I don't use any anesthesia because the clip is so swift and minimal that the anesthesia is probably unnecessary. The frenulum is pretty avascular, so clipping it produces at most a drop or two of blood which can be dabbed with a gauze pad. The baby can be put directly to the breast following clipping. I use one of those instruments that look like a shield with a split in it with a handle and a small pair of straight scissors. I have observed infants whose tongue I have just clipped act like someone with a new dental filling--they explore their "new" mouth with their tongue and spontaneously start sticking out their tongue. Of course, newborns will imitate facial expressions, so if the baby has had a particularly tight tongue-tie, I will often assign the older sibling to help the baby "practice" sticking out their tongue by having the older child model sticking out their tongue for the baby--they love it, needless to say! Linda Shaw MD FAAP *********************************************** 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