Lip-Tie in Babies
Content reviewed against published AAP, NIH, ABM guidelines
Last reviewed:
A lip-tie occurs when the labial frenulum — the band of tissue connecting the upper lip to the gum above the front teeth — is unusually thick, tight, or low-attached, limiting upper lip movement. All babies have a labial frenulum; a lip-tie is only a concern when it is tight enough to restrict the upper lip from flanging outward during breastfeeding, potentially causing a shallow latch. Lip-tie is less well-studied than tongue-tie, and there is ongoing debate about when intervention is needed. It often coexists with tongue-tie.
Key takeaways
- A lip-tie occurs when the labial frenulum — the band of tissue connecting the upper lip to the gum above the front teeth — is unusually thick, tight, or low-attached, limiting upper lip movement.
- Most common cause: Normal anatomical variation in frenulum attachment
- Emergency: Lip-tie itself is never an emergency
- Home care: Work with an IBCLC lactation consultant to optimize latch and positioning
Possible Causes
When to Seek Help
Emergency — Call 911 or go to ER:
- Lip-tie itself is never an emergency
Urgent — See doctor today:
- Newborn with lip-tie and tongue-tie combined causing inability to feed and weight loss exceeding 10% of birth weight
Same-day appointment:
- Suspected lip-tie contributing to breastfeeding difficulty with nipple damage
- Lip-tie with documented poor weight gain and feeding-related distress
Monitor at home:
- Visible prominent frenulum with no feeding difficulties
- Mild lip restriction with adequate latch and weight gain
- Lip-tie identified incidentally during oral exam with no symptoms
By Age
0-2 months
Normal: All newborns have a labial frenulum. A prominent frenulum that does not restrict lip movement during feeding is normal.
Worry if: Upper lip unable to flange outward during breastfeeding, persistent shallow latch despite positioning correction, painful latch with blanching of upper lip, and poor weight gain.
2-6 months
Normal: As baby grows, the frenulum may thin and become less restrictive. Feeding often improves naturally.
Worry if: Ongoing feeding difficulty with poor weight gain, chronic nipple damage in breastfeeding mother, or excessive air intake causing severe gassiness and reflux symptoms.
6-12 months
Normal: Lip-tie rarely causes problems with solid food introduction. The frenulum naturally recedes as the upper jaw grows.
Worry if: Difficulty drinking from a cup due to lip restriction, or persistent feeding issues not explained by other causes.
1-3 years
Normal: The frenulum often stretches or recedes with growth. Some children retain a prominent frenulum into preschool years without problems.
Worry if: Gap between front teeth (diastema) that does not close, recurrent trauma to the frenulum from falls, or difficulty with oral hygiene of upper front teeth.
Home Care
- Work with an IBCLC lactation consultant to optimize latch and positioning
- Try asymmetric latch technique — aim nipple toward roof of baby's mouth
- Support baby's upper lip to flange outward manually during latch
- Use laid-back (biological nurturing) position to allow gravity-assisted latch
- If bottle feeding, ensure upper lip is flanged around bottle nipple
- Gentle upper lip stretches only if recommended by a qualified provider
- Do NOT attempt to cut or release the frenulum at home
- Consider evaluation by pediatric dentist or ENT if breastfeeding remains difficult despite lactation support
Frequently asked questions
What causes lip-tie?
When is this an emergency?
What can I do at home?
When should I call the doctor?
Sources
All content follows our editorial policy and is reviewed against published clinical guidelines.
2,705 evidence-based guides6 authoritative medical sources
Related Symptoms
Bottom line
Most cases of lip-tie in babies are not emergencies. However, seek immediate care if lip-tie itself is never an emergency.
Trust your instincts. If something feels wrong, reach out to your pediatrician. Worrying about your baby means you care — that is a good thing.