Identifying and Treating a Lip Tie in Babies and Toddlers

Identifying and treating a lip tie in babies and toddlers: A brief review

Lip ties are common congenital conditions that affect approximately 1% of all newborns. They occur when one or both sides of the mouth do not form properly, resulting in the lips being tightly joined together (a “lip lock”). There are several causes of lip locks, but most commonly they result from defects in the growth plates at the back of the jaw. These defects cause abnormal development of teeth and bones around the mouth.

A variety of treatments have been developed to correct these defects. Some involve surgery, while others use implants or other devices to hold the lips together during chewing and swallowing.

The first treatment option is to remove the defect and allow the growth plate to grow normally again. However, this procedure may require additional operations in future years. Other options include surgical correction with implants or screws; or non-surgical correction using devices such as clips, rings, bands and pins.

In some cases, there is no cure for a lip tie condition and it remains permanent. In other cases, treatment is appropriate and can be effective at alleviating symptoms. The best treatment can be a combination of operations and non-surgical strategies, such as orthodontics (braces).

A lip tie in babies and toddlers can lead to poor infant feeding and malnutrition. As a result, parents may not be able to produce enough milk for their baby (especially breastfeeding mothers) causing the baby to be fussy, cry more than usual, and even fail to thrive. It is important to have this condition diagnosed by an experienced professional.

The type of treatment recommended for a baby or toddler depends on several factors including the age of the child, the type and severity of symptoms, and the experience and recommendations of the doctor. The most common treatments involve clipping or cutting the lip tie, or performing a minor surgery called a frenulectomy.

After treatment, it is important to monitor the child for signs of improvement or worsening of symptoms. If your doctor recommends surgery, you will probably need to wait until your child is old enough to undergo general anesthesia. After this operation, your child may require another procedure later in life.

Lip tie in babies and toddlers can be a frustrating condition with few good treatment options available. It is important to work with a team of doctors who have experience treating this condition. This might include a pediatric dentist, ear, nose and throat specialist (otolaryngologist), or orthodontist.

Treatment for lip tie in children

The treatment for a lip tie in babies and toddlers will depend on the cause of the lip tie, whether there are any other associated symptoms, such as problems with breastfeeding or other feeding difficulties, and the age and general health of the child.

Lip ties can often be treated with a minor surgical procedure known as a frenulectomy. This involves releasing the tight band of tissue under the lip by making a small cut in the lip. The procedure can be performed in an office-based surgery or in a hospital. Most children only require local anesthetic to numb their lips, however, general anesthesia is sometimes required for younger children.

The procedure is quick and most children can return to their usual activities within a day or two.

Frenulectomies are relatively simple procedures and have few associated risks or complications. Risks may include excessive bleeding and infection. These risks are low, provided you follow any post-op care instructions provided to you by your surgeon.

Velamentous attachment (also known as “velo-cardio-facial syndrome”)

There is a rare type of lip tie that is connected in a way that it can affect the heart and blood vessels (cardiovascular system). This is known as a Velamentous Attachment of the Lower Lip. It occurs when the tissue under the bottom lip (the undersurface of the vermilion) attaches to either the upper gum or the bottom of the nose. It can also involve the palate and sometimes even the eye.

A Velamentous attachment is more than a simple lip tie and can cause a range of health problems. These include:

obstructive sleep apnoea (stopped breathing during sleep)

repeated ear infections

trouble feeding

breathing difficulties

If your child was born with a Velamentous attachment, they will need to see a pediatric cardiologist and otolaryngologist (ear, nose and throat specialist). Depending on the severity of other symptoms, treatment may involve observation without surgery (watchful waiting), or surgery.

Although Velamentous attachments are rare, if your child has any of the above symptoms, make sure you seek treatment from a medical professional.

How do I know if my child has a lip tie?

Most babies get a little drool during sleep and this is completely normal. If your baby has excessive saliva (known as Persistent Drooling), they may have difficulty swallowing, and this can cause their clothing to become wet with spit.

Sources & references used in this article:

Incidence and Prevalence of Tongue-Tie by AK Hazelbaker, C Baeza, CW Genna… – Clinical …, 2017 –

Tongue-tie (ankyloglossia) and breastfeeding: a review by KL Berg – Journal of Human Lactation, 1990 –

Tongue-Tied: How a Tiny String Under the Tongue Impacts Nursing, Speech, Feeding, and More by DM Baxter – 2018 –

Ankyloglossia: incidence and associated feeding difficulties by AH Messner, ML Lalakea, J Aby… – … –Head & Neck …, 2000 –

The healing power of play: Working with abused children by E Gil – 1991 –

Ankyloglossia: assessment, incidence, and effect of frenuloplasty on the breastfeeding dyad by JL Ballard, CE Auer, JC Khoury – Pediatrics, 2002 – Am Acad Pediatrics

Hemangiomas in children by BA Drolet, NB Esterly, IJ Frieden – New England Journal of …, 1999 – Mass Medical Soc

The handbook of child language by P Fletcher, B MacWhinney – 1995 –