The diagnosis and impact of oral ties, including lip and tongue tie, has been a topic of exponentially growing interest, largely driven by parent demand. Despite a growing body of evidence regarding upper lip ties (ULT), there remain many questions about the impact of ULT on infant feeding, what constitutes a symptomatic lip tie, and whether releasing the ULT is advisable. Census among pediatric otolaryngologists is scarce. Several early clinical studies showed a benefit to releasing ULT, but these studies often combined release of tongue and lip tie in the same setting, making the outcomes of ULT release difficult to determine. In a recent study including a cohort of 100 healthy newborns, the anatomical presence of a more pronounced ULT did not correlate with feeding difficulty. Another recent study on isolated ULT showed an improvement in feeding outcomes for symptomatic infants who underwent upper lip frenotomy; however, a systematic review of articles published from 1946-2018 concluded that the evidence for routine ULT release in infants is poor. While clinicians may wish to take a wait-and-see approach for the literature to bear out, meanwhile, parents are continuing to make appointments asking what we can do for their babies who are struggling to breastfeed. This seminar is designed to prepare clinicians with adequate information to undertake shared decision making with parents and caregivers, as well as to promote informed dialogue with other professionals involved in infant feeding.