Attached Upper Lip Frenulum - advice needed

[jills]

My 18 month old son has an attached upper lip frenulum (i.e. the skin that attaches the upper lip to the gum grows right down between his two front teeth, a bit like a tongue tie but on the upper lip). We never noticed it until his front teeth came in with quite the gap - adorable, but it's a good one. When he was born they only checked his lower mouth for a tongue tie. Once we figured out what he had (he was close to a year?), I flagged this with the HVs (Edinburgh at the time) who just shrugged and said it will probably go away. More recently, my dentist suggested it may need to be snipped, but he's in Canada.

So I'm wondering if anyone else has had an experience with this and could give some advice. There seems to be a big, scary 'to snip or not to snip' debate. Dentist also wanted more teeth to grow in first, which makes sense to me, but some reports say a snip earlier mitigates teeth and speech issues.

Advice greatly appreciated!

PS - It's always worth checking those upper lips if you're having trouble with bf in the early days. I wish I had looked into it more at the time as I now see it's probably why we had so much trouble breastfeeding and never got a proper latch. We did our own version of bf (bad latch followed by formula) that lasted 5 months, by which time he was not interested as I clearly didn't have much milk (never did, and was only ever able to express one ounce at a time - sometimes pumping for 30-45 min to get that ounce - ahh the memories). We had been admitted to NICU for a week post birth due to birth weight dropping so much, followed by 2 different feeding clinics (twice a week for months), numerous midwives, HVs, and GPs and no one ever picked it up. Had we only looked at that little lip we may have saved ourselves a lot of grief!

[Ruth_Baldock]

Hello,

Our 14mo old has this, luckily it didn't affect his breastfeeding but he does have those tell-tale 'Madonna' teeth. We were going to leave it, but me and my husband have a nasty feeling it's affecting his speech. There are certain sounds he CANNOT make- and it frustrates him. We can see him trying over and over to say things and he gets so upset that he breaks down into floods over it. With that in mind, we are thinking of getting the snip for him, but are trying to put it off as long as possible.

[Fudge]

I had the operation to cut mine (about 20 odd years ago) when I was in my early teens. I had completely forgotten about it until I saw your post - don't think that I have ever come across a fellow "frenulumian"

Don't remember much about the operation - which is a good sign.... Had it done at Kings. I had to have the stitches removed a few days later which was a bit uncomfortable but I expect the procedure may of changed in the years that have gone by.

I was a breastfed baby and my mother has never mentioned any problems she had feeding me nor any speach problems.

good luck with whatever you decide to do

[jills]

Thanks for your posts. Ruth - it must be hard to watch him get frustrated at not being able to say things. I am starting to wonder about speech too but it sounds like your little one has a lot more words than ours so I can't tell much yet. I'm now worried he will sound like Madonna...maybe an attached frenulum caused that weird accent! Fudge - Am glad to hear that the operation even later on wasn't a point of concern, thanks. I have heard it's possible for it to be done by laser these days, but only by dentists.

It's great to hear that the attached frenulum doesn't cause everyone bf problems. I should have said that because of the particular shape of my son's mouth things were more complicated for us. His upper lip is pulled very low/tight, he still can't open his mouth very wide (we have to use very flat spoons), and he has the cutest, but barely there, thin little lips so combined with the attached frenulum, all made for suction problems. There was always air getting in at the sides. Oh, am totally happy to blame my boobs too.

[Gussy]

Hi Jills my son has this and also has tongue tie. We struggled to breastfeed and went through a year of trauma. I've literally just stopped bfeeding (he's 1 year next week) as after my 5th round of mastitis and cracked bleeding nipples I just couldn't go on any more.

Anyway, I self diagnosed his upper lip tie around 4 months as I noticed when he latched his top lip would curl under instead of outwards, and his frenulum was really tight and attached right to the tip of his gum. He had a poor seal around the breast, swallowed air and it caused colic (and lots of frustration and upset for our family). I mentioned this to lactation consultant No.4 who wasn't too sure, but after getting out her book with photo's in it, she agreed with me. As with what to do, she had no idea and just said to ask the surgeon at Kings to snip it at the same time as snipping the tongue tie! (I didn't get around to it in the end.....long story). Anyway, at 7 months my little boy got his front 2 teeth and like you, he has a big old gap between them. I've done a lot of Googling and it seems the dentists in the US and Canada are much more clued up on this and treat it quite commonly. Everyone here (including a speech therapist) didn't really have any advice. I'm going to take him to the dentist soon just to see his opinion. But I'm not planning on doing anything until he starts talking and then re-evaluate. It's a difficult one, I'd like to find a specialist dentist or experienced dentist in this area but haven't come up with anyone yet.

On a side note, does/did it affect his swallowing? Or does he dribble a lot? My little man has a few difficulties with swallowing lumps, so we are a bit behind everyone else with weaning....not concerned though, but wondered if you found the same? It's not often I've heard of anyone else with upper lip tie, I thought I was battling on alone!

[jills]

Hi Gussy, good for you for managing the bf so long - hats off. I'm sorry to hear you've not been getting too many answers either. It's funny you mention the weaning - at 18 months my son still won't go near anything with lumps because of a bad time swallowing in the early days. He basically went from purees to pieces of food - but is still very fussy about what he eats. We started out well because of soft stage 1 foods, but soon fell behind everyone else. I had it chalked it up to a fussy eater. I try not to worry about it, but definitely something to consider. I have noticed a slight improvement in the last month which I'm trying to take as a sign of good things to come. You're not alone!

[KM]

My daughter, now 5, also has this. It affected neither her feeding, we managed 13 months, nor her speech, but our dentist has been monitoring it, and had suggested to wait and see how, and if, it changes with her face and teeth growing. It does look significantly different now at 5, and as she has grown, and got all her teeth,her front teeth have closed slightly, and she seems to have more of a stretch to her lip. Not sure what will happen when she loses them though..... We're back to the dentist next month...

[BanJo]

My daughter is 4 and has this too, as did I as a child. Got mine snipped around 8 from what I remember as had a big gap between my front teeth as they came through. My daughter is complaining that her mouth is sore and is making a fuss when I am brushing her teeth saying it hurts. I think she must have irritated the tissue between her front teeth from eating something. Dentist has referred us to Kings for them to decide whether she needs to have it removed now or later. In the meantime, dentist's advice was no biting in to apples and wait for cereal to go a bit soggy before tucking in. Tbh, though not happy at the thought of her having an operation however minor, I would rather get the problem sorted now as I'm worried that we're not cleaning her teeth properly as always going gently round that area. I have a feeling we will probably be told to wait and see.

[Belle]

This is an interesting thread...I have a gap and my dentist recently told me for the first time about the frenulum (though suspect mine wasn't really that attached), he said often they kind of recede themselves (?! perhaps I'm getting this wrong) as you grow up, and that I could have had something done to ensure the teeth came together - and still could. As it is, I like my gap :)

[anna_r]

My 7 month old's top front teeth have just come through with a big gap so I've just checked this and it looks like she has a very obvious frenulum on top too which comes all the way between the teeth. She had posterior bottom tongue tie which was snipped at 4 weeks. Perhaps this top tongue tie also contributed to all the difficulties we had establishing breastfeeding at first too. Something to watch in future I guess. Thanks, very useful thread.

[Gussy]

Hi Anna, I did a lot of reading and it did say that posterior tongue tie and uppler lip tie often go hand in hand. Very interesting isn't it? Lots of HV's GP's have no idea of this either.

[JessB]

My three week old has a very tight upper lip tie that is pulling his top gum up. This was spotted while dealing with Claire kedves at kings about his tongue tie. Claire said that kings don't cut lip ties but a consultant in Southampton might??! At the tongue tie clinic they also commented on it and said the gap would likely close with adult teeth but some orthodontic treatment may be needed. Feeding is fine and better since the tongue tie cut, but he has a big sucking blister on his top lip from not turning his lip out enough, no doubt because it's so tight.

As an aside my 2 year old had a minor untreated tongue tie and is a very fussy eater particularly lumpy food because of difficulty moving food around his mouth, although he's fine with things like biscuits etc. Although he has no obvious lip tie, the eating issues and some of the speech ones sound familiar and mat be caused by tongue tie.

Also, Claire kedves is now on holiday for about 3 months I think! She is the tongue tie guru but the lady who runs the peckham breastfeeding cafe on a Thursday morning is aalso very good and will make referrals to the clinic etc.

[Gussy]

Hi Jess my little boy also had a big sucking blister on his top lip, although it went around 3 months I think? The guy in Southampton is a consultant paediatric surgeon called Dr Mervyn Griffiths. He does private work, not sure how you would get referred otherwise? I spoke to his secretary (when I was desperate) but at the time he was away on a sabbatical for 6 weeks, so I didn't want to wait that long and took him to Kings. Anyway, Mr Griffiths (from my research) is the trailblazer of tongue tie so I hear and may well have lots of experience with upper lip tie as well? Could be worth a call for those who can afford it/willing or that worried to travel to Southampton.

[jills]

It's so interesting to hear everyone else's experiences. It sounds like it's fairly common which surprises be because of the lack of information from health professionals. Thanks JessB and Gussy for the names, hopefully in time a referral may shed some light on the subject. Maybe balanced against a dentist's opinion.

As I'm fairly new to the area and don't have a dentist here, does anyone recommend a dentist that you think would be helpful re baby's frenulum?

[pebbles]

North cross road r great for adults and kids. Above pharmacy. Can't remember name

[crystal7]

My 2 year old daughter has this too. We had no problems at all with feeding but I remember she did have a sucking blister and her lips never seemed to be in the 'recommended' position when breastfeeding (but she was perfectly satisfied). However she is a really fussy eater (never considered that this could be the reason) and hates to have her top front teeth brushed. Hard to tell if it has an effect on her speech at the moment...Really useful thread will definitely ask my dentist about when we next go.

[Knomester]

Baby K is in the same boat as anna_r's baby. When we were seeing midwives and BF counsellors about his feeding problems they used to tell me to turn his top lip out to get a better latch but it was impossible, the reason being that his top lip is attached in the same way. He hasn't got any teeth yet but I'm wondering whether it's something we ought to have looked at now for an opinion or wait until we know whether it causes him any problems...

[JessB]

I'm on my way to peckham breastfeeding cafe now so will ask the midwife there as she helps at the tongue tie clinic too so may have a useful opinion. Will update later!

[Gussy]

Knomester I was told to do the same thing but found it an impossible task. I had to use all my energy, arms, pillows just to get him into a position where he could latch without taking my nipple off!

I was also told by a speech therapist to try holding his cheeks squashed together whilst feeding (to aid his seal around boob) but it was impossible. Talk about making a task already harder than it is.

One other note, many people (including a paediatrician) told me to give up breast feeding and bottle feed. I tried a few bottles, but I actually found his seal around the teat was even worse, and he gulped so much air I had to stop. So, it's not always the answer...

Good luck Jess, be interested to hear what they say.

[Ruth_Baldock]

:O SHOCKED that anyone would suggest giving up breastfeeding and bottle feeding, rather than sort out the problem at hand! This makes me sad.

Seb's is definitely affecting his speech now, and also, he will not let us brush his upper teeth which makes me think it's hurting him- poor sod. We're seeing our GP next week to get some kind of referral made. I feel very, very sorry for him.

In another note, my husband has the tell-tale Madonna teeth and there are certain things (including my own name...) that he can't pronounce. His Mum says it was worse when he was younger. I had both upper and lower tongue tie, the latter was snipped, the former never been much of a problem. So I'm not surprised little Seb has it!!!!

[jills]

Gussy - Oh my god, squeezing his cheeks together while bf! What, with your third arm? We also had a tough time with bottle teats for his top ups. Eventually we found that Medela worked best when he was little, and after 7-8 months or so he could get his mouth around an Avent teat without too much trouble. Got better as he grew.

Jess - keep us posted!

[jills]

Ruth - your poor little guy. I hope they offer some information/options. I'd love to hear what they had to say.

[JessB]

Afraid I don't have a useful update! View was to wait and see if any problems later on and she didn't have any experience of dealing with this. Claire kedves the ither week did recommend massaging it to try to stretch it.

Thinking about it I had a gap between my baby teeth but it closed with adult teeth so I wonder if that's linked. My poor little Bubba has a tight lower lip tie too and his bottom lip gathers in the middle!

I'd be interested to hear what your gp says Ruth, if you don't mind sharing!

[Ruth_Baldock]

Not at all, I'll keep you all updated!

I wanted to ask, how do you get an appointment with Clare Kedves/her colleagues if you needed it? I'm assuming they're mad busy, serving the whole of Kings and their infant feeding woes! (I am overly paranoid about my second baby having tongue tie, so wanted to ask in advance...)

[buggie]

Ruth - you call and leave a msg on their answerphone and they get back to you within a day or so. I saw Joanne when we were still on the post natal ward and then emailed her for a few weeks and always got replies within a day or so.

If you were worried about ?tongue tie, I'd go to the fab breastfeeding cafe in Peckham Library on a Thurs morning as a first port of call x