{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,3]],"date-time":"2026-05-03T23:52:27Z","timestamp":1777852347051,"version":"3.51.4"},"reference-count":16,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2013,7,2]],"date-time":"2013-07-02T00:00:00Z","timestamp":1372723200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Hum Lact"],"published-print":{"date-parts":[[2013,11]]},"abstract":"<jats:p>Successful breastfeeding is dependent upon an infant\u2019s ability to correctly latch onto a mother\u2019s breast. If an infant is born with oral soft tissue abnormalities such as tongue-tie or lip-tie, breastfeeding may become challenging or impossible. During the oral evaluation of an infant presenting with breastfeeding problems, one area that is often overlooked and undiagnosed and, thus, untreated is the attachment of the upper lip to the maxillary gingival tissue. Historically, this tissue has been described as the superior labial frenum, median labial frenum, or maxillary labial frenum. These terms all refer to a segment of the mucous membrane in the midline of the upper lip containing loose connective tissue that inserts into the maxillary arch\u2019s loose, unattached gingival or tight, attached gingival tissue. There is no muscle contained within this tissue. In severe instances, this tissue may extend into the area behind the upper central incisors and incisive papilla. The author has defined and identified the restrictions of mobility of this tissue as a lip-tie, which reflects the clinical attachment of the upper lip to the maxillary arch. This article discusses the diagnosis and classifications of the lip-tie, as it affects an infant\u2019s latch onto the mother\u2019s breast. As more and more women choose to breastfeed, lip-ties must be considered as an impediment to breastfeeding, recognizing that they can affect a successful, painless latch and milk transfer.<\/jats:p>","DOI":"10.1177\/0890334413491325","type":"journal-article","created":{"date-parts":[[2013,7,3]],"date-time":"2013-07-03T00:44:20Z","timestamp":1372812260000},"page":"458-464","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":52,"title":["Diagnosing and Understanding the Maxillary Lip-tie (Superior Labial, the Maxillary Labial Frenum) as it Relates to Breastfeeding"],"prefix":"10.1177","volume":"29","author":[{"given":"Lawrence A.","family":"Kotlow","sequence":"first","affiliation":[{"name":"Private practice, Albany, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2013,7,2]]},"reference":[{"issue":"1","key":"bibr1-0890334413491325","first-page":"19","volume":"19","author":"Edmunds J","year":"2011","journal-title":"Breastfeed Rev"},{"key":"bibr2-0890334413491325","unstructured":"Livingstone V. A diagnostic approach to breastfeeding problems. Canadian J Ped. http:\/\/www.breastfeedingclinic.com\/pdf\/DiagnosticApproach.pdf. Published February 1990. Accessed January 2012."},{"key":"bibr3-0890334413491325","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2011-0077"},{"key":"bibr4-0890334413491325","doi-asserted-by":"publisher","DOI":"10.1177\/089033449501100419"},{"key":"bibr5-0890334413491325","volume-title":"Supporting Sucking Skills in Breastfeeding Infants","author":"Watson Genna C","year":"2008"},{"key":"bibr6-0890334413491325","unstructured":"Palmer B. Breastfeeding and frenulums. http:\/\/www.brianpalmerdds.com\/bfeed_frenulums.htm. Published December 2003. Accessed December 2011."},{"key":"bibr7-0890334413491325","doi-asserted-by":"publisher","DOI":"10.5005\/jp-journals-10022-1016"},{"key":"bibr8-0890334413491325","volume-title":"Tongue-tie: Morphogenesis, Impact, Assessment and Treatment","author":"Hazelbaker A","year":"2010"},{"issue":"3","key":"bibr9-0890334413491325","first-page":"171","volume":"17","author":"Huang WJ","year":"1995","journal-title":"Pediatr Dent"},{"issue":"4","key":"bibr10-0890334413491325","doi-asserted-by":"crossref","first-page":"332","DOI":"10.1177\/089033440001600409","volume":"16","author":"Marmet C","year":"2000","journal-title":"J Hum Lact"},{"key":"bibr11-0890334413491325","doi-asserted-by":"publisher","DOI":"10.2223\/1249"},{"key":"bibr12-0890334413491325","unstructured":"Wagoner C, Rosenkrantz T. Counseling the breastfeeding mother. Medscape reference website. http:\/\/emedicine.medscape.com\/article\/979458-overview. Updated September 18, 2012. Accessed May 21, 2013."},{"key":"bibr13-0890334413491325","doi-asserted-by":"publisher","DOI":"10.1177\/0890334410362520"},{"issue":"3","key":"bibr14-0890334413491325","first-page":"11","volume":"10","author":"Kotlow L","year":"2004","journal-title":"J Pediatr Dent Care"},{"issue":"3","key":"bibr15-0890334413491325","first-page":"26","volume":"10","author":"Kotlow L","year":"2004","journal-title":"J Pediatr Dent Care"},{"key":"bibr16-0890334413491325","doi-asserted-by":"publisher","DOI":"10.1007\/BF03262789"}],"container-title":["Journal of Human Lactation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0890334413491325","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/0890334413491325","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0890334413491325","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T22:34:48Z","timestamp":1777502088000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/0890334413491325"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,7,2]]},"references-count":16,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2013,11]]}},"alternative-id":["10.1177\/0890334413491325"],"URL":"https:\/\/doi.org\/10.1177\/0890334413491325","relation":{},"ISSN":["0890-3344","1552-5732"],"issn-type":[{"value":"0890-3344","type":"print"},{"value":"1552-5732","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,7,2]]}}}