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Lip Tie Q&A

Affiliate Disclosure | in Motherhood | by | with 83 Comments


I don't draw on my kids. That "pen mark" between his baby blues is a vein. Just sayin' :)

Have in common with this little lady . . .

And this little dude?

They all have lip ties, of course. As we fly out this morning for Micah’s surgery I am thinking of these two sweet babes and others whose mama’s I have chatted with in the past few weeks. So many of you identified maxillary ties in your children after reading last weeks post . . . and sent me pics to prove it! Word is getting out, yet few lactation consultants, pediatricians or pediatric dentists know about it.

How is that possible? Are we all just jumping onto a fad diagnosis? I don’t think so. More mothers are breastfeeding today than the past few decades, so it makes sense that we are more likely to notice when something is “off” with a baby’s latch. Second, there is

research that shows when moms use cocaine there is a higher incidence of tongue tie in their babies.  After Mellanie mentioned this research to me the other night, when I quote it to moms they get the weirdest look on their faces.  ”I’ve never used cocaine!” some will quickly blurt out, to which I chuckle.  I’m not accusing you of wild behavior, but this study brings up some interesting points too.  If one researched chemical (cocaine) can cause this abnormality, what other chemicals- that no one has yet researched- might do the same?  Furthermore, one of the most prescribed drugs in our society are stimulants to treat conditions like ADD and ADHD.  Cocaine is a stimulant, and these prescribed stimulant drugs many times work on the same areas of the brain and cause some of the same side effects.  Countless studies have shown that many drugs- and several different types- have been found in our water supply.  Are we seeing increase in abnormalities due to all of this?  In my opinion, possibly so.

Ankyloglossia, So Common?!?!

If you suspect your child might be tied and are struggling with questions, I hope this info will clarify some things for you. And if you have a friend that is having trouble breastfeeding, please pass this info along!

Q: What are the symptoms and complications associated with a maxillary (lip) tie?

A: Baby’s Symptoms (Micah had all of these except poor weight gain. We never tried a paci or bottle)

  • Difficulty latching on or falls off the breast easily
  • Gumming our chewing the nipple while nursing
  • Unable to hold a paci or bottle
  • Gassy (babies with ties often swallow a lot of air because they cannot maintain suction properly)
  • Poor weight gain
  • Excessive drooling
  • Baby is not able to fully drain breast

Mama’s Symptom (I had none of these except discomfort)

  • Creased/flat/blanched nipple after feedings
  • Cracked/blistered/bleeding nipples
  • Discomfort while nursing
  • Plugged ducts
  • Thrush/mastitis

Complications of Tongue and Lip Ties

  • Babies may not be able to stimulate milk production through vigorous nursing, leading to low milk supply
  • Painful nursing/early weaning because child gets too frustrated
  • Improper tongue mobility may prevent babies from clearing milk from their mouth, causing tooth decay (especially in the front teeth)
  • Colic
  • Reflux
  • sleep apnea
  • abnormal sleep patterns (Micah woke every two hours to feed at five months old because he was hugry ALL the time)
  • Speech difficulties
  • Gap between teeth/jaw issues

Q: How do I know if my baby has one?

A: Here is an excellent pictorial guide with the information needed to make an informal diagnosis.

Q:My husband’s little brother was tongue-tied. They were told in the hospital that the operation was going to be a big deal – expensive, scary, I don’t know what all. But the family lives kind of in the boonies, and there’s a country doctor down the road, and they took the baby to him (for a second opinion?) and he said, “Oh yeah. That’s easy.” And snipped it right then and there. Gabe’s been fine ever since, and now that relieving anticlimax is a family story. Of course, I’m telling this vaguely and third-hand, so I’d love to get the details on how it went for you and Micah.

A: A frenulectomy is a relatively simple procedure for newborns because the nerve endings haven’t fully formed and they’re easy to hold still. Because he was older, Micah had to endure more discomfort, bled more and was more difficult to keep still (putting a five month old under anesthesia has risks and costs about $3-5K. Daniel had just changed jobs and wasn’t eligible for insurance yet. The surgery couldn’t wait, so we had to keep him awake and swaddled through the procedure).

Maxillary ties are more difficult. They can’t be snipped because it will just create scar tissue that is thicker and tougher than the original tie. Scissors and scalpels cannot usually go deep enough into the tissue to correct the problem. However, a laser can be used, which has the side benefit of increased healing time and minimal scar tissue. Unfortunately, few doctors have laser instruments, which is we we are going to New York to have it done.

Q: Is it ever okay to wait and see if they outgrow it? Or is it something that I need to have taken care of ASAP?

Dr. Kotlow, who is one of the most respected authorities on the subject, doesn’t advocate the “wait and see” approach. According to this article, he says “individuals who state most abnormal frenum attachments will resolve or go away by themselves are incorrect. The result is continued pain for moms and eventually infants giving up nursing. These frenum attachments may contribute to breastfeeding problems and should be evaluated for revision along with the lingual frenum revision for breastfeeding problems.”

I think my child has a lip tie. What now?

[pullquote_right]Come hear board certified pediatric dentist Dr. Lawrence Kotlow speak on Saturday, May 14th from 9am-12pm in North Richland Hills. Tongue-ties and lip-ties will both be discussed and Dr. Kotlow will be giving informal consultations following the presentation, so bring your baby! Pre-Registration is required. Cal 817-428-9595 [/pullquote_right]If it were me, I would email Dr. Kotlow a pic of my child’s mouth. He’s agreed to do a phone consult for many concerned parents, and he can talk you through options. If surgery is necessary there are only a couple places I know of to get it done. One is Dr. Kotlow’s office in Albany, New York. The other is Dr. Cole’s in Fort Worth, Texas.

Why are we going all the way to New York when Dr. Cole is in our own backyard? Good question.

When we found Micah’s tongue tie we were told he’d have to be sedated to have it clipped. The surgery, when performed on babies, is quick and easy. But as babies get older and stronger, they can move at the wrong time and healthy tissue could be damaged in the process. Fortunately, Dr. Biavotti, a Dallas ear/nose/throat specialist, agreed to do procedure without general anesthesia (he did a fabulous job, btw!).

Dr. Cole is one of the most respected holistic dentists in the nation. However, because he only recently began doing the procedure we felt that the best scenario would be to put Micah under to ensure a good outcome. But due to the risks of anesthesia we opted to go to Dr. Kotlow, who has lots of experience with wriggly babies and can perform the procedure with only a local anesthetic. On the flipside, we feel Dr. Cole is the best person to correct Katie’s maxillary tie (which we just discovered and believe is part of the cause of her tooth problems).

As more lactation consultants, pediatricians and pediatric dentist become aware of this problem the options will increase, but these are what I know of right now.

Okay, I think it time to board our flight. Have a great morning!


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83 Responses to Lip Tie Q&A

  1. Tiffany says:

    Evie has this tongue tie too. I was planning on going to Dr. Cole but after reading this I think Dr. Kotlow is a better choice. I don’t want to put Evie under anesthesia.

    • Heather says:

      Tiffany – I tried posting a response from my phone yesterday but I guess it didn’t go through. I just wanted to let you know that each situation is SO DIFFERENT, and it might be best to talk to both dentists before deciding on which one to go with. I don’t think Dr. Cole insists on general anesthesia, but since I observed his first procedure I knew wriggling would be an issue and since Dr. K has done over 90 of these procedures since the first of the year I felt confident that wouldn’t be a problem. On the flipside, we are taking Katie for a consult with Dr. Cole when we get back because we feel he is the best person to handle her procedure. Does that clarify things at all? Not that you were asking . . . I just noticed my original statements may seem to indicate that Dr. Cole insists on general anesthesia.

  2. Michelle McCoy says:

    I hope all goes well and try to enjoy NY!! It is a great place to visit! Thanks again for all your help ♥

  3. My second son was tongue-tied. Thankfully the ped caught it in the hospital. He couldnt latch well and I was cracked and bleeding within a few hours (ouch!!!). The clipped it right there, it was quick and simple and he cried about 2 seconds then latched on perfectly. So glad you posted this to get the word out and Im glad you are getting your son’s fixed!

  4. Amber says:

    Hello. I’ve been following your blog regarding tongue/lip tie. I am pretty sure my 3mth old daughter has lip tie. We live in Missouri, so traveling to NY is crazy expensive and long, however, I would love to go to Dr. Kotlow. Could you tell me about the procedure at all. Pain, crying, price, anything you could tell me would be so helpful & greatly appreciated.

    • Heather says:

      Hi Amber – I’ll try to answer as best I can. When we took Micah to have his tongue tie clipped using scissors at 5 months there was a lot of blood and I had to hold Micah almost constantly for about 24 hours because he was miserable. When we took him at almost 8 months to Dr. Kotlow there was virtually no bleeding and he was crawling around happily on our hotel room floor an hour later. The procedure costs $450, but Dr. K’s office offered us a HUGE discount because they knew we had to travel to see him. (like, ahem, 50%). If your daughter has a lip tie there is a very good chance she has a tongue tie as well. When we finally made it to Dr. K we learned that Micah had some scar tissue from his first procedure and that the tongue wasn’t fully free, so Dr. Kotlow corrected that. If I had known then what I know now I would have chosen to the laser procedure in the first place. Does that help?

  5. Amber says:

    Thank you so much Heather. That helps quite a bit. That would be so great to get that discount too :) If we drove it would take us nearly 20hrs – dreadful. Did they numb the lip/tongue before using the laser?

    • Heather says:

      Because Micah is older and therefore had more nerve endings in the tissue they did. However newborns don’t have the same level of sensation so I don’t think he uses anything. One of my best friends (who is very gentle with her babies – no crying it out and all that stuff) had her daughters done at two months and said it was super quick and her daughter wasn’t even crying when Dr. K brought her back in. Micah was definitely crying but he settled down in less than two minutes, which was a huge contrast with his first procedure.

    • Amber says:

      Amber did you end up having your child’s lip tie corrected? where did you end up going? I live in IL very close to Missouri and don’t think that trip to NY is a possibility!

  6. Renate says:

    Thanks Heather for posting this on your site. Wow, I can completely relate to a lot of this. My firstborn who just arrived in early March of this year had an upper lip tie and a posterior and sublingual tongue ties. Poor sweet baby…boy have we had a hard 9 weeks. My midwife Christy Martin saw at 2wks that she had these and referred me to Mellanie Sheppard LC as well. She has been my rock since then. I saw her weekly because I had most if not all of the baby and mom symptoms and it was bad but we endured breastfeeding because I felt my daughter was not getting a fair shot since it wasn’t her fault she had faulty parts that needed correcting. We went to Dr. Biavotti and he only did the tongue but just the posterior tie at 2wks. It helped but Mina had the same was traumatic, lots of blood, she hurt for days and things still were not getting better. I got mastitis back to back then an abscess and she was not gaining and was eating every hour with long feeds of 1.5hrs. We then got referred to Dr. Cole at 4wks for her lip tie and that helped a lot. It was the laser procedure. He was a sweet Dr. and he put a topical anesthetic on her, it was a bit longer (minutes more but that feels like forever when your watching them work on your sweet baby) than Dr. Biavotti’s procedure but she quickly calmed down afterwards as I nursed her and her healing time was much faster. We swaddled her with that procedure and it worked quite well. He told us we were his 2nd lip tie procedure he had done on a newborn. I would not have known..he did a great job. Mina still was not making great weight gain and I was nursing her, giving her a bottled of pumped milk and pumping at every feeding so Mellanie recommended I go back to Dr. Cole to have the tongue tie reevaluated. We did and he performed the procedure their to fix the sublingual tongue tie at 6wks. Their was no frenum their so Dr. B did do his part but it was still restricted. Dr. Cole did not use any anesthetic that time, used the laser and it took a few minutes as he was going slow to make sure he did it correctly. She did seem to have a quicker healing time but was more uncomfortable for a couple of days like the first Frenotomy. I still have a hard time thinking that she endured 3 procedures but I know it was necessary and beneficial. She has a much better latch, it doesn’t hurt anymore, I am healing as well and she has been gaining well for the past 3 weeks! I think we are on the road to recovery but am hoping to have Dr. K check her mouth out on Sat. just in case. I know Dr. Cole and his whole staff plan to attend the seminar as well. I didn’t give up breastfeeding but I absolutely can see how easy it is to give up with all the symptoms that are present with these mouth problems. I hope my information helps moms out their and the decision to get the procedures.

  7. jada says:

    This is way late but there’s a dentist in CA that does procedure with local as well. Dr. Kotlow actually recommended him to us. Dr. Jesse James is his name. our 2 year old and 1month old had the procedure done at his office. It’s worth it!

  8. […] If you want to learn more about the issue itself, you can take a look at the posts over at The Mommypotamus or Tempest […]

  9. Thais says:

    I think that this is what my son had a problem with. I have a long sublingual frenulum and I noticed that my son has one as well. The maxillary one is very tight as well and his teeth in the front are separated. I did successfully breastfeed for 7 months exclusively. But I did have A LOT of trouble with the latch for about 3 months. With baby #2, this will be handled before I leave the hospital! Thanks for this post, I will repost this for my mama friends as well :)

  10. Mandy says:

    Heather! Someone just posted a link to this on my blog, and I wanted to let you know… YOU are the reason Ruby and I went to Dr Kotlow. I read this article many months ago when I first discovered Ruby was lip tied, went to his site, and took your recommendation. I just had to let you know. Thank you. I adore you. I hope we can get the word out there so more mommas know what to look for and don’t have to go through the pain we have. <3

    • Heather says:

      Hi Mandy, I thought I recognized you! Or actually, I thought I recognized Ruby’s name from her birth story. Praying you will find the solution you are looking for. <3

  11. My grandson is a handsome lad. He has beautiful eyes.

  12. Heather Brandt says:

    Is this something that would still need to be fixed in my 4 year old? Or in my 1 year old? trying to figure out if they might have it. never saw a dr. chk for it.

    • Heather says:

      Hi Heather! If the maxillary tie is causing a gap between the teeth it might be beneficial (or if your 1 year old is still nursing and you are having difficulties there). Depending on how bad it is, a tongue tie is also something a parent of an older child might want to correct because it can cause speech issues. Hope that helps!

      • Heather Brandt says:

        Our baby is bottle fed breast milk (we adopted her so not nursing). Who would need to diagnose this sort of thing and/or do procedure? My son who is 4 is a thumb sucker and we thought the teeth were changing a bit due to that but now I’m wondering about his….Not sure if I’m looking at them correctly. He doesn’t seem to have any speech problems. Our baby is too little to tell yet.

        • Heather Brandt says:

          I forgot to say that our son is currently have gut/tummy problems. Trying to figure out what is causing tummy pain and some other probs. Not celiac…I don’t think this digestive problem(s) could be related to tongue tie if he had it but I’m considering every possibility in effort to help him….hmmm…

        • Heather says:

          Hi Heather! Very few lactation consultants know how to diagnose a posterior and/or maxillary tie. Are you in the DFW area? If so I can recommend some people. If not, the best thing to do is contact Dr. Kotlow’s office and talk to them on the phone. Their website is

          • Heather Brandt says:

            Is tongue tie something our pediatrician or pediatric dentist could diagnose? We think our baby girl (almost 1 year old) has it (no longer think our 4 year old does). Our baby’s 2 top teeth in middle are growing in with a gap between them & I think the frenum looks like the photos you’ve shown. (sorry it took so long to ask this!)

          • Heather says:

            HI Heather! Most pediatricians aren’t properly trained to diagnose ties. And almost no one is trained to diagnosed a maxillary tie. Dr. Kotlow in NY is most qualified and will usually make an informal diagnosis if you email him a pic. His website is

            Hope that helps!

          • Katherine says:

            I would love those recommendations for the DFW area. I believe my 2 month old has a lip tie. He is nursing okay but sometimes has a bad latch and is obviously swallowing too much air. Dr. K said if he’s having latch problems it could be the lip tie (I sent him a picture), so I’m guessing that was the informal diagnosis. He is gaining plenty of weight so I don’t know if I should worry about it or not, but after reading about it lately I think I should. Any recommendations would be greatly appreciated! We are in North Richland Hills but can travel to anywhere in the DFW area. Thanks!

  13. Heather Brandt says:

    Even though I live out of state, he is willing to make an informal diagnosis? Does he charge for the informal diagnosis?

    Thanks so much!

  14. […] was how to get Heather enough sleep so she could function (Katie and Micah both had undiagnosed lip ties that made them fussy […]

  15. […] is very possible. Sore nipples, hectic schedules, social pressures, even situations where your baby’s mouth isn’t able to achieve a latch – it can be overcome, and there are lots of resources out there to help you do so. (If you […]

  16. […] for your baby with this pictorial guide. If you think there might be an issue check out my lip tie Q&A for more photos and answers to commonly asked […]

  17. MamaS says:

    Just wondering if you ever had your little girls lip tie corrected by Dr Cole? My 3 yr old has maxillary lip tie (diagnosed by Dr. Kotlow today!) and decay on her 4 front top teeth. Also, a big gap. Dr. K recommended a frenectomy & repairing the damaged teeth ASAP. We’re in Texas so I’d rather use Dr. Cole or Dr. Oser. Was wondering your experience with Dr. Cole, or which of the two you’d recommend more?

    • Katherine says:

      Did you ever get this done? Which dentist did you use? I have a new baby that needs the procedure and I am looking into Dr. Cole and Dr. Oser as well and would love to hear testimonies about both because I am a little nervous about this! My email is Thanks!

      • Melodie says:

        Might be a little late for OP, but for future reference, we used Dr. Cole and had a fantastic experience. All of our issues related to the ties went away within days of laser revision (we had to stop and exlusively pump for weeks due to extreme pain, poor latch on, sliding off the breast, fussiness, gassiness, arching back, pinched nipples, clicking sounds, vasospasms, and many more.) Now that we got his tongue/lip revised (initially the tongue was clipped by an ENT, but not deep enough) we have been breastfeeding for 13 months without any more issues, and no plans to stop!

  18. glen says:

    Do you know what the recovery time is like after a laser tongue-tie and lip-tie procedure? My daughter had one done yesterday and she has been very cranky and will not latch (although I have not been trying hard, since we’ve always had latch issues).

    • Heather says:

      Procedures done with a laser tend to heal faster than those done with scissors/scalpels. My son was right as rain after 2-3 days except for the time of day we did the stretching exercises (which we did for 10-14 days following the procedure). Some kids take longer to heal, some don’t seem to notice it was even done. Although my son nurses MUCH better now I regret not asking a lactation consultant to help me work with his latch right after the procedure. He’s still a bit wonky in the way he nurses and I think it could have been more comfortable for me if I’d asked for more help.

  19. […] exclusively breastfed children are not without functional challenges these days. My son was born tongue-tied. We didn’t realize it until he was five months old and it took three months and two […]

  20. […] to me. Micah was an avid thumb sucker until he had surgery to correct his tongue tie – in fact the pic I shared right before the surgery is one of him sucking his thumb! From that point forward, though, […]

  21. Susan Olvera says:

    Just emailed Dr. K this evening. I’ve had it up to “here” with doctor’s not listening about these issues. My son has a lip tie ( diagnosed by our dentist 2 months ago ), possible a tongue tie, and 7 teeth with cavities and 2 teeth with decalcification. This was not caused by diet or poor hygiene.

    He had reflux/colic as a baby and has always had digestion issues. We’re taking a natural method to tooth remineralization and have seen remarkable results on his bottom teeth in just two months. The top teeth are struggling. Our holistic DDS wants to wait on the lip tie.

    We took him to a local ENT in Raleigh NC today, recommended by La Leche for a evaluation and she said she only clips if the membrane goes between the two front teeth and under the palate. His stops right at the top of his two front teeth, but a very thin piece of membrane goes between it. She also said he doesn’t have a lip tie. When I mentioned the tooth decay/lip connection, she looked clueless. Did I mention we’re not insured and at 200 % of the federal poverty guidelines? We wasted $100.00 today. It’s extremely frustrating. We also do not want to put him under G.A. for such a short, relatively simple procedure.

    Very happy to see your site here with the different suggestions. I look forward to hearing back from Dr. K. about this. So ready to have someone listen.

    • Heather says:

      I’m so sorry for what you’re going through, Susan! I hope Dr. K has some great suggestions and a referral for you <3

    • Nicole says:

      Whatever happened with your little one’s lip tie? We live in Raleigh and have an 18 month old with speech delay and looking like tooth issues. Have been wondering if a dentist will clip the tlip tie or the ENT. We saw an ENT when he was 4 months old suspecting tongue tie because he wouldn’t bottle feed and tnever suspected lip tie until e speech issues came up.

  22. […] so as his nutritional needs grew he compensated by nursing more often. (He turned out to be lip-tied, too, which made the problem even […]

  23. Susie says:

    I am SO glad I found this post. Yesterday I took my 2 year old to the dentist for the first time to check on some teeth that got knocked hard in a fall, and they found substantial decay on the backs on his top lateral incisors. I sighed knowingly, because I was certain that it is due to his lip tie, which we’ve known about since he was about 6 months. We discovered it because we started having nursing issues, which haven’t entirely resolved, but also aren’t bad enough to justify the procedure. But now with the teeth stuff, I’m revisiting the idea of clipping it.

    The dentist, of course, when I pointed out the tie, affirmed that it was tied, but denied the correlation between the tie and the decay, pinning the blame firmly on his nursing habits. He advised night weaning, no more nursing to sleep (neither is an option), and $2,000 worth of work to be done under general anesthesia.

    My dilemma is that my lactation consultant doesn’t think that at his age, even if we do clip it, that he will change his latch. We are about to start the GAPS protocol anyway, and I’m reading Cure Tooth Decay, and I’m hoping that the nutritional changes will help, even though we are already grain free.

    We live in Austin, so now I’m thinking that I’ll get a second opinion from Dr Cole and see where that leads us.

  24. Melissa Boyd says:

    Heather – did you do any dental treatments for Katie for the damage with a dentist, as well? I’ll probably take my daughter to see Dr Kotlow but am not informed enough yet on what conventional dental treatments might be acceptable to me as a natural parenting style, such as avoiding flouride treatments, to her damaged tooth due to the lip tie. Any suggestions on care resources? Thanks!!!!

  25. […] The Mommypotamus Lip Tie Q & A – Great blog post on questions that you may have about lip-tie. […]

  26. Ellie says:

    I am just stumbling across this and I am so happy to see that there is an issue like this. My son has what I think to be an upper lip tie. We identified the tongue tie at the Hospital, but didn’t even think this could also be tied…
    I wanted to send a photo to the doctor, but I can’t seem to find his email address…am I missing something??

  27. ellie says:

    Thank you. He is super nice and replied to my emails so fast. Thanks to your blog we have identified a severe lip tie.

    • Heather says:

      I am so glad you were able to identify the issue, Ellie! I hope you find that the discovery helps you make the best decision regarding what to do going forward.

  28. Lily says:

    Hi there- I’ve become obsessed with your blog! There are HOURS of reading here! I found this post particularly interesting. As soon as I saw the first pictures I ran to google and found out that I actually have a lip tie. Apparently I turned out fine! I had really weak baby teeth, but after my adult teeth grew in I didn’t have any cavities. I DO have one, but it’s because when I had braces they did a poor job gluing on a band on a molar. I’m still finding it really weird knowing that my “lip tie” that I’ve lived with my whole life isn’t normal!

  29. Sarah says:

    We took my daughter to see Dr Kotlow at 7 month and she had the laser procedure done on her lip tie and tongue tie. Dr Kotlow was AMAZING!! So very nice and informative! The procedure literally took less than five minutes. I felt like we blinked and it was all done. My daughter did amazing! There was only a tiny bit of blood and she didn’t even seem to be in much pain. It healed beautifully and quickly. I had NO PAIN or pinching when she latched on after the procedure. Two months later, we are still breastfeeding and she’s doing amazing! Heather and Dr Kotlow helped save our breastfeeding relationship when none of the doctors or lactation consultants we saw could help. No one knew why my daughter was an inefficient breastfeeder, they just assumed she was a lazy feeder or that I had low milk supply. Neither were true! Thankfully I also had the support of a la leche league group who encouraged me to feed her on demand as often and she would like and I pumped liked crazy. After 6 months of an up and down supply, struggling to keep my daughter’s weight gain up, and dealing with post partum depression because of the stress, I’m so happy we were able to stick it out and FINALLY figured out the problem. Thank you again!

  30. […] cracked/blistered nipples, plugged ducts, and reflux. Those are just the things I found from this list that we’ve already experienced. I’d like to figure it out before Anders has weight […]

  31. Natalie says:

    I am 33 and had a lip tie. When I was 10 our dentist did a little laser work and corrected it in a few minutes. I just noticed that my 5 yr old has one because if the gap in his front teeth, which this the same issue I had. . Once mine was corrected my to front teeth closed together. The dentist said that your teeth gap because of the heavy blood flow that runs through the lip tie. I didn’t know that it could effect speech, because right now my son is in speech therapy.

  32. Tawnya says:

    Thanks so much for sharing this information. It would appear that my oldest son has a lip tie which is causing a gap in his front teeth & may have been why he was so gassy as a baby & self weaned at 12 months (also I got blocked ducts a couple of times which was horrible). He’s 3 now & I’m planning on contact the dentist you recommended to see if he thinks he should have surgery. I’m concerned that he’ll need braces later. If this is the cause of the gap & can be remedied that’d be great. My other son is 6 mo. old & has also been gassy, not nursing well (frequently will stop & cry & then nurse some more, repeat), my milk supply seems low, & he won’t take a bottle & if he does he mostly chews on it. So, I’m wondering if he has 1 of these issues too. I plan on try to see when he wakes up from his nap.
    Since it is hereditary I contacted my s-i-l too, as her son (now 5) had reflux as a baby, had speech delay & is still hard to understand. Her daughter (now 2 & 1/2) also is speech delayed & even now only says a hand full of words. So, I’m wondering if perhaps that they have 1 of these issues too. Again, thanks for the info I really appreciate it. Especially if it will help our kids. :)

  33. Dave says:

    Whoops! I just noticed I commented on two different entries! I promise I’m not being overly inquisitive. haha Feel free to only respond to one of my comments since they both ask the same question. Sorry bout that! :-)

  34. Kathey says:

    Hi Heather! So glad I’ve read these posts. Breastfeeding has been getting more difficult with my 12 month old and now we are taking him to Dr. James Jessee next week to have his class 4 LT undone (there might be a tongue tie too, not sure). I feel so grateful for all the information available here and via the WAPF for raising healthy children, but I’m feeling discouraged because I want to be less critical of my son. I was vegetarian for may years when I conceived and didn’t get on a traditional diet until he was 8 months old when I saw all the cavities I had developed. Seems the more I learn, the more regret I have, despite him being super healthy and active. All the information about how allergies, bone structure, etc empowers me to keep us all on a nutrient dense diet, but it can be so overwhelming and seems like I’m looking for things that aren’t perfect because of my previous diet, showed up in him and now need to be fixed. Am I the only mom who feels this despair underneath all the positive changes in our life?

    • Samantha says:

      Hi Kathey, I’m thinking of taking my daughter to Dr Jesse too… any review/information you can provide – my daughter is 18 months.

  35. Sarah says:

    I called Dr. Kotlow’s office and they were able to recommend a dentist in the DC area who they recommend assess and perform surgery for an upper lip tie. I have an appointment with Dr. Marcus next week who trained with Dr. Kotlow. It’s worth calling to see if he recommends someone in your area if traveling is not possible.

  36. Jasmin says:

    Thank you for this article! As I was looking to the pictures you posted, I looked at my 11 months old son and saw the exact same thing on him. He has 2 teeth on top and it has a gap in the middle. I didn’t paid so much attention to this because he was and is a great baby when it comes to breastfeeding. I did not had problems on him latching to my breasts although I had 2 incidents of plugged ducts. He didn’t liked bottles or pacifier but it didn’t really bothered me. For the first 3 month he was a colicky baby but he improved a lot better now. He has some sleep disorders and even until now, he would wake up every 3 to 4 hours during the night to feed. Can you please advise me Heather on this, is this a cause for alarm? We live in Colorado and flying to NY could be really expensive and I’m afraid that we can’t afford it right now. Thank you.

  37. Jasmin says:

    Hi Heather. After seeing the pictures you posted, I checked my 11 month old son and it appears to me that he has lip tie causing a gap between his 2 front teeth. But he was and still is a very good eater, never had a problem with his latching except for the 2 occasions where I had plugged ducts. He was a colicky baby for the first 3 months but has gotten better as he grew older. He still wakes up every 3 to 4 hours during the night to feed. He didn’t liked taking pacifiers or bottles but never really bothered me so much. The thing is, after reading your blog I am worried that it might cause complications in the future. We live in Colorado and flying to NY is not possible at the moment. Should I have him checked? Please advise. Thank you.

  38. Eliza says:

    My daughter finally got diagnosed with a lip tie. 20 months after feeling so guilty for her being unable to breast feed I have an answer as to why. No amount of help from the LC helped! I am headed to New York to get this corrected. I was wondering what you used for pain control if anything for your son. I really don’t want to use Tylenol. She is not nursing at this time. Any information would be appreciated. Thank you!!

  39. amber b says:

    maybe this is a dumb question, but do you not feel there are negative side effects to laser treatment? i know nothing about it and respect your opinion on natural alternatives, so i was just curious if you’d done any research or what your reason for confidence in laser treatment was? I obviously see how it’s more effective and less painful than the scissor method, but is there evidence that laser treatment can cause any other problems?

    • Heather says:

      Hi Amber, I would check with your dentist/ENT on that. Like any instrument, they need to handled by someone who is capable of using them correctly, but I am not aware of any known side effects.

  40. Racheltwo says:

    Thank you SO much for this information. After one month of increasing difficulty with breastfeeding, numerous consults with lactation consultants, la Leche, the pediatrician, and two terrible days with hardly any eating whatsoever, I finally stumbled across your website on Monday. Today (Wednesday), we have a diagnosis (lip tie and posterior tongue tie) and an appointment with Dr. Marcus (DC/Baltimore area) to get it fixed tomorrow!! I can’t thank you enough for your information. Without the links to Dr. Kotlow, who was an invaluable resource, and your descriptions, I’m not sure we would have known what to do. While we haven’t had the procedure yet, Dr. Marcus has been incredible thus far – and is recommended by Dr. Kotlow as well. He may be worth adding to the list. :) Thanks so much, from a mommy that has some hope.

  41. Jill says:


    I wish I had found this article a year ago!! My two year old daughter has terrible teeth which we have been trying to heal with the heal your own teeth protocol. It seems to have slowed the decay but is not reversing it. I am almost certain we have a lip tie issue. We are in Austin, Tx so I am looking into Dr. Cole. Can Dr. Cole also help with reversing the dental decay or did you just see him for the lip tie and then do your own reseach/work for healing cavities? I feel like we are behind the curve on this! I am currently still nursing my DD at 27 months. Should I try harder to wean her?? I feel like she isn’t going to have any front teeth left. Thanks!

  42. Jessica says:

    Dr. James Bronson of Bronson Family Dentistry in McLean, VA will treat these with a local anesthetic and laser – he has corrected my 7 yo & 5 yo’s tongue ties, and my baby’s upper lip tie (no anesthetic for the baby). The older kids did therapy along in prep for and during recovery to help their tongues heal properly. Hope that help someone! Just learned all of our babies had issues with this last year. It really does make a difference!

  43. Samantha says:

    Hi Heather, I wanted to thank you SO much for doing a podcast on the Wellness Mama with Katie. I listened to the podcast a few days ago and came home to check out my 18 month daughter and she has a horrible lip tie (stage 4 I’m guessing). I’m now on a quest to find someone that will laser it. I had a miserable first 4 months with my daughter and had no clue even after seeing lactation consultants that this was a thing. I had never heard of a lip tie before. My daughter ended up just refusing to feed altogether and I introduced a bottle and she became a different baby, but I ended up exclusively pumping until my supply diminished around 13 months or so. I noticed a couple weeks back that her teeth are now yellowing and have been brushing them more. I just thought the skin was normal and would lessen over time. I feel so foolish for not knowing sooner. It would have changed my first few months memories of my sweet daughter significantly if I had known.

    • Heather says:

      Oh Samantha, it makes me so happy and sad to read this. I know firsthand the feelings of “I wish I had known” and also the feelings of relief that there really **was** a reason things were so difficult. Thank you for sharing your story. Hugs to you, mama.

  44. George says:

    So my wife and I have 7 month old boy. He has both a lip and tounge tie. He has never had an issue with latching and feeding, my wife hasn’t had any major issues with her nipples either. We were told to leave these as the tounge tie my stretch out, as far as he lip tie goes we were also told to leave it as he has very good definition of his lips. Our boy is able to get his tounge out just past his lip. I guess I’m just wondering should we have this corrected or just let nature take its course and see what happens?

  45. Sheri says:

    My son is lip tied, I am now waiting for a call back from the Dr. My son is 16 months old! I had difficulty getting him to latch but the lactation consultant showed me techniques to help him and me…none of us knowing at the time he was lip tied, they only saw he was a tongue thruster! I didn’t notice the lip tie for some time and then since he is a BIG boy and had always been so healthy I kept forgetting to ask about the odd feature that I never remember my other three having…till last night, he fell and must have broken it. After he fell I picked him up and checked him over, he had blood in his mouth and my fears were he bit through his tongue or lip, or cheek. It was not until he calmed down and later fell asleep with his mouth open that I saw the lip tie was broken and already healed closed on the broken ends. It’s never easy when we find out our babies have something that may need corrected, hugs to all who have been here and all who are following.

  46. Diana says:

    Hi, I know this post is old but I figured I asked anyway. I have an appointment with Dr. Kotlov next Tuesday. My son is 13 months old and both lip and tongue tied. He never had a problem latching nor nursing. I decided to have the procedure done after reading your post (thank you, I was unaware of all the issues). I was wondering if anyone had this done to a 13 month old and, if so, how they reacted. Were they able to nurse afterwords? I’m very nervous…. Thank you :)

    • Melissa says:

      My daughter had hers at 13 months! She was fine afterwards. A little red-faced from crying (I think from the swaddling most likely), but perfectly fine. She nursed immediately after the procedure. She seemed uncomfortable several hours later, in the night time, but we gave arnica, aloe and teething gel as well as some dissolved caldendula Boiron tablets with a little water using a dropper. She was fine. The stretches were challenging afterwards, but we did them anyway to prevent re-attachment. The procedure prevented further tooth decay, got rid of my recurring mastitis, engorgement and nipple blisters, and got her back on track with speech with a little pathologist help. I only wish we had known sooner! She was glued to me as she never (she couldn’t because of the lip tie, but we didn’t know) took a bottle.
      The procedure is so fast. He will be away from you for only a few minutes and then right back. They are quick paced there, so be sure to ask what questions you have. After the waiting room, you go into another tiny room to wait, meet the Doc and watch a video. Then he will come back and take your son, then bring him back and have you nurse right away (that man has probably seen more breasts than anyone else! :) ha.).
      I bet it will go very smoothly for you and your son!

  47. Chelle says:

    I remember reading this (or another article on problems with breastfeeding/tongue and lip ties) when my son was first born, and I’d be up all hours of the night reading and doing stuff, because I couldn’t sleep. But then I had to wonder if I was just looking for something to be wrong (and while a lot of things pointed to it, it wasn’t like I had any real problems, I just read the article and thought that a lot of the signs were present). Well… fast forward quite a few months (like 10) and we were at a friends who was talking about her twin babies both having to have their clipped (one just one side, the other top and bottom) and so I showed her my sons lip (he now has his two front teeth which came in with a huge gap, because of the tie)… There was no question. So, what I am wondering is, if he is already weaning/we are both moving in that direction and I’m fine with that (he’s over 14 months old), and he seems to eat solids fine, how do I know if I need to still consider having it clipped? Are there reasons other than cosmetic?… I mean, I saw the tooth issues that are “possible” and things like that, but health risks/benefits to having it clipped? How do I really know (like the ability of cleaning a spoon?)… And I understand not supporting wait and see, but if we’re past that (like, any feeding issues it caused while nursing are now near the end, and it is not going to make him wean earlier – we are ready to wean)… so now, is wait and see a practical approach? Please help. Thanks!

    • Heather says:

      Hi Chelle, according to conversations I’ve had with Dr. Kotlow, an untreated tongue tie can sometimes cause issues past the weaning age. I can’t remember all of what he mentioned, but I know TMJ was one of them. It might be worth having someone who is knowledgeable about ties evaluate him.

  48. Andrea says:

    Hi my name is Andrea…I know this is very late but I just came upon this and was very interested. I have been looking this up and I belive I have a lip tie. I’m already 16 years old and I was wondering if I am already to old to get any procedures done due to maybe nerves or other things?

    • Veronica says:

      I would say no. I got mine cut at 14 or 15 when i had braces because it caused me to have a huge gap in my teeth

  49. Veronica says:

    Do the tongue and lip ties only affect breastfed babies? I’m bottle feeding and I think my baby may have a lip tie so I was just wondering if it’s a big deal for bottlefed babies

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