I'm a little behind in reading posts but one I wanted to respond to was
regarding using a lidocaine gel before performing a frenotomy.
I have been to several presentations where frenotomies were the topic,
including Dr. Palmer, Dr. Jayne and an ENT from my area.  None of them
recommended using any numbing medications and one stated it would interfere
with the baby's ability to nurse after the procedure.  I have been told the
most uncomfortable part of this procedure for the baby is holding the tongue
with a gauze so it can be lifted and better visualization of the frenulum.
The actual clipping has no nerve intervention and therefore should not be
that uncomfortable for the baby.
I had a mother call me recently regarding her baby's need to have the
tongue-tie clipped.  I reviewed how it should be done and that the baby does
not need surgery, there is no or minimal bleeding and should be able to nurse
right away.  She said the ENT doctor she was going to see suggested using an
analgesic cream but I told her the down side of this and that it was not
necessary.  She called me back the next week to let me know the clipping was
done in the doctor's office and her baby is nursing better and less pain for
her.  I asked if she was able to nurse right after the procedure and she said
no because due to the lidocaine cream the baby was drooling and could not
organize her suck.  I'm happy she found someone to clip the frenulum but I do
not like the trend of encouraging the analgesic and therefore interfering in
the most comforting measure a baby could have and that is to be able to go
directly to the breast.
I look forward to hearing others on this topic.

Ann Perry RN, IBCLC
Boston, MA

             ***********************************************
The LACTNET mailing list is powered by L-Soft's renowned
LISTSERV(R) list management software together with L-Soft's LSMTP(TM)
mailer for lightning fast mail delivery. For more information, go to:
http://www.lsoft.com/LISTSERV-powered.html