My understanding is that the nerves under the tongue are not fully developed in a newborn and it is a quick, painless experience that requires no anesthesia. As a baby gets older, most peds or ENTs require anesthesia to perform it. Some pediatric dentists also perform the procedure. When this question came up in our LLL meetings, the leaders always suggested consulting a pediatric dentist because they may be more familiar with blocking nerves without the need for a general. For an older child, though, this may be more traumatic than having a general. I've had two friends with children my son's age who were tongue tied. Both waited to have it fixed and both children had speech delays.