Jay, my experience has been that ENT specialists and oral surgeons are less close-minded about performing frenotomies. Of course, it is such a "no-big-deal" procedure that I get exasperated at physicians who balk. Consider that in the "olden days" it's said that midwives often kept one fingernail long and sharp to take care of a tight frenulum when the baby was first examined! The first time I assisted with a frenotomy (it was the first day of a long holiday weekend--it was us or another week of agony for the mom!) I talked the pediatrician through the procedure by describing what I had seen on slides during a conference session. It was one snip and...voila. As others have said, and I repeat, the baby often sleeps through the procedure. When babies cry during the procedure it is usually because they hate having their head held still. Once released and allowed to nurse they are fine. No blood. No tears. What other bloodless, painless procedure elicits such vehement opposition by physicians?. In my not-so-humble opinion, physicians who minimize the effects of tight frenulum and refuse to do frenotomies (after being presented with the latest information) are misogynists at heart. Especially if they do ear piercing as an office procedure. What is the medical necessity of that? I am "spoiled for choice" now that I know several physicians who will do frenotomies. But I still keep a few packets of information (copies of JHL articles) to hand out--just in case. Good luck, Jay. It is frustrating to be the voice crying in the wilderness. For the poor mother's sake I hope someone listens to her, and you! Margery Wilson, IBCLC Massachusetts Institute of Technology Cambridge, Massachusetts, USA ------ ILCA Region I (New England States) Representative