We do frenulotomies in our unit as needed. This topic is difficult to be objective about. Generally if the frenulum is short and anterior, it does interfere with breast feeding and later in life with speech develoment. We find it is better to do it early than require an ENT, dentist or general surgeon do it when the child is 2 or 3. By then the tongue is used to some movement restriction and does not regain its function right away so speech therapy needs to continue. Of interest is the genetics of the condition. Not unusual to find that a parent, a sibling or an aunt/uncle also had it or still has it and has a lisp. We anesthetize the frenulum with 4% lidocaine solution using 2 sterile Q-tips and cut the frenulum with very fine curved scissors. I have trained our pediatricians and NP’s to do it and we have not had any problems related to the procedure. Is it needed? That is where the subjective part of indications comes into play. One always feels unsure of the need.