Tongue and Lip Ties: What Parents Need to Know

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Postpartum is famously known as a transition period with a lot of woes. If your baby has tongue and lip ties, those first weeks can feel overwhelming until you find the right help. The first step is figuring out if your baby has an oral restriction. So in this post, you’ll learn how to tell if your baby has a tongue or lip tie. From there, there are solutions!

Disclaimer: This post is NOT medical advice and is no substitute for visiting a doctor. Everything shared on NavigatingParenthood.com and within this post is meant as an educational tool to close the “I wish I knew” gap. Please share your new knowledge and any questions with your doctor or specialist.

This post was originally published in April 2022 and has been updated.

The Basics: Tongue and Lip Ties in Babies

What do Oral Ties Look Like?

There are different oral ties (or tethered oral tissues) classes of lip ties and tongue ties, which your frenulum specialist will discuss with you. Some ties may be more noticeable, like when an upper lip can’t flange at all, a heart-shaped tongue, a tongue that is completely flat and can’t lift up to the roof of the mouth, a tongue that can’t extend out past the lips, etc. Other ties aren’t as noticeable until much later when you feel like your milk supply is dropping.

Everyone has a lingual frenulum (or band of tissue) that connects the tongue to the floor of the mouth. If it’s tight, restricted, or tethered, and paired with specific symptoms and functional difficulties, a provider may suspect a tongue tie. When looking for a lip tie, you’ll see this same tether as a thick line between the gums and lip. Some come down the gums to where the teeth will be, while others do not. If you see blanching on your baby’s upper lip when you flip it up to look for ties, it is a sign that there is tightness around the lip. Lip blisters and poor feeding are also indicators. Please see a frenulum specialist for an actual diagnosis.

Oral Ties Symptoms

Aside from poor growth and weight gain, tongue tie symptoms and/or lip tie restrictions are often the cause of things like a gassy, uncomfortable baby, a baby that has difficulty latching or latching correctly, a baby who pulls away from the breast, Torticollis, flathead, lipstick nipples, painful breastfeeding, and a baby that isn’t meeting milestones. Keep in mind that providers will first look at weight gain as an indicator, but if you have a strong letdown or are able to feed baby well enough they may not have weight issues at all but a tie could still very much be an issue. Aside from breastfeeding issues, bottle feeding issues, had and neck tension (leading to poor range of motion), oral ties can also contribute to problems when your baby should be babbling, first start to crawl, or when they try solids for the first time.

What Causes Lip and Tongue Ties?

Experts link tongue and lip ties to genetics, the MTHFR gene mutation, and low cell death in utero. They’re most common in boys. However, researchers have done very little study on oral ties, even though humans have dealt with them for centuries — midwives once cut them with a fingernail, and the Bible even mentions or depicts tongue ties.

Who Diagnoses Oral Ties?

If you think your baby has a tongue or lip tie, contact a nearby frenulum specialist and read parent reviews in Facebook groups (California/Nevada have a really great group with a provider list). Most pediatricians aren’t trained to identify oral ties (though some are), so I strongly recommend seeing a specialist for an accurate evaluation.

Some lactation consultants and ENTs have oral tie training and may test the tongue’s range of motion. Some parents choose an ENT to cut their baby’s tongue or lip tie, and the ENT puts the baby or child under anesthesia for the frenectomy. When a frenulum specialist (a dentist specially trained in oral ties) performs the procedure, they usually use a cold laser while your baby stays awake. It takes just seconds! Since a frenulum specialist is a dentist, dental insurance may cover a large portion of the tie revision.

Oral Ties Next Steps

As a mom and wellness practitioner, I’ve learned tie treatment needs full care. Work with your care team before and after treatment. Be sure to talk to providers and parents to find the right specialists before choosing your family’s care team.

Want to learn more about oral restrictions, who is on the care team, and tips for helping your baby before and after their tie revision? Get my Your Baby’s Tie Care Bestie resource!