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

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