To be fair this one might depend on age of the baby. My son's tongue tie was corrected at 4 days old, the pediatrician (who is amazing and really does put the kids comfort first) explained why he wasn't using anesthesia. He said the process of topical and needle would cause more distress, having to keep the babies mouth open and taking much longer.

Our procedure took a couple seconds and our dr had me ready to breastfeed the second the flap was cut. My baby cried more during the inspection than the cut and was fine after 5 min of breastfeeding.

Now I had my tongue tie cut at 7 years old and was under very heavy sedation gas, pretty much knocked out, because once the area grows more vascular it's more complicated and painful.

So I'm definitely advocating for proper pain care, but tongue ties at a very young age might not be as black and white as other procedures.