This is not a flame, but I would say "back off a bit". You feel strongly about certain things, but this does not mean your co-workers will feel exactly the same nor practice exactly the same. It sounds as if you have made many positive inroads in your bf program and in recognition of the frenulum issue. Therefore, I would suggest just doing the assessment, like the Hazelbaker assessment process, then discuss your findings with the family and documenting and sending the report to the physician. You might tell the family that you believe the tight frenulum is contributing to the bf problems and that some practitioners like pediatricians, dentists, ENTs believe in clipping and others don't. You could provide them with citations from the literature if they want to read and inform themselves more. They are then left to pursue this with the docs. Laurie Wheeler, RN, MN, IBCLC Hospital LC Violet Louisiana, USA mailto:[log in to unmask] ______________________________________________________ Get Your Private, Free Email at http://www.hotmail.com