lip tie--worth getting clipped if it's not causing obvious problems?

[VeganCupcake]

My DS is 4 months old and is not a really great nurser. He constantly slips off the breast, clicks, and has problems everting his upper lip. He is still gaining well, though, because as a tandem nursing mama, I have an enormous milk supply that basically pours into his mouth if he's anywhere in the vacinity.

I have had a few incidences of nipple pain and I had a little blister on one side a few weeks ago, but it's generally not painful to nurse him.

My friend who is a PA looked at his mouth and he definitely has a thick, tight, low upper lip frenulum. She gave me the name and number of a pediatric dentist who clipped the lip tie of her oldest daughter, who is now 4 years old. This dentist won't do the procedure, though, until the child is at least 2 years old.

So would you pursue getting it clipped now or not? I have heard that the upper lip procedure is more invasive and complicated than clipping a tongue tie.

[lifeguard]

Ds has a upper lip tie but I didn't realize (& no one else noticed) that was what our problem was until he got teeth - at a year old. We never got it clipped & we didn't really have any problems but I am fairly confident if we'd had it clipped to begin with bfing would have been more comfortable for me - it wasn't necessarily painful but it was never really comfortable.

[homemademom]

I would not attribute the clicking and slipping off to the upper lip necessarily. Have you had his tongue looked at? Those can be signs of tongue tie. Posterior tongue ties are particularly hard to get a diagnosis for (as they occur farther back in the mouth and many peds are unaware of them). My ds had both the posterior tongue tie and the lip tie (iirc, there are quite a few moms here whose babies had both). I had the lip tie treated at the same time as the tongue by a pediatric dentist who used laser. I can't imagine having the lip done any other way, because cutting or snipping would seem to me to to cause a lot of bleeding and be hard to suture. The laser worked amazingly well though.

It would depend on the severity of the lip tie to determine if I would cut it, but my ds couldn't even peel his upper lift off his gum line, it was so bad. So, with him, I'd do it again. My other kids all had slight lip ties, but the frenulums were thinner and stretchier. Most of the them have torn their somehow (I have no idea when) because they each have a little notch in them.

[CheriK]

I would second having his tongue checked for TT by someone experienced in diagnosing both classic TT and posterior TT.  Midline issues such as TT and lip tie often occur in tandem. 

As far as getting the lip tie clipped, I did a lot of research on this with my DD2.  She also had TT (clipped at 5 days) but continued to have latch issues.  Like your LO, she was unable to flange her upper lip, and would click or slip off the nipple.  Interesting, I also have oversupply, and this can also contribute to baby coming on/off the breast, clicking, and in general being a lazy nurser.  I spoke to several IBCLCs and doctors about having it clipped and ultimately decided to leave it alone.  The LCs fell into two very separate camps - clip it ASAP because they believed her latch issues were due to the tie, vs. leave it alone because upper lip ties shouldn't really impact latch since the lower jaw and lip flanging is most critical for controlling the latch and suction.  After reading everthing I could find, the second view just made the most sense to me, she was gaining well, and the concerns were slowly resolving.  I think if I'd caught the lip tie at the same time as the TT, I would have had both clipped at the same time, but by the time she was several months old, it would have been (as you noted) a more invasive procedure.  Our pediatrician, who clipped our DD's TT, noted that most children with upper lip tie will tear it themselves at some point in childhood, as PP noted.  We discovered through this process that our older DD also has a lip tie (never noted when she was an infant).  She also clicked and would slip off at times.   This resolved on its own for both children as they grew.  I never had nipple soreness or trauma with DD1, but did w/ DD2 (mild but persistent).