Baby Lip Tie
Medically reviewed by Dr. Michael Okonkwo, MD, FAAP · Board-Certified Neonatologist
Content reviewed against published AAP, AAP guidelines
Last reviewed:
If your baby has been diagnosed with or you suspect baby lip tie, here is what the evidence says.
The short answer
A lip tie occurs when the tissue connecting the upper lip to the upper gum (the labial frenulum) is unusually thick or tight, which may limit lip movement. Nearly all babies have a visible upper lip frenulum, and true lip tie causing functional feeding problems is much less common than many online sources suggest. Treatment is rarely necessary unless there are clear feeding difficulties.
Key takeaways
- A lip tie occurs when the tissue connecting the upper lip to the upper gum (the labial frenulum) is unusually thick or tight, which may limit lip movement. Nearly all babies have a visible upper lip frenulum, and true lip tie causing functional feeding problems is much less common than many online sources suggest. Treatment is rarely necessary unless there are clear feeding difficulties.
- Usually normal when: Your baby has a visible frenulum under the upper lip, as this is a normal anatomical structure that almost everyone has
- Call your doctor if: Your baby is not gaining adequate weight and lip tie in combination with tongue tie is suspected as a contributing factor
- Varies by age — see the age-by-age breakdown below
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What Parents Should Know
According to AAP guidelines, a lip tie occurs when the tissue connecting the upper lip to the upper gum (the labial frenulum) is unusually thick or tight, which may limit lip movement. Nearly all babies have a visible upper lip frenulum, and true lip tie causing functional feeding problems is much less common than many online sources suggest. Treatment is rarely necessary unless there are clear feeding difficulties. At 0-3 months, if a lip tie is causing feeding issues, it typically shows up early as difficulty achieving a deep latch during breastfeeding, inability to flange (curl outward) the upper lip, or excessive air intake leading to gassiness. However, many latch difficulties have other causes, so a thorough breastfeeding assessment with a lactation consultant is important before attributing problems to a lip tie. It is generally considered normal when your baby has a visible frenulum under the upper lip, as this is a normal anatomical structure that almost everyone has. However, you should contact your pediatrician promptly if your baby is not gaining adequate weight and lip tie in combination with tongue tie is suspected as a contributing factor.
Normal vs. Concerning
By Age
What to expect by age
0-3 months
If a lip tie is causing feeding issues, it typically shows up early as difficulty achieving a deep latch during breastfeeding, inability to flange (curl outward) the upper lip, or excessive air intake leading to gassiness. However, many latch difficulties have other causes, so a thorough breastfeeding assessment with a lactation consultant is important before attributing problems to a lip tie.
3-6 months
By this age, many babies have adapted their feeding technique regardless of a lip tie. If breastfeeding is going well and your baby is gaining weight, a visible lip tie does not need treatment. Some providers may recommend releasing a lip tie along with a tongue tie if both are contributing to persistent feeding difficulties.
6-12 months
As babies begin eating solids, a lip tie typically does not cause problems. The frenulum naturally thins and recedes as the face grows. Cup drinking and spoon feeding are generally unaffected. A lip tie is very unlikely to need intervention at this age for feeding purposes.
12 months+
The upper labial frenulum often recedes on its own during toddlerhood. In some children, a thick frenulum persists and may eventually contribute to a gap between the upper front teeth (diastema), but this is a cosmetic consideration that is typically assessed much later, around age 7-8 when permanent teeth are coming in.
What to Tell Your Pediatrician
- Describe when you first noticed baby lip tie and how it has changed over time.
- Note your baby's current age and which age-specific patterns you are seeing.
- Mention if your baby cannot flange their upper lip outward at all during breastfeeding, resulting in a shallow latch.
- Mention if you are experiencing persistent breastfeeding pain despite working with a lactation consultant on positioning and latch.
- Bring a list of any questions or observations you want to discuss at the appointment.
What Should You Do?
When to take action
- Your baby has a visible frenulum under the upper lip, as this is a normal anatomical structure that almost everyone has
- Your baby can breastfeed or bottle-feed effectively and is gaining weight well, even with a visible lip tie
- The upper lip flanges out adequately during feeding and your baby achieves a comfortable latch
- Your baby sometimes takes in a bit of air during feeding, which is normal for all babies regardless of lip tie
- Your baby cannot flange their upper lip outward at all during breastfeeding, resulting in a shallow latch
- You are experiencing persistent breastfeeding pain despite working with a lactation consultant on positioning and latch
- Your baby is excessively gassy or fussy after feeds and you suspect poor lip seal as a contributing factor
- Your baby is not gaining adequate weight and lip tie in combination with tongue tie is suspected as a contributing factor
- Your newborn is unable to feed effectively by any method and lip restriction appears to be contributing
What You Can Do at Home
- Keep track of when you notice baby lip tie — noting the time of day, duration, and any triggers can help your pediatrician.
- Remember that your baby has a visible frenulum under the upper lip, as this is a normal anatomical structure that almost everyone has — this is generally within the range of normal.
- At 0-3 months, focus on observation rather than intervention unless your pediatrician advises otherwise.
- Follow any care instructions from your pediatrician. Keep a written log of symptoms to bring to appointments.
- While monitoring at home, seek immediate care if your baby is not gaining adequate weight and lip tie in combination with tongue tie is suspected as a contributing factor.
Related Resources
Milestone Checklists by Age
Track your baby's developmental milestones from birth to 5 years with age-specific checklists.
Month-by-Month Development
Detailed monthly development guides from birth through 24 months.
When to Call the Doctor
General guide on when to call the pediatrician, visit urgent care, or go to the ER.
Frequently asked questions
Is baby lip tie normal?
When should I call the doctor about baby lip tie?
When is baby lip tie normal?
What causes baby lip tie?
What should I mention to my pediatrician about baby lip tie?
Is baby lip tie normal at 0-3 months?
Is baby lip tie normal at 3-6 months?
Should I go to the ER for baby lip tie?
Does baby lip tie go away on its own?
References
Doctor Visit Checklist
Bring this checklist to your next pediatrician visit to discuss Baby Lip Tie.
Things to mention
- Describe when you first noticed baby lip tie and how it has changed over time.
- Note your baby's current age and which age-specific patterns you are seeing.
- Mention if your baby cannot flange their upper lip outward at all during breastfeeding, resulting in a shallow latch.
- Mention if you are experiencing persistent breastfeeding pain despite working with a lactation consultant on positioning and latch.
- Bring a list of any questions or observations you want to discuss at the appointment.
Observations to share
- Your baby cannot flange their upper lip outward at all during breastfeeding, resulting in a shallow latch
- You are experiencing persistent breastfeeding pain despite working with a lactation consultant on positioning and latch
- Your baby is excessively gassy or fussy after feeds and you suspect poor lip seal as a contributing factor
Urgent signs to report immediately
- Your baby is not gaining adequate weight and lip tie in combination with tongue tie is suspected as a contributing factor
- Your newborn is unable to feed effectively by any method and lip restriction appears to be contributing
My notes
From ismybabyalright.com — free, evidence-based baby health guides
All content follows our editorial policy and is reviewed against published clinical guidelines.
2,705 evidence-based guides6 authoritative medical sources5 medical advisory board members
Related Resources
Bottom line
Most cases of baby lip tie are normal. Talk to your pediatrician if your baby is not gaining adequate weight and lip tie in combination with tongue tie is suspected as a contributing factor.
Trust your instincts. If something feels wrong, reach out to your pediatrician. Worrying about your baby means you care — that is a good thing.
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