19/08/2026
The more I study photos and videos of the face, the more I am recognising new patterns that were not immediately obvious to me before.
If the lips don't come together comfortably without strain, I start asking why.
A short or tented upper lip makes me curious about how freely the upper lip moves.
A deep crease below the lower lip, chin dimpling or lower lip/chin strain with lip seal makes me curious about how freely the lower lip moves.
Importantly, none of these features diagnoses a lip tie. There can be many reasons for the way a baby's lips and face look or move.
For me, they are simply clues that make me look more closely.
Can the lips move freely? Are they flexible enough to fl**ge well? Can the baby create and sustain an effective seal during feeding? What does the feeding history tell us? And when I examine inside the mouth, is there a short, tight or restrictive frenum that may be relevant to the functional picture?
This little one is 10 months old and has struggled with latch and taking in air during feeds since birth. She still needs frequent assistance to burp, becoming very distressed and uncomfortable until she is positioned upright. She wakes every night after being settled to sleep needing help to burp, and this pattern has been disrupting her sleep for much of her life.
Her family had previously raised concerns with multiple healthcare professionals before their osteopath suggested further oral and feeding assessment with an IBCLC.
And this is where I think awareness of these simple extraoral clues can be really useful.
Not to diagnose a lip tie from the face, but as part of screening - recognising when something may not be functioning well and when a baby may benefit from a closer oral and feeding assessment.
The earlier we recognise the clues, the earlier we can connect families with the right assessment and support.
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