Is your baby unable to latch on deep enough during breast feeding, does she spit out milk often, or does she seem to choke on it, is she not putting on weight though feeding frequently? It might be just a thick fold of tissue in the baby’s mouth. Maybe, it is time to check if your baby has a tongue tie, or a lip tie.
What are tongue, lip ties?
Both conditions, also referred to as Ankylogloassia, have a similar cause. A fold of tissue, called the frenulum, which is attached to the gums, is thicker than normal and thus restricts lip movement. In the mouth, there are two types of frenula - the fold connecting the tongue to the floor of the mouth, called lingual frenulum, and the fold connecting the lips to the gums, also known as labial frenulum. The function of these folds is to provide support to the tongue and lips, allowing for normal movement of the mouth, but sometimes, the fold can become thick, or unnaturally short, restricting free movement. An abnormal lingual frenulum causes tongue ties and a problem with the labial frenulum and buccal frenulum can cause a lip tie and cheek tie, respectively.
Why does this happen?
What exactly causes the thickening of the frenulum is not clear, but dentists have advanced the argument that it could be genetic, and is passed down generations. The Wright Parkway Dental Clinic in Florida, U.S., in a social media post, had listed statistics which show that about 10% of babies are born with a lip tie and nearly 8% of babies have a tongue tie. Authors of a paper in the International Journal of Paediatric Otorhinolaryngology mention that while tongue tie is the most well-known of these conditions, lip tie and cheek tie have gained increasing attention in recent years due to their potential impact on breastfeeding, speech, and dental health. Interestingly, they also record: Reports of abnormal frenulums date back centuries, as one report from the 18th century states Midwives at the time would keep one of their fingernails long so they could clip an abnormal frenulum immediately following childbirth.
Signs in babies
What are the signs that you can look out for in your baby? Is the baby latching on deep for effective feeding, demonstrating poor weight gain, seeking feeds at frequent intervals sometimes, besides making a clicking sound during breastfeeding, spitting milk or choking regularly while feeding? Even the development of jaundice may be a sign, where it will be possible to see the skin turn slightly yellow. If you notice these signs, the ideal thing would be to take the child to a neonatologist or paediatrician to check for a lip tie, but a lactation consultant also can help at this stage.
There are, of course, various grades of severity, depending on the thickness or the length of the frenulum, and its location, and how exactly it is attached. The most severe is level 4, papillar penetration, where the frenulum extends into the papilla, the gum tissue between the teeth.
Later life issues
Later in life, as a child grows, problems might continue, if the lip tie is not corrected. If the baby has not breastfed properly, it might lead to poor absorption or nutritional status and may affect the dental health of a child, causing tooth decay as well. The gums may also recede because bacterial build up is likely if the mouth is not cleaned well, hampered by the abnormal frenulum. Parents should focus on cleaning the mouth of the child well, or ensuring it has been cleaned thoroughly after a meal. Dentists say, a severe lip tie can also cause huge gaps between teeth, which, apart from ruining aesthetics, can also cause long-standing dental issues, including the child not being able to consume some types of foods. Speech can also be affected with a severe lip tie. However, there are others who believe that there is insufficient evidence to show that lip ties can cause dental issues.
How is it treated?
The solution, experts say is a frenectomy, if the restriction is severe for the child. The procedure is simple, a dentist will use a laser to cut the piece of skin connecting the tongue to the gums. After this procedure, a parent must take charge of the procedure of stretching the baby’s mouth and gently massaging the area in order to prevent the fold from growing back in the same place.
Published - November 27, 2025 12:10 pm IST
