What Is a Lip Tie?

What Causes a Lip Tie?

What causes a lip tie? Lip ties can appear in any infant or child, and not all will cause problems. However, certain influences may increase the likelihood of a restrictive frenum. Recognising these factors can help families identify issues early and seek timely evaluation when needed. This overview of what causes a lip tie highlights genetic, developmental, and environmental contributors often discussed in clinical settings.

Genetic factors:

• A family history of oral soft tissue variations, including restrictive frena, may indicate a genetic component.
• Inherited traits can affect the thickness, elasticity, or position of the frenum, raising the chance of limited lip mobility.

Developmental influences during pregnancy:

• Variations in foetal development of oral tissues can result in a frenum that is unusually short, fibrous, or attached lower on the gum line.
• These anatomical differences are typically present at birth and are not necessarily linked to maternal health issues; infant lip ties are often identified soon after delivery.

Environmental factors:

• Elements affecting overall prenatal growth may play a role, although evidence tying specific environmental causes to lip ties is limited.
• Postnatal habits generally do not create a lip tie but can worsen symptoms associated with restricted lip movement.

How Are Lip Ties Diagnosed?

A thoughtful clinical assessment focuses on function as much as appearance. A healthcare professional evaluates the frenum, the lip’s range of motion, and any symptoms affecting feeding or oral health. When appropriate, referrals to specialists, such as lactation consultants, paediatric dentists, orthodontists, or ENT providers, ensure a comprehensive plan for infant lip ties and for older children with functional concerns.

Visual examination:

• The provider inspects the upper lip and frenum for thickness, attachment point, and blanching (whitening) when the lip is lifted.
• Grading systems may describe severity, but visual findings are weighed against functional impact to guide decisions.

Assessment of feeding and symptoms:

• Clinicians review latch quality, feeding duration, frequent breaks, clicking sounds, and signs of excess air intake.
• Weight gain patterns, fatigue during feeds, and milk transfer efficiency are observed to determine whether the lip tie is contributing to difficulties.

Functional criteria:

• Consideration of limitations such as reduced upward lip flange, gum traction, and lip blistering helps clarify the extent of restriction.
• Documentation of associated concerns, including maternal nipple pain or recurrent plugged ducts, builds a complete clinical picture.

How Does a Lip Tie Affect Breastfeeding?

What is a lip tie in the context of feeding? A restrictive upper lip can make it hard for an infant to flange the lip outward, which is essential for a secure seal and effective suction. This can lead to inefficient milk transfer and discomfort for the breastfeeding parent. Early identification and supportive strategies often improve feeding, whether through conservative measures or procedural intervention when appropriate. Infant lip ties are commonly discussed in lactation support because they can influence latch quality and feeding efficiency.

Challenges in latching and feeding:

• Difficulty maintaining a deep latch, frequent detachment, and clicking sounds during feeds.
• Increased intake of air, potentially causing gassiness or reflux-like symptoms.

Discomfort for the breastfeeding parent:

• Nipple pain, tissue trauma, and persistent soreness related to shallow latching mechanics.
• Elevated risk of clogged ducts or mastitis, which can affect feeding comfort over time.

Impact on milk supply and duration:

• Longer feeding sessions with incomplete emptying may affect supply regulation.
• Inefficient transfer can necessitate supplemental strategies recommended by the care team.

Lip Tie Concerns Later in Childhood

Many infants outgrow early feeding challenges, but some lip ties can contribute to ongoing functional or dental issues. Monitoring development and reinforcing healthy oral habits support long-term outcomes. If concerns persist, consultation with dental and orthodontic professionals can help determine whether intervention is beneficial. Families who first asked “what causes a lip tie?” during infancy may revisit the question as growth changes reveal different functional needs.

Possible speech and dental effects:

• Speech articulation difficulties may occur when lip mobility is notably restricted, though this is not universal.
• A thick or low-attached frenum can be associated with spacing or a midline gap (diastema) between the upper front teeth.

Social and comfort considerations:

• Self-consciousness about appearance or speech patterns can affect confidence in group settings.
• Discomfort when smiling widely or lip strain may lead to avoidance of certain expressions.

Oral health and hygiene:

• Limited ability to lift the lip to access the gumline can make brushing and flossing more difficult for young children.
• Increased plaque accumulation around upper incisors is possible if hygiene is challenging; routine dental care and guidance can mitigate risks.

Lip Tie Treatment: Frenectomy

When a lip tie significantly affects feeding or function, a frenectomy, release or removal of the restrictive frenum, may be recommended. The aim is to improve mobility, comfort, and overall oral function. Coordinated care with appropriate providers supports oral development before and after any procedure advised by your child’s healthcare team. For infant lip ties, treatment decisions balance potential benefits with conservative options and close follow-up.

Overview and purpose:

• A targeted release using sterilised instruments or laser technology, performed by trained professionals.
• Intended to enhance lip movement, improve latch mechanics, and support better hygiene or orthodontic alignment.

What to expect during the procedure:

• Typically a brief visit using local anaesthetic; infants may be swaddled for comfort and safety.
• Minimal bleeding and quick treatment time; families receive instructions for feeding and care immediately afterward.

Aftercare and recovery tips:

• Gentle stretches as advised by the provider to support healing and help prevent re-attachment.
• Frequent, comfortable feeding sessions to reinforce improved latch and soothe the infant.
• Follow-up with your care team to monitor healing, feeding progress, and oral function.

When to Seek Evaluation

Consider an evaluation if your infant struggles to maintain a deep latch, feeds for prolonged periods without adequate milk transfer, or shows signs of excess air intake (such as frequent gassiness). Persistent nipple pain, recurrent plugged ducts, or concerns about weight gain are also reasons to consult a healthcare professional. In older children, difficulty lifting the upper lip to brush, visible lip strain, or spacing between the upper front teeth may warrant a dental or orthodontic assessment. Parents often ask what is a lip tie and what causes a lip tie when these signs appear.

Early, collaborative care often yields the best outcomes. A multidisciplinary approach, combining guidance from lactation consultants, paediatric dentists, orthodontists, and ENT providers, can help determine whether conservative strategies or a frenectomy are the most appropriate next steps for your child.