A lip tie can sometimes be subtle and slip past parents who are just worried that their otherwise healthy baby is not feeding well. They might not know that the upper lip is restricted in its movement until they have to deal with clicking, leaking, long feeds, and discomfort. Having a clear idea of what a lip tie is, how it can change function, and when to ask for an assessment can help you feel a bit more confident in how to proceed.
What is a Lip Tie?
A lip tie is when the band of tissue between the top lip and top gums (there is a helpful breakdown at www.my.clevelandclinic.org/health) is thick or tight. That band of tissue is completely normal, but with some babies (and kids) it can prevent the top lip from lifting or flinging out as much as needed.
Having a lip tie does not automatically mean there is an issue. Sometimes it is visible in a kid and it does not bother them. Sometimes the band is harder to see, but is still affecting function. In other words, function is what matters most.
Common Lip Tie Clues in Baby
It is often in the course of breastfeeding or bottlefeeding when parents start to suspect their baby may have a lip tie. Babies need to be able to move their upper lip around to seal to breast or bottle, when the top lip is restricted they may not seal properly or consistently.
baby feeding signs related to lip tie
Some possible signs:
- Shallow latch
- Clicking
- Milk coming out of the mouth
- Long sessions or frequent feedings
- Pulling on and off the breast/bottle
- Gas from air intake
- Slow gain
- Pain or damage to nipples in breastfeeding
Any of these clues could have other causes; however, having multiple feeding-related issues may indicate an evaluation to determine if an upper lip restriction is one of the issues.
Lip Tie in Older Children
It can also show up in children of all ages. Some kids may have discomfort when the top front teeth are being brushed, and there is more on this blog link, because it restricts pulling on the top lip. Food can collect in the top gum line and the child may resist pulling up the top lip to brush those teeth.
Lip tie is sometimes part of the conversation about a gap between the top two teeth. Not all gaps are from lip tie, but the tissue can be a factor in development. It is all part of a more comprehensive look at the child’s speech, breathing and tongue rest posture.
Function Trumps Form
Having a lip tie does not mean you automatically need a procedure. The key question is, is the band of tissue impacting function?
A good assessment might look at:
- Feeding, weight gain
- How the lip moves
- How they latch at the breast or how the seal is on a bottle
- Tongue movement, coordination
- Breathing and mouth posture
- Concerns from parents about symptoms
This gives a more comprehensive view to determine if the lip tie is actually a problem in the child’s overall picture of function.
lip tie assessment focused on oral function
Lip Tie Treatment
A lip tie that is not causing issues or impacting function is not an immediate treatment candidate. But when it is causing feeding issues or a range of symptoms in children, we often offer a procedure to help improve top lip mobility.
Sometimes we find that the child will benefit from some support with relearning the latch or coordinating the movement of their oral muscles, or in a child it might be working on oral habits/hygiene. While the procedure helps when it is a factor, it may not immediately clear everything else up.
Time to Get an Assessment?
You may want to be assessed by Dr. Meggie at Untethered Airway Health Center, someone who is trained to look at the function of a lip tie if feeding is painful, stressful, time consuming and/or associated with slow weight gain. If you are dealing with milk leaking frequently and/or clicking while feeding and/or your baby seems to suffer from discomfort due to air swallowing.
For older kids it may be discomfort on the gums, having difficulties brushing the upper teeth or difficulty in pulling on the top lip.
The Next Step in Clarity
A lip tie presents differently for each child. It may be most helpful to look at movement and symptoms or daily function. Having a thorough assessment can help parents and child have a clear idea if lip tie is a factor and what support may help.
During an appointment at Untethered Airway Health Center with Dr. Meggie, feel free to bring feeding videos, growth charts and notes on your baby’s symptoms as you see them at home. These pieces of real-world experience can help you better correlate what you see happening in the mouth to its overall function.