The truth about “Lip Tie”
Many parents become concerned about the structure of their baby’s upper lip, its impact on breastfeeding and baby possibly having a gap between the front teeth (diastema) when older. Worry no more – here’s the good news! Almost all babies have a Labial Frenulum (piece of tissue under their top lip) which joins on to the top gum of their mouth. It is normal anatomy, which naturally changes shape and thickness as the baby grows. Some people believe the labial frenulum can cause breastfeeding problems if it is a certain shape or thickness, however there is no evidence to support this assumption. The baby’s upper lip only needs to rest in a neutral or slightly everted position to seal at the breast during breastfeeding. It does not need to flange outwards (like “fish lips” or “special K” shape) to breastfeed effectively and comfortably. Adjustments to positioning and attachment technique can correct ineffective or uncomfortable breastfeeding. In spite of these facts some practitioners recommend surgically dividing the labial frenulum (also called maxillary frenulum) by scissors or laser (called frenectomy or frenotomy) to improve breastfeeding. This painful unnecessary procedure has resulted in a number of babies being admitted to hospitals due to excessive bleeding, and many others refuse to feed for days or weeks following the procedure. Another reason parents may believe the “release” or “revision” of a baby’s labial frenulum which someone has identified as a “lip tie” is concern about baby having a gap between the top teeth later in life. However, there is no evidence to support surgically dividing a baby’s labial frenulum for this reason either. This has been confirmed by a recent study involving paediatric dentists and other oral specialists, which indicates surgical division of the labial frenulum should only be considered after the child has all the second teeth in place (after 12 years of age). https://www.ncbi.nlm.nih.gov/pubmed/29245001/
Congratulations for your sensible and experienced explanation on this matter. Much appreciated
Hi Robyn, thanks for your positive feedback about my article on “Lip Tie”. Kind regards, Lois
is there something to be bothered if your baby has this so called lip-tie?
Hello Janice, there is a great deal of misinformation circulating about so-called “lip tie” – particularly on social media. There are also some practitioners who are obsessed with this normal anatomical feature of infants’ oral anatomy, who can be very convincing in determining it is a “fault” which requires “correction”. The labial frenulum of the upper lip alters as the baby grows, naturally becoming thinner and gradually relocating upwards over time. It is normal. It does not contribute to feeding problems. If any treatment is indicated from a dental perspective it should not be considered until after the child is 12 years old and all second teeth are in position. Best wishes, Lois