I think my baby has a lip tie

If you’ve been wondering whether your baby might have a lip tie, you’re not alone. This is a very common question, especially if feeding hasn’t felt comfortable or straightforward.

There’s a lot of information online about oral ties, and it can be confusing - particularly when different professionals appear to give different advice. This page explains what we currently know, what we don’t yet know, and how we approach this in an evidence-based way.

What is a “lip tie”?

A lip tie usually refers to the small piece of tissue (the upper labial frenulum) that connects the top lip to the gum.

All babies have this tissue. In many babies it looks quite prominent, and in most cases this is normal anatomy, not a problem. The appearance of the frenulum alone doesn’t tell us whether it is affecting feeding.

What is a normal upper lip frenulum?

The upper labial frenulum is a normal structure that varies widely between babies. Size, thickness and position can all differ, and this variation alone does not mean there is a problem.

In newborns and young babies, the frenulum often:

• looks thick or prominent

• attaches low down on the gum

• appears tight when the lip is lifted

This can be worrying to see, but in most cases it is completely normal for a baby’s age.

Normal movement of the top lip

A common belief is that a baby’s top lip must fully “flange out” during feeding. In reality, feeding is driven mainly by the tongue, jaw and oral seal, not by dramatic top-lip movement.

In normal feeding:

• the top lip may rest neutrally or only slightly turned out

• it does not need to lift high or flip outward

• babies can feed effectively even if the lip looks tucked in

Lifting the lip with a finger is not a reliable test of feeding function. The way a lip moves when pulled up is different from how it behaves during feeding.

Why the frenulum often looks “tight” in babies

A baby’s mouth is very small. The gums are shallow, the jaw is still developing, and the facial bones are compact.

Because of this:

• the frenulum often appears short or tight

• it may blanch (go white) when lifted

• it may limit how high the lip can be lifted during an exam

This appearance is developmentally normal in infancy.

Does the frenulum change as babies grow?

Rather than disappearing, the frenulum changes in position and proportion as the mouth grows.

Dental and anatomical studies show that:

• a low or prominent frenulum in infancy is common

• the attachment typically moves higher on the gum line over time

• the frenulum becomes less noticeable as the mouth enlarges

This is one reason why early surgical treatment is rarely recommended based on appearance alone.

What a normal upper lip frenulum looks like

Newborn / young baby: The frenulum often looks thick and attached low on the gum. The lip may not lift very high. This is normal for a small mouth.

Growing baby: As the mouth and upper jaw develop, the frenulum appears longer and less tight. The mouth has grown, the frenulum hasn’t “shrunk”.

Older child: The frenulum attachment usually sits higher and is less noticeable. Spacing between teeth may appear and later close naturally.

Can a lip tie affect feeding?

This is where things become less clear.

In theory, the top lip needs to move freely to help form a deep latch. Some clinicians believe a tight lip might contribute to feeding difficulties in certain babies.

However, there is currently no good quality evidence to show that dividing a lip tie on its own improves infant feeding.

Because of this, there is no recognised clinical guidance in the UK supporting routine lip tie division for feeding concerns.

Lip tie and tongue tie - what’s the difference?

The tongue plays the main active role in feeding. It needs to move forward, lift and shape the breast or bottle teat to transfer milk effectively.

Both research and clinical experience suggest:

• Tongue tie is far more likely to affect feeding than a lip tie

• A lip tie rarely causes feeding difficulties in isolation

• Many babies labelled with a lip tie also have a tongue restriction

Why don’t you assess or treat lip ties?

We don’t assess or treat lip ties because:

• There is no strong evidence that dividing a lip tie alone improves feeding

• There is no recognised UK training or clinical guideline for lip tie treatment for feeding

• Providing procedures without evidence or guidance does not sit safely within evidence-based practice

This is not about dismissing concerns, it’s about making sure care is safe, appropriate and supported by evidence.

Is lip tie a dental issue?

The upper labial frenulum is more commonly considered in dentistry and orthodontics.

Gaps between front teeth are normal in children. If a gap remains once adult teeth come through, a dentist or specialist may consider treatment.

What about private treatment?

Some private dentists and clinicians do offer lip tie division. This is usually based on individual clinical opinion rather than strong evidence.

Parents choosing private treatment often do so hoping to improve feeding, but it’s important to know this sits outside NHS guidance and evidence-based infant feeding practice.

So what can help if feeding is difficult?

What does have good evidence is:

• A full feeding assessment

• Support with positioning and attachment

• Assessing milk transfer

• Looking at baby’s behaviour, comfort and feeding patterns

• Exploring whether tongue function or other factors are involved

Many feeding challenges improve significantly with skilled support, without surgical intervention.

In summary

• All babies have an upper lip frenulum

• A prominent frenulum in infancy is usually normal

• There is currently no strong evidence that lip-tie division alone improves feeding

• Lip tie rarely causes feeding problems in isolation

• Tongue function plays a much bigger role in feeding

• Current UK guidance does not support routine lip-tie treatment for feeding

If you’re worried about feeding, support is always available, and we’re here to help you focus on what can make feeding more comfortable and effective for you and your baby.