When I see a posterior tongue-tie, and tell the pediatrician about it, they aren't comfortable doing a frenotomy for the more complex TT and  most of them refer to an ENT, who then tells the parents that, " it isn't that bad, and we could do the surgery, but it would require general anesthesia, and I'm not sure you want to do that"....and discourages it.  

The better option, is to give parents the information of several options, including that of going to see a physician or dentist who does Laser surgery for tongue tie.  It doesn't require anything but local anesthesia, and even with the more involved posterior tongue-ties, there is no bleeding.  When I was in private practice, I sent people to the dentist, and they usually fit them in within one or two days.  In the hospital setting, many of the pediatricians are not that familiar with PTT or with a tight labial frenum, and it is challenging. 

Good luck!
Kathleen Gale RN, IBCLC, RLC
Chicago, IL 

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