Lip Tie (Lip Frenulum) : Symptoms, Causes, Treatment and Complications

Overview

The tissue situated at the back of the upper lip is known as the frenulum. When this membrane is too thick or stiff, it prevents the upper lip from moving freely. This health condition is known as a lip tie.

A lip tie can result in breastfeeding problems in babies, including difficulty in getting sufficient milk. It may also cause pain in the breastfeeding mother.

This blog is a comprehensive understanding of a lip tie, its causes, symptoms, complications, and treatment.

What is a lip tie?

The condition in which the frenulum obstructs the upper lip movement and makes breastfeeding challenging for babies is called a lip tie. To breastfeed correctly, babies must seal their lips around the nipple. The nipple should completely enter the baby’s mouth so they can move the upper lip sufficiently to accommodate the nipple and safely latch on to it. 

Some babies have a thick or stiff frenulum, making it more challenging to move their upper lip. According to the paediatrician’s guidelines, a lip tie is not dangerous for babies if they gain weight. Doctors can treat a lip tie once they diagnose it.

What are the symptoms of a lip tie? 

One of the most common indications that the baby may have a lip tie  is when women face difficulty breastfeeding. The other symptoms in babies with a lip tie include:

• Difficulties latching on to the breast during breastfeeding
• Struggling with breathing during breastfeeding
• Problems with weight gain or lack of weight gain
• Making a clicking sound during nursing
• Feeling drowsy often during nursing
• Feeling fussy or frustrated during nursing
• Looks happy from drinking from a bottle

When babies are suffering from a lip tie, breastfeeding women can experience:

• Pain during or after breastfeeding
• Breasts that feel engorged after nursing
• Blocked milk ducts or mastitis (infection of breast tissue)
• Fatigue from breastfeeding, even though the baby is never full

When should women consult the doctor?

Women who face concerns with breastfeeding can consult a lactation counsellor or a paediatrician who are expert in breastfeeding.

Request an appointment at Apollo Hospitals

What are the causes of a lip tie?

It is usual for babies to have some lip attachments. However, inherited conditions such as infantile hypertrophic pyloric stenosis, Ehlers–Danlos syndrome, Holoprosencephaly, Ellis-van Creveld syndrome, and Oro-facial-digital syndrome may cause babies to have unusual lip attachments. 

What are the complications of a lip tie?

A lip tie should not be concerning, except for nursing babies. Breastfeeding can get disrupted if babies cannot latch on to the breasts. If a lip tie interferes with breastfeeding, it can cause complications such as:

• Sore, cracked, or itchy nipples in breastfeeding women
• A greater risk of infections associated with breastfeeding, including mastitis or yeast infections, in women
• Lack of weight gain in babies
• Malnourishment or dehydration in babies
• Shorter duration of breastfeeding

Some doctors believe that lip tie results in dental problems since milk and food can collect on top of the teeth, increasing the risk of gum disease, tooth decay, and other oral health issues. A lip tie does not cause many complications later in life.

How is lip tie treated? 

Initially, parents must work with a lactation consultant to discover ways to solve breastfeeding problems before choosing a medical procedure. The lactation consultant can generally assist in addressing any issues, like the possible effects of a lip tie. Some options exist for women who are breastfeeding babies suffering from a lip tie and seeking treatment. 

For instance, some women can decide to give breast milk to the baby in a bottle, whereas others may favour a lip tie revision. During a lip tie revision, the doctor will cut a tiny piece of tissue in the labial frenulum to loosen it. They can painlessly perform this with a laser, or they may perform it when the baby is under local anaesthetic.

A laser frenectomy may cause burns. Experts do not suggest this procedure for newborn babies. Though laser treatment for lip tie is becoming more common, it is expensive and has its own risks. Little evidence is available to prove that it improves breastfeeding outcomes, and a lip tie may sometimes reoccur after the completion of the treatment.

Older babies breastfed for several months with a lip tie may have learned compensatory strategies that no longer work after a revision. Parents and caregivers should work with a paediatrician or lactation consultant to help the baby nurse effectively and comfortably. Parents who do not seek a lip tie revision or want to try less invasive methods first may wish to change how they breastfeed the baby.

Conclusion

A lip tie may cause issues with weight gain and make nursing difficult in newborns. Paediatricians and lactation consultants can easily diagnose and treat a lip tie. Parents should evaluate if the baby is having issues with breastfeeding or not. A lip tie revision can help with long-term and healthy breastfeeding when other procedures do not help. However, additional research into these procedures is required.

 Frequently Asked Questions (FAQs)

How is lip tie diagnosed?

Babies facing challenges with breastfeeding must undergo a feeding evaluation. When babies have problems latching on to the nipple, the doctor must quickly detect if a lip tie or tongue tie is causing it.

How should women breastfeed a baby with a lip tie? 

A baby with a lip tie can find it easier to drink from a bottle. Good forms of nutrition include the milk pumped from the women’s breasts or formula bought from the store. They will keep babies on the right track, growth-wise, while parents assess if their baby requires a lip tie revision. If women decide to continue breastfeeding, they must ensure that they pump milk every time the baby consumes the formula to keep up the milk supply.

Women have to use different strategies to breastfeed babies with a lip tie. They can try softening their breasts with the baby’s saliva before attempting to latch and practice proper latching techniques so their babies can connect more fully to their breasts. Lactation consultants can help women use methods to make nursing comfortable and efficient for them and their babies.