Breastfeeding moms may be all too familiar with the struggle that comes when your baby has a lip or tongue tie. If your baby has a severe enough lip tie, your doctor may recommend having it resolved via surgical procedure. But can a lip tie come back after the surgery? It would be a shame for your baby to have to go through the same surgery twice, but experts say that's probably not likely.
"Occasionally, the upper lip may be more tethered than usual to the upper gum/gingiva. This may pose a problem with latching for breast feeding, albeit rarely," Dr. Diego Preciado, vice chief of Pediatric Otolaryngology at Children’s National Hospital tells Romper. "Later in life, if the upper lip frenulum extends too tightly onto the gum, it may influence a diastasis (separation) between the two central incisors."
Severe lip ties can lead to problems during feeding as they may be unable to achieve the amount of suction required to nurse, causing pain to the breast for mom and a potential lack of weight gain for baby. Additionally, speech problems could surface later on if the lip tie is not resolved, which is why making sure that the surgery is successful is important.
Preciado tells Romper that "most upper lip 'ties' do not need to be corrected and are a variant of normal," but if your baby has a severe enough lip tie to require surgery, Preciado says that a lip tie is "unlikely to grow back if it has been appropriately corrected." This is great news for parents who are worried about their baby struggling with one.
Although it is rare for a lip tie to grow back, there are a few reported instances of this happening, so it is good to be aware of proper recovery methods just in case. Research done on the topic is notably sparse, but one 2019 study published in the International Journal of Pediatric Otorhinolaryngology by doctors in the Department of Otolaryngology at SUNY Downstate Medical Center revealed a 9% reoccurrence rate reported by mothers of babies who underwent the frenotomy procedure in their office during the duration of the study.
Preciado explains that, "In most cases, the child should be able to resume regular diet the next day. Pain should be minimal, with Motrin being sufficient for control." For breastfeeding moms, this means resuming feeding should be able to happen, and hopefully with less issue than before the procedure.
"It’s important to remember that there have been limited studies on aftercare of a frenotomy site. There is inconsistency among healthcare providers as to the best way to care for this wound," lactation consultant Danielle Downs Spradlin tells Romper. "When I create a post-operative plan with my patients, our focus is on gaining a greater range of motion that facilitates quality feeding. Depending on other feeding factors, the aftercare plan for one baby can be vastly different from another."
It is unclear whether nursing post-procedure can prevent a lip tie from coming back after surgery, but breastfeeding after the procedure is possible, and Spradlin says that it can have several benefits.
"If a family chooses to have an upper labial frenotomy, nursing immediately afterwards and frequently throughout the healing phase is an excellent choice," Spradlin says. "The wound site stays active at the breast, helping baby achieve a greater range of motion. The wound site is irrigated with breast milk and saliva, helping keep the area clean."
Dr. Diego Preciado, M.D., Ph.D., vice chief of Pediatric Otolaryngology at Children’s National Hospital
Danielle Downs Spradlin, IBCLC, CLC with Oasis Lactation Services
Patel, P. S., Wu, D. B., Schwartz, Z., & Rosenfeld, R. M. (2019). Upper lip frenotomy for neonatal breastfeeding problems. International Journal of Pediatric Otorhinolaryngology, 124, 190–192. doi: 10.1016/j.ijporl.2019.06.008