Breastfeeding 101: Lip Ties

Disclaimer: I am not a medical professional. This post is strictly to share our own experience and the resources and support we received. Nothing provided here should be construed as medical advice.

Does your baby have a lip tie and tongue tie? Not sure? I shared about our experience with tongue ties here. Please review that post as well. It’s very common for lip ties to be accompanied by tongue ties.

So in my post about tongue ties I reviewed just how difficult our breastfeeding relationship was. I was fortunate, to a certain extent, because my daughter’s lip and tongue ties were very noticeable. So I knew from hour 1 that something was up. This helped me a lot because when doctors and nurses told me there wasn’t anything to worry about and that her issues would not impact breastfeeding, despite my bloody nipples, her nursing blisters, and weeks of suffering and pain, I knew better.

It can be much more difficult to find help with certain tongue and lip ties because professionals will be less likely to even diagnose, let alone treat certain ties. Tip: If you are having difficulty nursing and there is pain, latch issues, bleeding, nursing blisters, mastitis, etc. seek help and don’t wait. Keep going through pediatricians and pediatric dentists and lactation consultants until you find someone that actually helps you. Sadly, it can be a race against time because poor latch and nursing issues can impact supply and baby’s weight. Both of these things can be remedied but the longer it takes the more complicated things get. So move quickly and don’t stop until the issues are resolved.

Our Experience

Like I said, Boba had a very obvious lip tie. The tissue was very thick and spread wide and reached almost to the bottom of her gums, where her teeth would be coming in, eventually. I believe she had a Class III or IV (see Dr. Kutlow’s slide below).

What’s the big deal??

Lip ties can be minimal and you may have even had a lip tie as a child and never even noticed. Some children’s lip ties are released through injuries (face planting on the sidewalk, etc.) and others have issues later on and require orthodontia due to major spacing of front teeth and crowding. Others have large issues with lip ties and tongue ties that require more consideration.

With Boba’s lip tie (and tongue tie), we had incredible difficulty breastfeeding. Due to how impacted and restricted her upper lip was, she was unable to flange her lip out to get a deep latch. Her latch was shallow and very painful for me, it also caused large nursing blisters on her lips that were painful for her.

lip blisters
Nursing blisters. Image posted with permission fromĀ Dr. Ghaheri, DDS, a pediatric dentist in Oregon.

Her shallow latch also caused nipple compression for me which led to pain and discomfort, numbness, cracking, blistering and vasospasms. I tried a lot of things to stretch her lip tie to allow for a deeper latch but that tissue was tight and continued to cause us issues.

Breastfeeding issues, so what?

Many people who face issues during breastfeeding without support or relief from knowledgable professionals stop breastfeeding. Other people don’t ever attempt to breastfeed and both are personal choices that I will not debate here. Either way there can still be issues if you chose not to breastfeed your child that has a lip tie.

Other possible problems caused by lip ties-

  • Front tooth spacing and crowding of teeth leading to dental issues and braces later on.
  • Tooth decay due to lip being held down on the teeth more closely. This can be caused by bottle rot (milk sitting on the teeth), difficulty with oral hygiene due to limited space and food or drink being held on the teeth for longer periods than most.

What if you do decide to breastfeed? What issues may you face?

Dr. Kotlow, DDS shares in his article about exposing the top myths in diagnosing and treating lip and tongue ties that nursing babies with lip ties and their mothers may experience…

  • Colic and acid reflux (excess air due to improper latch will present as colic and reflux)
  • Failure to thrive due to poor latch (prolonged weight loss)
  • Non-nutritional breastfeeding (without proper latch and suction, baby might nurse for shorter less productive periods. This may cause the baby to get very little fatty, nutritionally dense milk, hind milk, and only receive foremilk, which is more sugary and may cause gas, frothy acidic poops, weight loss, pain, etc.)
  • Crying and gagging
  • Sleep apnea
  • Mom may experience plugged ducts and mastitis due to improper latch and incomplete nursing

So what did we do?

The road was a difficult one and we got help relatively quickly. I had an amazing lactation consultant on speed dial! Our birthing instructor happened to be a very knowledgeable lactation consultant with personal experience with lip and tongue ties in her own children. We contacted her immediately when things seemed off and the pain started. She diagnosed the tongue and lip ties and gave us some options. Again, we were fortunate in some ways because Boba was a very determined nurser even though her latch was shallow she sucked with all her might and was actually gaining weight, despite our issues. This was good and bad. Good because weight loss and pediatricians and mommy guilt is a lethal combination and bad because her pediatrician and other medical professionals determined there was no problem and wrote us off. Um??! Can we say bloody nipples and horrible pain? A tiny baby with gas, bloat, frothy and painful poops, and reflux and colic? Miserable! So we kept at it.

We decided to find someone who would clip her tongue tie but that didn’t do much for our nursing relationship due to a few reasons. 1) she was very inexperienced and conservative in the amount she clipped and 2) we still had the lip tie that was very restrictive in allowing for a deep latch. Kate Cropp, our lactation consultant recommended laser revision of both her tongue and lip tie. We looked into and it’s not as easy as it sounds. First my husband and I had to discuss the procedure and decide if we wanted to go ahead with oral surgery. Again we really lucked out that we had Kate because she recommended a pediatric dentist in Dayton, OH that revised infants. See here’s the deal, most pediatric dentists don’t deal with lip and tongue ties and if they do they will side with most medical professionals and state that it doesn’t need revision. Many of them don’t even clip tongue ties. Then there are those who might clip ties but they don’t perform laser revisions. Then there are those who perform laser revisions but only on adults and older children. Shesh!! Exhausted yet? Cut right to the source and just search pediatric dentists who perform laser revisions on infants. Will they be close to home? Maybe not. We had to drive and fortunate for us, he works very close to where my husband grew up so we combined the trip to see family. Is it worth it? ABSOLUTELY!

Below are images of Boba’s revision. The whole procedure lasted less than 5 minutes. They swaddled her and placed goggles on her face. He checked her ties and classified them. He explained the procedure and I held her with the assistant while he swiped a few times under her tongue and under her lip. Done.

Did she cry? Yes…but mostly from being restrained and held down and from having the goggles on her face. The wonderful thing about the lasers they use, they are practically painless and cauterize on contact. This allows for minimal healing time and less pain. They didn’t even have to numb the area. She was done in less than 5 minutes and back in my arms. Then Dr. Notestine, DDS, took us back to a private conference room and checked her nursing latch. ***DEEP, DEEP SIGH OF RELIEF*** For the first time ever, she latched correctly! Her top lip flanged completely and her latch was deep and painless. I cried! It was such a relief that we were finally here, nursing without pain. Was the the end of it? No. But we were on our way.

Boba swaddled
Boba’s goggles
This is a photo of Boba’s lip tie (her tongue tie was too difficult to photograph)
Post Revision

What else did we have to do?

It takes a team and support to continue nursing without pain. It isn’t just about the revisions and nothing else. There were other steps we took and all together they made the difference.

  • We had Boba adjusted by a infant specialized chiropractor from the moment she came home from the hospital. This helped with positioning during nursing, latch, gas, pain, bloat, colic, etc.
  • We also took her to several craniosacral therapy appointments after her revision. This is a licensed massage therapist with specific training, she basically used feather-light touches that move the plates in Boba’s head and in her upper pallet. This helped soooo much! It helped create a better latch and give her more comfort. After these appointments, Boba was nursing longer and receiving more hind milk which relieved so many issues I listed above (gas, colic, frothy painful poop, etc.).
  • We also continued to see Kate a few times.
  • WE DID THE STRETCHES AND EXERCISES the dentist told us to do! This is so important. I belonged to a few Facebook groups and forums about lip and tongue ties and many of the complaints after revisions had to do with reattachment. Can it happen? YES! Don’t let it. Our dentist gave us specific instructions on how to prevent reattachment because the mouth heals REALLY quickly. We had to firmly swipe under her tongue and lip several times before every feeding. Was it great? No! She didn’t like it and I’m sure it wasn’t the most comfortable thing. Did she tolerate it? Yes! For mama milk she tolerated a lot of stuff.

What does a lip tie look like? How do you know if your child has one?

Obviously, diagnosis from a medical professional is the only true way to know for sure but below are some images to help you take a look.

Here is a really wonderful slide by Dr. Kotlow, DDS that shows classifications of varying lip ties. Dr. Kotlow has a pediatric dentistry office in Albany, NY and provides laser revisions on lip and tongue ties. He is well known and very respected for his contribution to breastfeeding health and infant ties.

Lip tie classifications


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