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Thread: Upper Lip Tie/ Labial Frenulum

  1. #1
    Join Date
    Jan 2011
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    Default Upper Lip Tie/ Labial Frenulum

    Hi Ladies... i'm starting a new thread, hoping that it will catch the right person's eye.

    Just yesterday I noticed that the frenulum behind my son's upper lip extends all the way to the bottom of his gums, so I'm assuming it's an upper lip tie. From the searches I've done, I've found mixed information on whether or not an upper lip tie affects nursing. Some sources say yes, though many say no. I'd really love to hear from women who have been through this. We've had nipple blanching, slow weight gain, slow/sleepy nursing habits.... Has anyone had any experience with upper lip tie? If so, did you have nursing issues? Did you have it clipped? If yes, did your nursing issues improve? Were you advised of any additional long term issues an upper lip tie can cause?

    We've had nursing issues from day one, literally, and I want to think this is what's been at the root of our issues, as it's correctable. However, (1) I don't want to get my hopes up that all will be well if we get it clipped and (2) my husband has stated that if improved nursing is the only potential benefit of getting it clipped, he doesn't want it done. He feels that I may have ulterior motives and want DS clipped for selfish reasons.

    I've attached a picture. From those of you who are familiar with upper lip tie, am I right thinking that this is an upper lip tie?

    nicholas.JPG

    Is there anything else you can tell me? Even a good resource would be helpful! Most of the info I found was on tongue tie... which has already been ruled out.

    Thank you
    Last edited by @llli*alilwest; December 31st, 2012 at 02:20 PM.

  2. #2
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    Oct 2012
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    Default Re: Upper Lip Tie/ Labial Frenulum

    Hi,

    I would recommend emailing your photo to Dr. Kotlow in Albany. He treats a lot of tongue and lip ties and may be able to advise you on whether it looks like that's the issue. I've seen some resources of his explaining other issues the lip tie can contribute to (dental decay later in life, infant reflux, gap between front teeth). I don't have the page on hand and I'm NAK, but I think a quick search on "Kotlow lip tie" would do it. I should add that I really found my son's lip hard to lift at all to get a good look but I suppose there could be a lot of variation.

    Getting my son's upper lip tie and posterior tongue tie clipped locally clearly improved nursing but did not solve all of our problems, so we went to NY to see Dr. Kotlow. Since my son was 5 1/2 months old, we could not expect sudden dramatic improvement like with a newborn (due to learning curve) but I think things are getting increasingly close to normal. It took a few days after the procedure to notice the improvement (probably because he was a bit sore and I hoped it would improve instantly so I was discouraged at first), but now fussing during nursing is rarer than ever before. My husband used to often leave the room while we nursed because my baby was often screaming and crying loudly because his poor latch contributed to reflux and air intake, but now that is a thing of the past. We even took him to a social function recently and he nursed quietly and was content. It has been under two weeks since the procedure so it's too early to tell how things will go for us, but if your baby does have a problematic lip tie, it's best to get this done ASAP so your baby can adjust to his new mobility more easily. We treated both the tongue tie and lip tie at once so I don't have experience with just the lip tie alone.

    Dr. Kotlow uses a laser to treat tongue and lip ties which has many advantages over the usual scissors method. I know Albany is a long ways away for you but it's something to consider. He's treated patients from as far away as Australia. Of course you would definitely need to have your husband on board if you're going to make the trip. Hopefully you can find some of Dr. Kotlow's resources on other issues the lip tie can cause (or just email him for some resources). I hope you can also explain to your hubby that nursing is an investment in your child's long-term wellbeing and it's worth fighting for. Does he object to the cost of the procedure or the procedure itself? The frenulum, I believe, is a leftover piece of tissue from development in utero so cutting it should not compromise tongue function at all. The procedure can be painful, but so is nursing with a restricted tongue or lip. If I were the baby undergoing the procedure and I knew the risks and benefits, I would choose the procedure for myself.

    Has a posterior tongue tie been ruled out? It is not visually obvious like an anterior tongue tie, but can often be detected by an IBCLC who knows how to check the tongue's mobility inside the mouth (not just whether it can stick out).

    I wish you luck as you look into this. My LO seems to be on the right track and while I can't say for sure if things will continue to get better for us, I will have no regrets about the procedure because if I hadn't gotten it done I would probably have been left wondering how much better things could have been and at least this way I'll know I've tried everything.

  3. #3
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    Default Re: Upper Lip Tie/ Labial Frenulum

    Thank you for your response. I typed a long response yesterday, and the session timed out :/. The ped confirmed lip tie, and gave us a referral for an ENT. I've read that lip tie almost always co-exist with PTT, so we'll see what the ENT says. I think he probably will have it, though.

    While this kind of sucks, I am relieved to find a possible cause for the ongoing weight gain issues. I'm relieved that I wasn't just imagining that there was something going on. I may be anxious and persistent, but now I feel a little less crazy.

  4. #4
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    Nov 2012
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    Kansas
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    Default Re: Upper Lip Tie/ Labial Frenulum

    I have an appointment on the 9th to get my DS's lip and tongue looked at by an ENT. I wish I could go see Dr. Kotlow but I live halfway across the country. I have a lot of the same problems that you were talking about, so I'm hoping it'll help too! Good luck!

  5. #5
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    Aug 2012
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    Default Re: Upper Lip Tie/ Labial Frenulum

    My son has an upper lip tie that looks a lot like the picture you posted, only I think his is more prominent. We also had problems nursing at first (he is now almost 7 months), but it was more due to an anterior tongue tie, which was corrected/clipped at 1 week old. I had a pediatrician check the lip tie (referred by a lactation consultant) but he thought it looked too thick to clip. His IBLCL nurse also thought it would be best to leave it alone. Now, his latch is good and we don't have any of those early problems. I still get nipple blanching occassionally, but it is not painful. I also have creasing across the nipple, but the lactation consultant thinks this is due to his high palate, which we can't do anything about. His two front teeth are coming in, and it looks like there will be a big gap between them, but several people have suggested that once his other teeth come in the two will be pushed closer together--plus these are his baby teeth, which will fall out in a few years. If the permanent teeth have the same problem then braces will fix that (I had to have braces for a different problem and it wasn't that bad, so I'm not that concerned).

    How old is your LO? Could he be teething? My LO started "teething" at 2 months--excessive drooling, chewing on everything, fussing, and at about 3 months fussed at the breast for about 2 weeks until his two bottom teeth came in. If your LO is not teething, then perhaps something else is going on? I would be hesitant to clip the upper lip tie. For us, it hasn't really caused any problems. What has worked was trying to get a good latch, meaning getting a big mouthful of breast, and the way that happend for us was time--his mouth just needed to grow more so that he could get more breast in the mouth. Also, I kept adjusting him by pulling down the lower jaw (with mixed results; he really didn't want to be messed with while nursing). If your LO is not that old, I might wait and see if things improve on their own unless it's just too painful or if your Dr is really concerned with lack of weight gain.

  6. #6
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    Oct 2012
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    Default Re: Upper Lip Tie/ Labial Frenulum

    I wanted to write a quick update to this. Nursing is still going great! I'm very glad we went to see Dr. Kotlow because our days have completely changed over these past few weeks. Just don't give up hope if the first few days after the procedure aren't great because it might still get better...a lot better. If the ENT's procedure helps a little but not a lot, do consider the laser procedure because it's my understanding that the laser can get deeper with fewer risks. The ENT's procedure helped just enough to tell us we were on the right track, but the laser really changed our feedings entirely.

    Getting the tongue tie clipped wasn't too painful for my little guy but getting the lip tie clipped made him quite upset for several minutes. I say this not to discourage you, but so that you'll be prepared and can decide if it's worth it. In our case, LO was uncomfortable enough during each nursing session that it was definitely worth some temporarily increased discomfort to fix the chronic discomfort.

  7. #7
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    Default Re: Upper Lip Tie/ Labial Frenulum

    THank you for your responses. We saw the ENT on MOnday. He confirmed the upper lip tie, yet claims that lip ties aren't clipped until later in life, typically if and when the child needs orthodontic care caused by the lip tie. Now, i know that isn't the case. DS has become more efficient at nursing within the last few weeks, perhaps his mouth is bigger, or he's just better at compensating... but, either way, becaue of these recent developments, I'm not as concerned about it as I was. Thank you

  8. #8
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    Default Re: Upper Lip Tie/ Labial Frenulum

    ok. so i was totally wrong. weight gain tanked again. I don't think going to Albany to see Dr. Kotlow is an option for us right now, but I have the name of a dentist who does perform these procedures who lives a few hours north of us. i spoke to an IBCLC tonight, and she recommended i pump, feed DS that expressed milk, and then nurse immediately afterwards, as he obviously isn't transfering the milk efficiently. Per my pump output, she confirms that my supply is adequate. She's going to come over on Saturday to observe our latch and she has the name of a dentist that performs tie procedures who might live closer to me than the other dentist.

    DS is 5mo old. Quick history... He was born, naturally, at 10lb 11oz (I am woman, hear me roar!!! ) and got down to 9lb 13oz at day 4. He stayed down there for about a week despite very regular nursing and following all of the advice given on this forum. After a few weeks of relatively NO weight gain, I started supplementing. By month 2, he was 14lb 5oz, and on about 4-6oz of supplement per day. I stopped giving him the supplement, and he weighed 16lb even at his 4mo appt. We saw the ENT on Jan 7th, and he advised that he didn't think the lip tie affected breast feeding at all. Well, we have all the textbook symptoms. Slow weight gain, sleepy nursing, long and very frequent nursing sessions, blanched nipples and a diagnosed tight upper frenulum. So. I don't know. At this point, I just want it to work. I'm glad my supply hasn't tanked too bad considering he never really empties me. I'm lucky that his frequent, or shall I say constant, nursing coupled with my dedicated pumping routine has maintained my supply. he is teething, however all of these symptoms have been present literally since day one. I don't have any other options. Just a pair of crossed fingers.

    thanks for all your support and help.

  9. #9
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    Default Re: Upper Lip Tie/ Labial Frenulum

    I just want it to work. I'm glad my supply hasn't tanked too bad considering he never really empties me. I'm lucky that his frequent, or shall I say constant, nursing coupled with my dedicated pumping routine has maintained my supply.
    I call that making your own luck. Allowing baby to nurse frequently and your hard work with the pumping almost certainly allowed milk production to be OK despite having to supplement and your baby's poor transfer issues.

    I am sure this has been a very frustrating run and I really hope the lip tie is the issue and can be corrected. But I also think-it has been working- Despite an uphill battle, here you are, still nursing your child five months along. That is a huge accomplishment.

  10. #10
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    Default Re: Upper Lip Tie/ Labial Frenulum

    My SIL had a hard time with her DD -she had a tight upper frenulum as well. She found that the best way to get a good latch was to basically stick the tip of her thumb in the baby's mouth and flip up her upper lip as she withdrew her thumb. I with @meg...you're doing an awesome job!

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