When is frenectomy necessary for infants And the most important post surgery tips

Many mothers notice that their baby gets tired while breastfeeding, struggles to latch properly, or sometimes milk dribbles from their mouth, accompanied by a clicking sound during sucking.The truth is, the cause could be very simple yet quite common among infants: a lip tie or a short frenulum! The frenulum is a small piece of tissue that connects the lip to the gum. When it’s tighter than usual, it can affect the movement of the lip and make breastfeeding more difficult.And that’s when the question every parent wonders arises:
Does my baby need a frenectomy, or will it get better on its own over time?

In this article, we’ll cover in detail:

How to tell if your baby has a lip tie.
The signs that indicate the condition needs intervention.
The types of surgery your doctor might recommend.
Important tips after the procedure if it’s necessary.

Follow the article to the end to understand everything calmly and make the best decision for your baby ❤️

What is a Lip Tie (Frenulum) in Infants?

A lip tie, also known as a labial frenulum, is a thin piece of tissue that connects the upper lip to the upper gum or the lower lip to the lower gum.

This tissue is present in all babies and helps the lips move naturally during breastfeeding and speech.

However, in some cases, the frenulum can be short, thick, or too tight, which is what we call a "lip tie."

This condition can cause problems in:

Breastfeeding: The baby may have difficulty latching properly.
Dental development: It can cause gaps between the front teeth.
Speech later on: If untreated, it may affect pronunciation.

Lip ties are more common in the upper lip, but they can also occur in the lower lip. While having a frenulum is normal, severe cases may require a simple intervention by a doctor.

Should Bottles or Pacifiers Be Used for Babies with a Lip Tie?

Generally, no. Using a bottle or pacifier can make it harder for babies with a lip tie to suck effectively.
If your baby needs them, it should only be under the supervision of a pediatrician or lactation consultant to avoid worsening the problem.

When Should an Infant Be Seen by a Doctor?

If you notice that your baby:

Gets tired or struggles while breastfeeding
Milk dribbles from their mouth
Or is not gaining weight properly

…you should consult a pediatrician or pediatric dentist to assess the severity and decide if intervention is needed.

Is Frenulum Release Painful?

Not at all. The procedure is very simple, quick, and usually doesn’t cause real pain for the baby.
Most infants can breastfeed within minutes, and discomfort typically improves the same day or the next day.

Can a Lip Tie Resolve on Its Own?

In mild cases, the frenulum may stretch naturally as the baby grows.
But if the tissue is thick or very tight, it usually won’t resolve on its own and may require a simple procedure called a frenectomy.

What Happens If a Lip Tie Is Left Untreated?

Untreated lip ties can cause problems that appear at different stages of development:

Early on: Difficulty breastfeeding, fatigue, or slow feeding.
Later: Gaps between upper front teeth, speech delays or difficulties, gum recession, and uneven jaw or altered smile appearance.

Early diagnosis and treatment can prevent these complications.

Upper Lip Tie vs. Lower Lip Tie in Infants and Children

Comparison	Upper Lip Tie	Lower Lip Tie
Location	Tissue between upper lip and upper gum	Tissue between lower lip and lower gum
Prevalence	More common	Less common but can occur
Observation in infants	Usually noticed during breastfeeding due to poor latch or milk leakage	Sometimes noticed during breastfeeding but less obvious
Signs during feeding	Difficulty latching, milk leakage, clicking sound, cracked nipples, slow weight gain	Quick fatigue during feeding, minor milk leakage, difficulty closing lower lip tightly
Effect on teeth	Gap between upper front teeth, tension in upper gum	Possible gum recession or exposed lower teeth
Effect on speech	May affect pronunciation of sounds like “f”, “b”, “m”	Rare, only in severe cases
Lip appearance	Upper lip appears lifted and tight, smile may be affected	Lower lip appears droopy or tight downward
Symptoms in older children	Difficulty cleaning teeth, food trapping, gum discomfort	Mild gum tension or slight discomfort when moving lip
Diagnosis	Visual exam by pediatrician or dentist, sometimes using a simple tool to assess lip movement	Same method, to check flexibility of lower lip
Treatment	Observation if mild; simple surgery (frenectomy) if affecting feeding or teeth	Same procedure, minor surgery improves feeding and speech
Best timing for intervention	Days to months if affecting breastfeeding, or after 1.5 years if affecting teeth or speech	Based on case, usually after 6 months if clear issues

Causes of Lip Tie in Infants

Lip tie usually occurs due to genetic factors or development inside the womb, not because of birth method or feeding.

Cause	Explanation
Genetics	Most common; often a family member (mother or father) had the same issue as a child.
Incomplete development during pregnancy	During formation of the mouth in the womb, the tissue that connects lip to gum should recede or become thinner. If not, the frenulum may be short or thick.
Tissue formation issues	Sometimes tissue is less flexible or thicker than normal, making the frenulum tighter.
Tongue tie also present	Some babies have both tongue tie and lip tie, related to oral tissue development in the womb.
Not related to birth position or feeding	The condition is caused by genetic and tissue factors, not by how the baby was born or fed.

Types of Labial Frenulum in Infants

The labial frenulum is a small thread of tissue connecting the lip to the gum, and its shape and attachment location vary from child to child.

Type	Description	Potential Issue
Mucosal Frenum	Attaches near the base of the lip, not reaching teeth	Usually normal, rarely causes problems
Gingival Frenum	Attaches higher, closer to front teeth	May cause mild tension, rarely affects breastfeeding
Papillary Frenum	Reaches the small gum ridge (papilla) between front teeth	Can cause small gap or tension while feeding
Papillary Penetrating Frenum	Extends between front teeth to inner gum	Most problematic; often requires surgery due to impact on feeding and teeth

???? Important tip for mothers:
Not every visible frenulum is a problem.
What matters is how tight it is and how it affects lip movement and feeding, not just its presence.

Symptoms of Lip Tie in Infants

Lip tie in babies can be mild, moderate, or severe, which determines how obvious the symptoms are.
Here are the main signs that may indicate your baby has a lip tie:

During Breastfeeding

Difficulty latching properly.
Clicking or “popping” sounds while nursing.
Milk leaking from the corners of the mouth.
Baby tires quickly or falls asleep before finishing a feed.
Slow weight gain despite regular feeding.

Effects on the Mother

Nipple pain or cracking due to improper latch.
Engorgement or recurrent breast infections because the baby isn’t emptying the breast properly.

Lip and Mouth Appearance

Upper or lower lip does not move up or down naturally.
Visible tight tissue between lip and gum when gently lifting the baby’s lip.
Difficulty opening the mouth fully while sucking.

As the Baby Grows

Gap between the front teeth.
Difficulty pronouncing sounds like “f,” “b,” “m.”
Mild tension or discomfort in the gums when laughing or talking.

How Lip Tie Affects Breastfeeding

Problem	How Lip Tie Causes It	Signs Mom May Notice
Difficulty latching	Lip tie prevents the lip from flipping outward properly, so the baby can’t latch onto the nipple or areola correctly	Baby repeatedly tries to latch, lets go quickly, or cries
Milk leakage	Lip cannot seal tightly on the breast	Milk dribbles from baby’s mouth or chin
Clicking sounds	Air enters the mouth instead of keeping a tight seal	Mom hears repeated clicks or popping sounds
Swallowing air (gas/colic)	Baby swallows air during feeding	Baby cries after feeding, bloated belly
Fatigue while feeding	Baby works harder to extract milk	Baby falls asleep mid-feed
Poor weight gain	Weak suck = less milk = fewer calories	Weight increases slowly
Nipple pain/cracks	Baby pulls on nipple to compensate for weak latch	Severe pain or cracked nipples after each feed

Development Stages of the Frenulum in Infants

The frenulum (the thin tissue connecting the lip to the gum) changes in shape and length as the baby grows.

Age	Frenulum Shape & Function	Notes
Birth – 2 months	Thick and prominent between lip and gum	Normal unless it affects breastfeeding
3 – 6 months	Longer and more flexible	If baby feeds well, everything is fine
6 – 12 months (teething begins)	Gum changes with emerging teeth; frenulum moves slightly upward	Mild tension or small gap is normal
1 – 2 years	Frenulum matures, flexibility increases	Mild tension may resolve on its own
After 2 years (primary teeth stage)	Final shape usually normal	If still thick, doctor may consider removal

Important note: Not every visible frenulum is a problem. Doctors usually wait until teething to see if the frenulum loosens naturally. If it affects feeding or breathing, early intervention is recommended.

Home Check for Lip Tie in Infants

Mothers can notice potential lip tie at home, but should be very gentle:

Step	Method	What to Observe
1. Wash hands	Ensure hands are very clean before touching baby’s mouth	—
2. Gently lift the lip	Use your index finger to lift upper or lower lip slowly	Lip should move easily and naturally
3. Observe the tissue	Look at the thin band of skin connecting lip and gum	Thick or tight tissue may indicate a lip tie
4. Watch lip movement during crying or feeding	Observe lip flipping naturally	If lip doesn’t move, lip tie is likely
5. Observe lip while feeding	Watch in a mirror if needed	If lip remains “closed” and doesn’t flip, it’s a sign of tie
6. Monitor other signs	Difficulty latching, milk leakage, slow weight gain	Multiple signs increase likelihood of lip tie

⚠️ Note: Home observation gives an initial idea only.
Final diagnosis must be done by a pediatrician or pediatric dentist, as some ties are mild and don’t require intervention, while others may need a simple procedure called frenectomy.

Problems of Untreated Lip Tie in Infants

If left untreated, lip tie can cause issues from infancy through childhood:

Stage	Possible Problems	Explanation
Breastfeeding	Difficulty latching, milk leakage, slow weight gain	Limited lip movement reduces effective sucking
Mother	Nipple pain, cracks, engorgement	Baby doesn’t empty breast properly
Digestive issues	Swallowing air, colic, bloating	Air enters instead of milk
Teething	Gaps between front teeth, gum tension	Tight frenulum affects gum and teeth alignment
Oral hygiene	Difficulty cleaning teeth, food accumulation, gum inflammation	Limited lip movement makes cleaning hard
Speech	Difficulty pronouncing “f,” “b,” “m”	Lip not flexible enough for proper sounds
Smile & lip shape	Tight or raised/lowered lips, stiff smile	Short frenulum restricts natural lip movement

Important: Not every baby with a lip tie will have all these symptoms, but if a mother notices multiple signs (like feeding difficulties, gaps between teeth, or speech problems), the baby should see a doctor promptly.

Frenectomy vs. Frenuloplasty in Infants

Comparison	Frenectomy	Frenuloplasty
Definition	Complete or partial removal of the tissue connecting lip or tongue to gum	Adjustment of frenulum shape and position without full removal
Goal	Remove excess tension affecting feeding or lip movement	Improve frenulum shape/flexibility for normal lip movement and appearance
When used	When frenulum is very short or tight affecting feeding/teeth	When frenulum is moderate tension or affecting appearance/function
Procedure	Cut with simple surgical tool or laser, usually no stitches	Tissue adjustment with delicate cosmetic sutures
Duration & ease	Very short (1–5 minutes), baby can breastfeed immediately	Slightly longer (10–15 minutes), usually under local or mild sedation
Recovery	Very fast, heals in a few days	Slightly longer due to stitches, follow-up required
Expected results	Immediate improvement in feeding and lip movement	Cosmetic and functional improvement in moderate cases
When doctor decides	Primary goal is improving breastfeeding	When cosmetic or moderate tension can be corrected without full removal

Diagnosing Lip Tie in Infants

Diagnosis is usually based on observing symptoms and a simple exam, sometimes even mothers notice the signs.

Diagnosis steps:

Initial observation by mother: Notice breastfeeding difficulties such as poor latch, milk leakage, clicking sounds, or slow weight gain.
External lip exam: Gently lift the upper or lower lip to check for thick or tight tissue between lip and gum.
Assessing tension: Graded from mild (flexible tissue) to severe (thick, tight tissue).
Specialist exam: Pediatrician or pediatric dentist evaluates lip movement, frenulum shape, and effect on feeding or speech.
Feeding assessment with lactation consultant: Observes latch and mouth seal to confirm if frenulum is the cause.

Important notes:
Early diagnosis prevents feeding problems and nipple pain.
Mild cases may only require monitoring; severe cases often need frenulum release (frenectomy).

Frenectomy in Infants

A frenectomy is a very simple procedure performed when the tissue connecting lip and gum is too short or tight.

Goals:

Improve lip movement
Facilitate breastfeeding
Support proper breathing and speech development

Types of Lip Tie Surgery

Surgery Type	Description	Advantages	Disadvantages
Traditional scalpel (Frenectomy)	Cutting the frenulum manually with a small surgical tool	Simple, can be done in clinic without general anesthesia	Slight bleeding, requires wound care
Laser Frenectomy	Laser cuts tissue and seals blood vessels simultaneously	Faster, almost no bleeding, baby can feed immediately, faster healing, less pain	Requires specialist and laser equipment, slightly more expensive
Frenuloplasty	Adjusts position and shape of frenulum with cosmetic sutures	Preserves natural lip shape, suitable for moderate cases	Slightly longer, requires local anesthesia and precise suturing
Partial Frenectomy	Cuts a small portion to reduce tension	Good for mild cases in very young infants	May require follow-up if tension returns with growth

After Surgery:

Baby can usually feed immediately or within a few hours.
Doctor may recommend gentle lip exercises after procedure.
Healing occurs within a few days, results usually excellent.

Steps of the Procedure in Infants

Assessment: Doctor examines lip and mouth to determine need.
Sterilization & local anesthesia: Mild spray or gel for pain-free procedure.
Frenulum release: Using small surgical tool or safe laser for infants.
Control bleeding: Minimal, stops within seconds, especially with laser.
Immediate feeding: Encouraged to aid healing and lip movement.

⏱ Duration: 1–5 minutes, baby can feed normally afterward.

Benefits of Frenectomy in Infants

Immediate improvement in breastfeeding latch
Reduces nipple pain and cracking for mother
Prevents future dental issues, like gaps between front teeth
Restores normal lip movement, aiding proper speech development

Post-Operative Care

Tip	Explanation
Breastfeed immediately	Reduces pain and prevents tissue adhesion
Cold compresses	Soft cotton soaked in cold water (not ice) for minor swelling
Oral hygiene	Gentle cleaning once daily with warm, damp cotton
Pain relief as advised	Mild pain relief gel or medication per doctor’s instructions for first 1–2 days
Lip exercises	Gently lift lip twice daily to prevent tissue sticking; light massage under lip with clean finger
Avoid irritants	No creams or antiseptics without doctor’s advice
Follow-up after a week	Ensure healing and proper lip movement

⚠️ Important: If baby still struggles to feed, or there is excessive bleeding or redness, return to the doctor immediately.
In most cases, improvement is noticeable within the first 1–2 days.

Important Exercises After Frenectomy in Infants:

1. Gently Moving the Lip Up and Down

Wash your hands thoroughly.
Use your index finger or thumb to gently move the upper lip up and down.
Do this twice a day for 1–2 minutes.
Purpose: Prevent the lip from sticking to the gum and improve flexibility.

2. Gentle Lip Massage

Place a clean finger under the upper or lower lip.
Massage the lip with small, gentle circular motions.
Purpose: Relieve tension in the new tissue and stimulate natural movement.

3. Opening the Lip During Feeding

Observe the lip movement while breastfeeding.
Encourage the baby to feed while ensuring the lip moves freely.
Purpose: Acts as a natural exercise for the lip during feeding.

4. Mirror Exercises (for Older Children)

When the child is a bit older, the doctor may recommend teaching them to move their lips in front of a mirror.
Purpose: Improve muscle control and achieve a natural smile appearance.