A frenum is a naturally occurring muscle attachment, most commonly seen either under the upper lip or tongue. When this muscular attachment is more prominent than normal, it can limit the movement of the upper lip or tongue resulting in either a Lip Tie or Tongue Tie. Because the lips and tongue are integral in swallowing and speech, the great majority of problems arising from lip and tongue ties are related to feeding/eating and speaking in babies, toddlers and children.

What can happen with untreated lip and/or tongue ties?


Feeding difficulties including poor latching, colic symptoms, reflux symptoms, poor weight gain, frequent and short feeds. Mothers may have significant discomfort while nursing leading to the decision to bottle-feed their baby and abandon nursing.

Toddlers and Children

Toddlers may have difficulty transitioning to more solid foods and develop a hyperactive gag reflex due to the limited movement of their tongue. Lip-ties can cause spacing between the 2 upper front teeth and difficulty brushing the area leading to formation of decay on the front teeth.

Speech issues may arise between the ages of 2 and 3, especially when children are trying to make sounds with the consonants: l, r, t, d, n, th, sh and z. Evaluation may be needed if more than half of a three-year-old child’s speech is not understood outside of the family circle.


Babies tolerate the procedure very well and we try to ensure that discomfort is minimized. A topical numbing gel is placed on the area and a very small amount of local anesthetic is given. A laser is then used to release the frenum. The use of a laser minimizes bleeding and eliminates the need for sutures. It is common for babies to cry and/or act fussy during and after the procedure. Once the procedure is complete, your baby is immediately brought to you. The procedure takes approximately 5 minutes to complete.

Postoperative Care

Once the lip and/or tongue ties are released, it is very important to prevent reattachment. Reattachment is prevented with stretching exercises. Stretching of the lip and/or tongue and finger sweeping under the lip and/or tongue must be performed 6 times a day for 3-4 weeks after the procedure.

Nursing can resume as normal immediately after the procedure.