I position the baby on the examination couch (head to the left), under a
good light. Someone holds the baby's arms up close on either side of the
head to steady the head as well as the arms. I hold the frenulum under the
tongue with my gloved left hand and snip the frenulum with a small pair of
sterile scissors in my right hand. Very easy!
I don't use aneasthesia, and the baby is usually happy as soon as he/she is
picked up and put to the breast.
However, with this method I only do it up to about 3 months of age. After
that the baby is getting too big to hold down, and I am not happy to do it
in my rooms (Also this was what I was taught by Barbara Burge, a local GP /
Obstetrician.)

Lisa Amir
GP / LC in Melbourne, Australia
P.S. Congrats to Kathy Auerbach on a great edition of JHL
and to Jan Barger for all her work ( I think you're right about increasing
calorie content of milk as baby grows older).