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While many pediatric professionals are familiar with a tongue-tie, the elusive lip-tie hides in plain sight beneath the upper lip. Because I focus on feeding difficulties in children and an upper lip-tie can be a contributing factor if a child has trouble feeding, then I probably encounter more lip-ties than some of my colleagues. And document what you observe.

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Image source: United States Breastfeeding Committee. Are you experiencing pain while breastfeeding, possibly combined with slow weight gain for your baby? While the vast majority of such breastfeeding problems can be resolved by adjusting positioning and attachment, and with good breastfeeding management, occasionally tongue tie might be the cause of the problem.

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Barbie Carpenter worked as a technical writer and editor in the defense industry for six years. She also served as a newspaper feature page editor and nationally syndicated columnist for the Hearst Corp. Carpenter holds a Bachelor of Science in journalism from the University of Florida and a graduate certificate in professional writing from the University of Central Florida.

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The piece of tissue behind your upper lip is called the frenulum. When these membranes are too thick or too stiff, they can keep the upper lip from moving freely. This condition is called a lip tie. Lip tie has not been studied as much as tongue tie, but treatments for lip ties and tongue ties are very similar.

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Breastfeeding is important for babies. The most important thing to know is that even if your baby cannot breastfeed at first, you can still feed your baby your own breastmilk. When you are in hospital with your baby, there will usually be staff and equipment available to help you express or pump milk for your baby.

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A central goal of the Academy of Breastfeeding Medicine is the development of clinical protocols for managing common medical problems that may impact breastfeeding success. These protocols serve only as guidelines for the care of breastfeeding mothers and infants and do not delineate an exclusive course of treatment or serve as standards of medical care. Variations in treatment may be appropriate according to the needs of an individual patient.

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There are some breastfeeding benefits that are particularly important to a baby with a cleft lip or palate. Breast milk helps prevent common ear and nasal infections, and is less irritating to the mucous membranes exposed in babies with this condition. Nursing also strengthens facial muscles that ultimately support speech development later in life.

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Babies with a cleft lip without a cleft palate may be able to breastfeed. There can be difficulties with forming a seal between the breast and lip but, depending on the type and size of the cleft, the breast may be able to mould to the gap. A hissing sound usually means air is entering the mouth, so try to re-position the baby on the breast to help them to form a vacuum. The nipple needs to stay on the back of the tongue, so it may be useful to help the baby by holding the breast in the mouth.

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In fact, assessment of the labial frenulum in addition to the lingual frenulum should always be a part of a feeding assessment by an IBCLC. There have been many anecdotal reports of the revision of the upper labial frenulum improving breastfeeding outcomes. I also have found that upper lip ties cause a very specific, significant, and difficult to heal nipple trauma.

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This study attempts to define the effect of early repair and breast-feeding on the outcome of cleft lip surgery. The first part deals with consecutive cleft lip repairs categorized retrospectively by age at operation. Forty-nine patients were operated on during the first 3 weeks of life; 51 at an older age.


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