Post-frenotomy Methemoglobinemia Associated with Mepivacaine Use in a 3 Day Old

Although neonatal frenotomy is not a new procedure, there seems to be an increased incidence over the past decade. Even with some controversy over the utility of the procedure and its benefits to the breast-feeding child, more neonates are being referred for ankyloglossia related frenulum repairs as breast-feeding has gained popularity. The frenulum is poorly innervated and does not necessarily need an anesthetic for a frenotomy but some practitioners still use a combination of both topical and injectable anesthetics. These anesthetics put the patient at risk for complications such as methemoglobinemia [1].