds the lip in place without severely limiting movement, but in a lip tie it’s restrictive. Many adults and children have a visible labial frenulum, but it only qualifies as a “lip tie” when it prevents normal motion. As one pediatric dentist blog explains, most frenula are normal, but a lip tie is present if the frenulum is “shorter and tighter than the normal range,” limiting the upper lip’s movement.

Lip ties are congenital – babies are born with them – and tend to run in families. They occur in boys more often than girls. Parents can’t prevent a lip tie; it’s not caused by anything a mother did during pregnancy. In summary, what is a lip tie? It’s simply a tight upper frenulum restricting lip mobility. For example:

• Imagine gently lifting your baby’s upper lip. A normal frenulum will allow the lip to lift easily. With a lip tie, the lip feels “stuck” or can’t lift fully because the tissue is too taut.
• Lip ties can be classified by where they attach. If the frenulum attaches high on the gum line, or even between the front teeth, it may limit motion more.

In contrast, a normal frenulum gives a bit under gentle pull. Many babies have a visible frenulum, but it’s only a problem if it acts like a tether. Dr. Katie Clark, a lactation educator, notes that all babies have an upper frenulum; “it’s only problematic when the frenulum is particularly pronounced and reduces the flexibility of the upper lip”. In short, “lip tied” simply means “frenulum too tight.”

Figure: A dentist examining a toddler’s upper lip. The thick band of tissue between the lip and gum (yellow arrow) is an upper labial frenulum. When unusually short or tight, it causes a lip tie that can restrict lip movement and feeding.

Lip Tie vs. Normal Frenulum (What It Looks Like)

Because every baby has some frenulum, parents often wonder “what does a lip tie look like compared to normal?” It can be hard to tell by sight alone. The key sign is restricted mobility: in a lip tie, the upper lip won’t flap upward or outward easily. If you gently lift baby’s lip and it feels stiff or the frenulum looks unusually thick or broad, that suggests a lip tie.

For example, The Bump advises mothers to gently pull back the baby’s upper lip to examine it. If the flap of skin feels taut or “restricts the flexibility” of the lip, it may indicate a lip tie. However, because all babies have this tissue, you can’t diagnose by a photo alone – an experienced clinician needs to assess movement.

Lip Tie vs Normal Pictures: Many internet images claim to show lip ties, but caution is needed. Even experts say you can’t reliably diagnose from a picture. The Upper frenulum naturally varies in thickness and length, and it only becomes a tie when it clearly limits motion. In other words, if your baby’s lip can lift up to cover the gums without much tension, it’s likely normal. If you see an unusually thick band between the gums and lip that seems to anchor the lip down, that’s likely a lip tie.

In summary, look for these visual clues of a lip tie:

• Thick Frenulum: The tissue looks wide or opaque (not a thin strand).
• Low Attachment: The frenulum reaches close to or between the upper front teeth.
• Restricted Lift: When you lift the lip, it does not raise easily due to the tight band.

If in doubt, it’s best to have a pediatrician or pediatric dentist check it.

Signs & Symptoms of a Lip Tie in Infants

A lip tie may not cause obvious problems unless it’s restricting function. The most common issues are feeding difficulties. Because the upper lip can’t flange out, babies with lip ties often struggle to latch well for breastfeeding or bottle-feeding. Here are the key signs parents and clinicians watch for:

• Latching Problems: Baby can’t get a deep latch on the breast or nipple. They may slip off the nipple frequently or never latch for long.
• Sucking Noises: You may hear a clicking or smacking sound as baby nurses. This indicates the baby is losing suction because the lip isn’t sealing the breast or bottle properly.
• Poor Feeding and Weight Gain: If baby is “nursing all the time” but seems unsatisfied, or has slow weight gain, this is a red flag. In more severe cases, baby may fail to thrive without adequate nutrition.
• Fussiness or Fatigue: A baby with lip tie may fuss or appear frustrated during feeds, or fall asleep immediately at the breast from exhaustion. After feeding, they may be irritable or tired. Some also swallow more air and have reflux-like irritability (spit-up, gas) due to poor latch.
• Blebs or Blisters: Rarely, the tight lip can cause tiny blisters or white spots on the mother’s nipple after feeding, due to friction.

Mom’s Symptoms: Nursing parents often feel it too. With a lip-tied baby, a mother may experience painful or pinched nipples, continuous engorgement (milk not being fully removed), blocked ducts, or even mastitis despite frequent feeding. If you feel intense nipple pain or frequent breast issues without other cause, consider a lip tie.

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Toddler Signs: In toddlers (1–3 years) who still have a lip tie, issues may include messy eating (poor lip seal on sippy cup), difficulty blowing bubbles, prolonged drooling, or reluctance to brush upper front teeth if there’s a gap caused by the frenulum. They may also speak clearly enough, although some parents notice subtle speech sound issues (like trouble with “P”, “B”, or “M” sounds).

Summary of Symptoms: In short, any of the following in a baby or toddler could hint at an upper lip tie:

• Difficulty latching onto breast or bottle (poor seal).
• Constant slipping or clicking during nursing.
• Slow or poor weight gain due to feeding inefficiency.
• Painful nursing for mom (nipples get crushed or are very sore).
• Visible tight band of tissue under upper lip (especially when lifted).
• Speech or dental issues later (see below).

If you notice any combination of these signs, have your baby evaluated. Early detection of a lip tie can help address feeding issues quickly.

Potential Complications of an Untreated Lip Tie

A mild lip tie may go unnoticed and cause no long-term harm, but a significant lip tie can have consequences if not addressed. Pediatric specialists note the following possible complications later in infancy or childhood:

• Feeding Delays: The most immediate risk is inadequate feeding. A baby who can’t nurse effectively may need supplements or bottle-feeding to gain weight. If the lip tie isn’t corrected, some babies may resist feeding or have delayed transition to solid foods.
• Dental Issues: A tight upper frenulum can prevent the two front teeth (central incisors) from coming together normally. This often results in a gap (diastema) between the front teeth. The AAPD notes that a prominent labial frenulum is common, but severe ties can contribute to gum problems or midline diastemas later on. Untreated lip ties have been suggested to raise the risk of cavities by trapping food and making cleaning harder, though studies are not conclusive.
• Speech and Mobility: While evidence is limited, some pediatricians observe that very tight lip ties might affect speech development or lip mobility (for example, difficulty with certain sounds or puckering). The ENTtoday review notes scant evidence linking lip ties alone to lasting issues if not interfering with brushing. However, because lip and tongue ties often occur together, children with unresolved ties may need speech therapy or orthodontic care later.
• Oral Hygiene: A restrictive frenulum can make cleaning the gumline more difficult for toddlers. Dentists sometimes recommend stretching exercises and extra hygiene measures if a lip tie is present.

That said, experts caution that not all lip ties need treatment. The consensus in pediatric dentistry is that if the lip tie is not causing any functional problem (feeding or oral hygiene), it can often be left alone. Many infants “grow out” of a mild lip tie as the frenulum thins with age. So, the key question is: is it causing issues right now? If not, watchful waiting is usually fine.

Diagnosing a Lip Tie

If you suspect a lip tie (or if a lactation consultant / pediatrician brings it up), the next step is a thorough exam. A trained clinician will:

1. Inspect the frenulum: They will evert (flip) the baby’s upper lip and look at the frenulum under good light. As ENTtoday describes, doctors check whether the frenulum is “too thick, broad, and, specifically in children who have teeth, if the thick band is between the gap of both central incisors”. They also see if the frenulum goes down over the gum or palate (a more severe tether).
2. Assess lip mobility: The provider will note how far the lip can lift. With a normal frenulum, a baby’s lip should lift easily. If the upper lip remains anchored tightly at the gums despite effort, that indicates a lip tie.
3. Check feeding: Often, the clinician will observe a feeding session. Signs like a shallow latch, clicking, or baby fatigue can confirm functional impact of the tie. They will also rule out tongue tie (ankyloglossia) at the same time, since the two often co-exist.
4. Use assessment tools (optional): Some specialists may use standardized scoring tools for frenulum function, but these are less common for lip ties than tongue ties. In practice, diagnosis is usually clinical.

It’s crucial to involve a qualified pediatric dentist, pediatrician, or ENT. As the ENTtoday piece highlights, all babies have a frenulum; determining if it’s a “tie” requires skill. Dr. Julie Wei (pediatric ENT) says most clinicians know tongue ties but not all know what a lip tie looks like. So, if you’re concerned, ask for a second opinion if needed. A diagnosis isn’t made by a photo or parental guess alone.

Imaging: In today’s online age, you might search “lip tie vs normal pictures.” Trust that pictures from a credible medical source (like dental or pediatric websites) can help you understand what to look for, but do not rely on random online photos to self-diagnose. Always confirm with a professional exam.

Managing a Lip Tie: Non-Surgical Tips

If a lip tie is diagnosed, the first approach (especially for mild ties) is supportive feeding strategies. Not every lip tie requires immediate surgery. Here are common non-invasive tips:

• Lactation Consultant: Work with an International Board Certified Lactation Consultant (IBCLC). They can suggest positioning changes and latch techniques. As VerywellHealth notes, minor feeding issues can sometimes be fixed by coaching.
• Adjust Positions: Try different holds. A football hold (tucking baby under your arm so they face the breast) can sometimes improve lip placement. Cradle or laid-back positions might also help the lip flange better.
• Nipple Shields or Supplements: A thin silicone nipple shield can give baby a larger surface to latch onto and protect sore nipples. If weight gain is a concern, don’t hesitate to supplement with expressed breastmilk or formula until the issue is resolved.
• Bottle Feeding Techniques: Some lip-tied babies feed better from a bottle. Try paced bottle feeding to simulate breastfeeding rhythms. Keep practicing breastfeeding if you prefer to continue, but be patient.
• Tissue Stretching: Gentle massage or stretching of the lip frenum can be done. For example, after cleaning hands, a parent or therapist can pull the upper lip forward and gently slide it to stretch the frenulum edge. According to Healthline, doing this “sliding finger” technique over time can improve mobility.
• Feeding Aids: Ensure baby’s head is higher than the feet when feeding to prevent reflux. Some experts suggest “pre-tactile” methods, like rubbing the breast with baby’s saliva or a warm cloth to encourage latching.
• Patience and Positioning: Babies can adapt. Sometimes just optimizing skin-to-skin contact and ensuring baby is calm before feeding improves latch.

All these methods aim to maximize nutrition and comfort while waiting to see if the tie alone will resolve or improve with time. Many babies will respond to these supports and continue gaining weight normally.

Surgical Treatment: Frenectomy for Lip Tie

If a lip tie is significantly affecting feeding or later causing dental/gum problems, providers may recommend a frenectomy. A frenectomy (sometimes called frenulotomy or frenulectomy) is a simple procedure that cuts or releases the tight frenulum. Key points:

• What It Is: In a lip-tie frenectomy, a doctor makes a small incision in the upper labial frenulum to loosen it from the gum. This frees the upper lip to move normally. It can be done with sharp surgical scissors or with a medical laser.
• Timing: Frenectomies can be done at almost any age. Some experts advise doing it before the age of one year if breastfeeding is problematic, or waiting until 4–6 years if it’s being done for dental reasons. However, many pediatric dentists will perform it in infancy if feeding is severely affected. According to an Austin pediatric dentist, treating a lip tie before age 1 is often recommended to support breastfeeding.
• How It’s Done: It’s an outpatient procedure. If using scissors, it’s very quick (a few seconds) and usually just one cut. If using a laser (many pediatric dentists now use a CO2 or diode laser), the laser cuts the tissue and simultaneously seals blood vessels, reducing bleeding. The Poplin Pediatric Dentistry site notes that laser frenectomies are “minimally invasive” with faster healing and less discomfort. They describe laser release as causing “very little, if any, pain or discomfort”. In fact, most lip-tie releases require no anesthesia (especially laser) because the area has few pain receptors. Sometimes a topical numbing gel or even just swaddling/comfort is enough for a baby.
• Benefits: By cutting the tie, babies can immediately move their lips freely. Many mothers report that breastfeeding improves quickly afterwards. A 2017 study showed that tongue/tie release (including lip ties) nearly doubled milk transfer rates in 1 week. The same study found significant drops in maternal pain and reflux symptoms by one month post-op. Though it’s mostly about tongue ties, it confirms that releasing tied frenula can boost breastfeeding success and comfort.
• Considerations: As ENTtoday explains, surgeons urge caution: only do frenectomy if truly needed. In a toothless infant with only a mild lip tie, evidence for performing the surgery solely to improve nursing is limited. Many clinicians recommend trying feeding support first and only proceeding if baby still can’t nurse well or is not gaining weight.

Figure: A pediatric dentist uses specialized tools to release a toddler’s upper lip tie. After this simple procedure (frenectomy), the lip can lift normally, which often improves feeding and speech.

Laser vs. Scissors for Frenectomy

Both methods have pros and cons:

• Laser Frenectomy: Involves a focused surgical laser (often CO2 or diode). Lasers cauterize as they cut, so there is minimal bleeding. Recovery is often faster and with less pain or swelling. For example, the clinic at Poplin Pediatric Dentistry highlights “precise and controlled” laser release with “faster healing” and “less bleeding, swelling, and post-operative discomfort” than scissors. However, laser tools require special training and equipment.
• Scissor Frenectomy: A doctor uses sterile micro-scissors to snip the frenulum. This is quick and straightforward. There may be a small amount of bleeding, and sometimes a couple stitches are needed. Pain is still usually mild. Scissors are universally available and effective.

In practice, both are safe. Many parents opt for a laser if available and recommended by their provider, especially to minimize infant discomfort. Either way, the procedural goal is the same: release the tissue fully.

Recovery and Aftercare

After the procedure, healing is usually quick:

• Immediate After: Baby may fuss or cry briefly, but severe pain is rare. If scissors were used, there might be two small stitches; lasers may require no stitches. Pediatric dentists often give Tylenol for a day if needed. Swelling, if any, is minimal and short-lived. Feeding is typically resumed shortly after (some even nurse immediately post-op).
• Therapeutic Exercises: To prevent the frenulum from reattaching too tightly, providers usually recommend gentle stretching exercises. This might mean that parents gently massage or manipulate the upper lip (e.g., open and hold the lip) a few times a day for 1–2 weeks. These stretches keep the tissue mobile during healing.
• Feeding Improvement: Many mothers notice that nursing becomes easier within a day or two as baby relearns to flange the lip properly. The breastfeeding issues that led to the frenectomy (pain, clicking) often diminish greatly after healing. A lactation consultant can assist with latch retraining post-healing.
• Follow-Up: The pediatrician or dentist may have a follow-up visit a week or two later to check healing. In toddlers, once healing is done, braces or orthodontists sometimes revisit the frenulum if dental gaps need closure (the AAPD suggests frenulum release before braces if a high frenulum is causing a gap).

Overall, recovery from a lip-tie release is smooth. One dentist notes that it’s “quick, safe, and your baby shouldn’t feel too much discomfort”. Within days to a week, the upper lip can move freely, usually with no more feeding restrictions.

Lip Tie in Toddlers

By the toddler years (age 1–3), some children outgrow minor lip ties on their own as the oral tissues stretch. However, if a lip tie is still present at this age, you may notice:

• Eating Solids: A child might have trouble licking a lollipop or sealing lips around a spoon. Lip-leakage (drooling) can persist.
• Dental Concerns: A gap between front teeth may become obvious when permanent teeth come in. Cleaning between teeth might be uncomfortable if the frenulum is tight.
• Speech: Most toddlers speak normally even with a lip tie. True speech problems from lip ties alone are rare. However, in combination with tongue ties or other issues, some sounds (P, B, M) might be slightly affected.
• Considerations: If a lip tie was never treated but is now causing dental alignment or hygiene issues, a pediatric dentist might recommend releasing it as part of orthodontic treatment. The ENTtoday expert Dr. Wei suggests releasing a lip tie in a child with teeth if it causes problems brushing or pain.

In short, toddler lip ties are handled similarly: address any current issues, then watch for dental development. Some dentists prefer to correct the frenulum while baby still adjusts easily (infant frenectomy), but others handle it when the child is older and more cooperative, especially if waiting for orthodontics. Always discuss options with your dental provider.

Frequently Asked Questions (FAQs)

Q: What is a lip tie in a baby?
A: A lip tie is when the band of tissue connecting a baby’s upper lip to the gums (the labial frenulum) is unusually short or tight. This can prevent the upper lip from flanging out normally during feeding. It is present from birth and only considered a problem if it limits function.

Q: How can I tell if my baby has a lip tie?
A: Common signs include difficulty latching during breastfeeding or bottle-feeding, clicking sounds while nursing, or nipples that hurt after feeding. You can also gently lift your baby’s upper lip to see the frenulum: if it looks abnormally thick or the lip won’t lift up well, that suggests a lip tie. However, definitive diagnosis should be made by a pediatric dentist or lactation specialist.

Q: What does a lip tie look like vs a normal frenulum?
A: In a normal frenulum, the lip lifts easily and the tissue looks thin and delicate. A lip tie’s frenulum appears thicker or extends far down toward the gum line. If, when lifting the lip, the tissue feels like it “wraps around” the gums or is rigid, it’s likely a lip tie. Pictures online can be misleading; professional examination is best.

Q: Will a lip tie go away on its own?
A: Mild lip ties sometimes become less tight as the baby grows, because oral tissues stretch. If a baby is feeding well and gaining weight, some doctors recommend just monitoring it. However, moderate to severe ties that cause feeding problems usually don’t correct themselves and may require treatment.

Q: How is a lip tie treated?
A: If a lip tie is causing problems, the most effective treatment is a frenectomy – a quick procedure that snips the tight frenulum. It can be done with sterile scissors or a laser. Recovery is fast and babies typically nurse easier afterward. Prior to surgery, lactation consultants can try techniques like different feeding positions, nipple shields, or gentle stretching exercises.

Q: What are the risks of a lip tie procedure (frenectomy)?
A: Risks are minimal. You might see a small amount of bleeding if scissors are used, or slight swelling. Infection or significant pain is very uncommon. Laser procedures virtually eliminate bleeding. The biggest “risk” is unnecessary surgery – so doctors only recommend it if the lip tie truly impedes feeding or oral function.

Q: Can a lip tie affect speech later?
A: Lip ties primarily affect feeding, not speech. Most children with lip ties speak normally, especially if only the lip is involved. In rare cases, very restrictive ties in an older child could potentially make certain sounds harder, but this is uncommon. The bigger concern is infant feeding, not toddler speech.

Q: Are lip ties and tongue ties related?
A: They are different anatomical issues but often occur together. A tongue tie (ankyloglossia) is a tight frenulum under the tongue. If a baby has both, feeding challenges can be worse. Many specialists check for both conditions because the treatments are similar (frenotomy or frenectomy).

Q: When should I worry about a lip tie?
A: You should seek help if your baby is struggling to feed (poor latch, crying during feeds, not gaining weight) or if you have persistent nipple pain that doesn’t improve with nursing support. Also if a pediatrician or lactation consultant points it out. If baby is feeding well and thriving, it may be safe to simply monitor it.

Conclusion

A lip tie – a tight upper lip frenulum – is a common condition in babies and toddlers that can complicate feeding. By learning what a lip tie looks like, watching for key symptoms, and knowing your options, you can ensure your child feeds well and stays healthy. Many cases are easily managed with improved feeding techniques, while significant lip ties can be released via a simple frenectomy procedure. If you suspect your child has a lip tie, consult a pediatric dentist or your pediatrician. Early evaluation and supportive care can make a big difference in breastfeeding success and your baby’s comfort.

For further reading, see resources like the American Academy of Pediatric Dentistry’s policy on frenulum management or talk to a lactation consultant for personalized feeding advice. If you found this guide helpful, feel free to share it on social media or leave a comment below. Your questions and experiences can help other parents facing similar challenges.