In order for any practitioner (doc or midwife) to perform any proceedure, 
that person has to be licensed to do that procedure in the hospital. We 
have a very "frenotomy-friendly" ENT who helps us out quite a bit but she 
can do that because she has surgical priviliges in the institution and in 
her office, of course.

I did learn from her once that some frenulums are too thick to just clip 
without general anesthesia. I referred a tight frenulum to her but when 
she saw the baby,she said that it would have been too think to do without 
putting the baby under general.

Personally, there is no way at all, as an RN or as an IBCLC that I would 
ever want to make a judgement about, or have the responsibility of being 
able to do frenotomies. As far as I am concerned, the docs who pay the big 
bucks for the heavy duty malpractice insurance can shoulder that 
responsibility. In my position, I have more autonomy that I would like 
sometimes!

Betsy Riedel RNC, IBCLC
Connecticut

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