You’re trying to nurse your newborn and something feels off. The latch isn’t quite right, your nipples are sore, your baby keeps slipping off the breast, and feeds are taking forever. You’re exhausted and wondering what you’re doing wrong.
You might not be doing anything wrong. Your baby could have a lip tie.
Lip ties affect an estimated 4 to 10 percent of newborns. They’re often missed in the early days — but once identified, most cases can be managed with the right support. The information in this article is based on guidelines from the American Academy of Pediatrics (AAP).
Here’s everything you need to know about spotting, diagnosing, and treating a newborn lip tie.
Table of Contents
What Is a Lip Tie?
A lip tie happens when the labial frenulum — the small band of tissue that connects the upper lip to the gum — is too thick, tight, or positioned too low. This restricts how freely the upper lip can move.
In a normal frenulum, the upper lip moves easily and can curl outward during breastfeeding to create a wide, sealed latch. With a lip tie, that movement is limited. The lip can’t flange out properly, making it hard for your baby to form a deep latch.
Not every frenulum that looks different is a problem. What matters is whether the restriction is actually affecting how your baby feeds.
Signs Your Baby Might Have a Lip Tie
The signs of a lip tie often show up at feeding time. Here’s what to watch for:
During Breastfeeding
- Difficulty latching or repeatedly slipping off the breast
- Clicking or smacking sounds while nursing
- Feeding sessions that last a very long time
- Baby seems frustrated or keeps pulling away
- You hear little swallowing or baby seems to tire quickly
- Painful nursing — sore, cracked, or flattened nipples after feeds
With Your Baby’s Weight
- Slow weight gain or weight loss continuing past the first two weeks
- Baby always seems hungry even after long feeds
- Fewer wet diapers than expected
With the Upper Lip
- Upper lip curls inward (tucked under) during feeding instead of flanging out
- Visible tight or rope-like tissue under the upper lip when you gently lift it
- Lip can’t lift fully when you try to raise it
If you’re seeing several of these signs together, it’s worth getting a professional opinion.
How Lip Ties Affect Breastfeeding
A lip tie can make nursing hard for both of you — and it’s one of the most common reasons breastfeeding feels painful or unsustainable in the early weeks.
For Mom
- Intense nipple pain during and after feeds
- Nipples that come out flattened, creased, or lipstick-shaped after nursing
- Breast engorgement from incomplete drainage
- Increased risk of mastitis
- Physical and emotional exhaustion from long, difficult feeds
For Baby
- Can’t create a deep, sealed latch
- Takes in extra air while feeding — leading to more gas and discomfort
- Gets tired before getting enough milk
- May fall asleep during feeds from the effort without finishing
If your baby is struggling with gas and discomfort after feeds, our newborn crying at night guide covers what helps with gassy, fussy evenings.
Types of Lip Tie — How Severe Is It?
Not all lip ties are the same. Most specialists use a four-level classification:
| Class | Description |
|---|---|
| Class 1 (Mild) | Thin, flexible tissue — minimal restriction |
| Class 2 (Moderate) | Thicker tissue — affects lip mobility noticeably |
| Class 3 (Significant) | Prominent band — limits lip movement substantially |
| Class 4 (Severe) | Extensive attachment — impacts feeding and oral function |
Only a trained provider can classify your baby’s lip tie accurately. The class matters because it helps determine whether treatment is needed.
Lip Tie vs Tongue Tie — What’s the Difference?
These two are often confused — and they can appear together, which makes things more complicated.
- Lip tie restricts the upper lip’s movement
- Tongue tie restricts the tongue’s movement (a short or tight frenulum under the tongue)
Both can cause feeding difficulties. Both can occur in the same baby. But they’re separate conditions that need separate assessments.
If your baby has a lip tie, it’s worth asking your provider to also check for a tongue tie during the same visit.
Getting a Diagnosis
Diagnosing a lip tie requires a hands-on assessment — not just a visual look. A trained provider will:
- Examine the appearance and thickness of the frenulum
- Check the range of motion of the upper lip
- Watch how the baby feeds or latches (ideally during an actual feeding)
- Assess whether the restriction is causing real functional problems
The right person to see is a pediatric dentist, lactation consultant, or tongue-tie specialist with experience assessing oral restrictions in newborns. Not all providers are equally trained in this area — it’s okay to ask about their experience before the appointment.
Bring a list of your feeding challenges to the appointment. The more specific you can be, the better the assessment.
Treatment Options
Not every lip tie needs treatment. The decision depends on whether it’s causing real problems for your baby — particularly with feeding and weight gain.
Conservative Approaches (for mild cases)
- Working with a lactation consultant to adjust latch and positioning
- Gentle stretching exercises (only if recommended by a provider — never do these without guidance)
- Nipple shields as a temporary aid
- Trying different feeding positions
Surgical Treatment — Frenectomy
For moderate to severe lip ties that are genuinely affecting feeding, a frenectomy (also called a frenotomy or frenuloplasty) may be recommended. This is a minor procedure where the tight tissue is released — usually with a laser or sterile scissors.
It’s a quick procedure and most babies feed better within days. It’s typically done by a pediatric dentist or oral surgeon with experience in infant frenulum releases.
After Treatment
- Some soreness for a day or two is normal
- Feeding usually improves within 1 to 2 weeks
- Follow-up stretches may be recommended to prevent reattachment
- Most babies recover quickly with no lasting effects
Feeding Tips While You Wait or Decide
Whether you’re waiting for an appointment or managing a mild case, these strategies can help:
- Try different positions — side-lying or laid-back nursing sometimes helps babies with restricted lip movement latch more easily
- Soften the breast before latching — gentle compression before the feed can make it easier for your baby to get a deeper latch
- Use a nipple shield — a temporary tool that can protect sore nipples and help your baby stay on
- Consider a slow-flow bottle if breastfeeding becomes too painful — a lactation consultant can help you do this without affecting supply
If you’re tracking your baby’s weight during this time, our baby growth tracker tool lets you log measurements and spot whether gain is staying on track.
Long-Term Effects of Untreated Lip Ties
The research on long-term effects is still evolving, but here’s what’s currently known:
- Dental development — a very tight frenulum can create a gap between the two upper front teeth as they come in; it may also make oral hygiene harder
- Speech — direct impact on speech is not well established; most children with untreated lip ties do not have significant speech delays
- Eating — some children may have difficulty with certain textures or foods that require strong lip movement
Every child is different. The best approach is an honest conversation with your pediatric dentist about your child’s specific situation over time.
When to Call Your Doctor
Trust your instincts. Reach out to a provider if:
- Breastfeeding is consistently painful despite good positioning
- Your baby is not gaining weight adequately
- Feeds take more than 40 to 45 minutes every time
- Your baby seems hungry all the time and is never satisfied
- You can see a tight, visible band of tissue under the upper lip
- You’re exhausted and feeding feels unsustainable
You don’t have to wait until things get worse. A good lactation consultant or pediatric dentist will assess the situation and tell you honestly whether treatment is needed.
You’re Paying Attention — That Matters
Noticing something feels off with feeding and looking into it is exactly what good parents do. A lip tie is not your fault and it doesn’t mean you’ve missed something obvious.
Get the assessment. Ask your questions. And know that with the right support, most babies with lip ties — treated or managed conservatively — go on to feed well and thrive.
You’re already doing the hard part by showing up for every feed. 💛
Frequently Asked Questions
What exactly is a lip tie in newborns?
A lip tie is when the tissue connecting the upper lip to the gum is too thick or tight, restricting how freely the lip can move. This can make it difficult for babies to latch properly during breastfeeding.
How can I tell if my baby has a lip tie?
Watch for trouble latching, clicking sounds during nursing, frequent slipping off the breast, slow weight gain, and an upper lip that curls inward instead of flanging out during feeds. These signs together suggest a possible lip tie.
Do all lip ties need treatment?
No. Mild lip ties that aren’t causing feeding problems often don’t need intervention. The decision to treat depends on whether the restriction is genuinely affecting your baby’s ability to feed and gain weight.
How does a lip tie affect breastfeeding?
A lip tie prevents your baby from creating a wide, sealed latch. This can cause nipple pain for mom, extra air intake for baby, long exhausting feeds, and inadequate milk transfer — leading to slow weight gain.
What is a frenectomy and is it safe for newborns?
A frenectomy is a minor procedure where the tight frenulum tissue is released, usually with a laser. It’s a quick, well-tolerated procedure when done by an experienced provider. Most babies feed better within days of the procedure.
Is a lip tie the same as a tongue tie?
No — they’re different conditions. A lip tie affects the upper lip’s movement. A tongue tie affects the tongue’s movement. They can occur together, so it’s worth checking for both if one is found.
Who can diagnose a lip tie?
Pediatric dentists, lactation consultants, and tongue-tie specialists with experience in infant oral assessments are best placed to diagnose a lip tie. Not all general practitioners are trained in this area.
Written by S.A., founder of NewbornCry.com. Learn more about me here.
Medical Disclaimer: This article is for educational purposes only and is not a substitute for professional medical advice. Always consult your pediatrician or a qualified specialist with any concerns about your baby’s health or feeding.