Whole-child care
Tongue-tie & lip-tie care (frenectomy) for kids
A tongue-tie or lip-tie only matters if it gets in the way of feeding, talking, or keeping teeth clean. We look closely at how your child's tongue and lips actually work, team up with the other people helping your family, and suggest a release only when it's likely to help.
What tongue-ties and lip-ties are
Everyone has small bands of tissue, called frenula, that connect the tongue to the floor of the mouth and the lips to the gums. They come in all shapes and sizes.
A tongue-tie (the medical term is ankyloglossia) means the band under the tongue is short, thick, or tight enough to limit how the tongue moves. A lip-tie describes a tight band between the upper lip and gum.
Here's what many parents don't hear: a visible band, even a prominent one, is often perfectly normal. In babies, the upper lip band commonly looks thick and attaches low on the gum, and it tends to change as the face and teeth grow.
When a tie matters: function comes first
We don't treat a tie because of how it looks. A release is worth considering only when a tie truly gets in the way of feeding, speech, or keeping teeth clean.
Keep reading: When a tie matters: function comes first
For babies
- Trouble latching or staying latched, or clicking sounds while feeding
- Long, frequent feeds with slow weight gain
- Nipple pain or damage that doesn't improve with positioning help
- A tongue that can't lift well or reach past the lower gum
Feeding trouble has many possible causes, from positioning to milk supply, so a tie is only one possibility.
For older kids
- Speech sounds that a speech-language pathologist thinks may be tied to tongue movement
- Trouble licking the lips, moving food around, or clearing food from the teeth
- A tight upper lip that makes brushing the top front teeth uncomfortable
And a gap between the top front teeth? That's normal in young children and often narrows as adult teeth come in. If a lip band seems to hold a gap open, it's usually wiser to wait for the adult teeth and plan any treatment with an orthodontist, something we check during early orthodontic evaluations.
Why we're careful about diagnosing ties
Tongue-tie releases have become much more common in recent years, and not every one has helped. In 2024, the American Academy of Pediatrics (AAP) published a clinical report urging caution. It recommends a thorough feeding evaluation, including help from a lactation specialist, before deciding on a procedure for a baby, and it finds no good evidence that releasing an upper lip-tie improves breastfeeding. The American Academy of Pediatric Dentistry (AAPD) also encourages careful evaluation and teamwork with other health professionals.
Keep reading: Why we're careful about diagnosing ties
That's our approach, too. A release is a real procedure on a very small person, so we recommend one only when a tie clearly affects function and other support hasn't been enough. Sometimes the most helpful thing we can tell you is that your child's tongue and lips are working just fine.
How we evaluate, as a team
Feeding and speech involve much more than one small band of tissue, so we work alongside the people who know your child well:
- A lactation consultant, ideally an International Board Certified Lactation Consultant (IBCLC), who can assess latch, positioning, and milk transfer before anyone considers a procedure.
- Your pediatrician, who tracks weight gain and overall health and can look for other causes.
- A speech-language pathologist, who can tell whether a speech difference is likely related to tongue movement.
- A feeding therapist, often an occupational or speech therapist, for kids who struggle with solid foods or textures.
Keep reading: How we evaluate, as a team
At the visit
We ask about feeding, sleep, and speech, and we're glad to see notes from your lactation consultant or therapist. Dr. Chris gently lifts the lip and tongue and checks how far the tongue lifts, stretches forward, and moves side to side. Babies stay in your lap, just like at our infant and toddler visits.
Then we explain what we see and whether it seems to affect function. If a release could help, we'll go over benefits, risks, and alternatives, and you'll have time to decide. Often the first plan is more feeding or speech support. While we're looking, we'll check on those first teeth, too. Our baby teething timeline shows when each tooth usually arrives and how to soothe sore gums.
What a release involves
If a release makes sense, it's usually quick. A frenotomy is a simple snip of the band, most often done for babies. A frenectomy removes or reshapes more of the tissue and is more common in older children, sometimes with a few small stitches that dissolve on their own. Providers use either sterile scissors or a dental laser. Studies haven't shown that one method works better than the other, so the choice depends on the child and the situation.
Keep reading: What a release involves
For babies
The release itself takes only moments. We'll explain beforehand how we keep your baby comfortable, and you can usually feed right afterward, which helps settle them. Bleeding is usually minimal.
For older kids
Older children get numbing medicine first, just as they would for a filling, and laughing gas can help a nervous child relax. Our page on sedation and laughing gas for kids explains how that works, and our guide on helping a child who's afraid of the dentist has tips for getting ready at home.
Like any procedure, a release has risks. They're uncommon, but they include bleeding, infection, injury to nearby tissue, a baby who fusses at or refuses feeds for a while, and tissue that heals back tighter. We'll go over them before you decide.
Healing and aftercare
Most kids are a little sore for a day or two. Within a few days, a soft white or yellowish patch forms where the band was released. That's normal healing tissue, not infection, and it fades over about one to two weeks.
- Comfort. Ask your pediatrician which pain reliever suits your child's age and weight.
- Feeding. Most babies feed normally soon after. Some need a few days and extra patience, and your lactation consultant can help with latch as things heal.
- Stretches or exercises. Some providers recommend stretching exercises after a release. The AAP's 2024 report found no evidence that they help, and they can be uncomfortable for babies and make feeding harder. Please ask us before starting any exercise routine.
- When to call. Call us at (916) 770-4567 for swelling that gets worse or bleeding that starts again. If your baby has a fever or won't feed, call your pediatrician right away. For a baby under 3 months, a temperature of 100.4°F (38°C) or higher needs prompt medical care.
Call 911 or go to the nearest emergency room if bleeding won't stop with gentle pressure, or if your child has any trouble breathing.
What a release can and can't do
When a tight band is truly the problem, a release can make it easier for a baby to latch or for an older child to move the tongue freely. It isn't a cure-all, though, and it isn't an established treatment for snoring or sleep apnea. Feeding often improves gradually, and many babies still need lactation support afterward. Speech usually needs practice, too, with a speech-language pathologist guiding new movements. And if things don't improve, the cause may lie elsewhere, and your team will keep looking.
We'll check in during healing, see your child for follow-up, and share updates with your other providers, with your permission.
Wondering about a tongue-tie or lip-tie?Bring your questions, and we'll take a careful look together.
Join the VIP listTongue-tie FAQ
Questions parents ask about tongue-ties and lip-ties
Still deciding? Give us a call. We're happy to talk it over before you book.
Does every tongue-tie need to be released?
No. Many babies and children have a visible tongue or lip band that causes no trouble at all, and they never need a release.
Can a lip-tie cause cavities?
A tight upper lip can make it harder to brush along the gumline of the top front teeth, and plaque left there can lead to cavities. Usually the fix is technique: gently lift the lip while you brush. A release is rarely needed for this reason alone.
Will a tongue-tie release help my child talk more clearly?
Sometimes, if a speech-language pathologist finds that limited tongue movement affects certain sounds. Most speech delays have other causes, though, and a release doesn't teach new speech patterns. Speech therapy usually does the heavy lifting.
Is my child too old for a frenectomy?
No. A release can be done at any age when a tie affects function. Older kids receive local numbing, and we explain each step ahead of time so there are no surprises.
What if my baby's latch doesn't improve after a release?
Give it some time and keep working with your lactation consultant, since babies often need practice using their tongue in a new way. If feeding still isn't getting better, let us and your pediatrician know so the team can look for other causes.
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