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@MrsDragon: I would 10000% have her evaluated by an ENT if you think she has a posteriorl tongue tie! They are much harder to see/feel than anterior (traditional) tongue ties, so you need a practiced eye. If your LC doesn't see it, have someone else evaluate her--it doesn't matter only if she can bring her tongue out past her gum, it matters how she is using her tongue as a whole as she nurses, and a posterior tie will hold it down in back as you are seeing.

HOnestly based on the symptoms you describe it definitely sounds like a TT/lip tie to me. My LO had both a posterior tongiue tie and a lip tie (they often go together) and I had the TT clipped and that, along with exercises my LC gave me to help him learn to use his tongue effectively, were what saved my nursing relationship!!

@MrsDragon: hmm are there any pediatric dentists near you? They can also perform frenulectomies if your doctor can't. This site has GREAT info, especially if anyone tries to tell you that tongue ties/lip ties don't interfere with nursing: http://www.kiddsteeth.com/articles.html

@MrsDragon: well good luck!

Sounds just like my DD, and we also started to have trouble around 4 weeks. I thought she was overwhelmed by my oversupply/forceful letdown, but once I could tell she was dealing better with that but the pain/latch issues/clicking/spilling milk didn't improve at all, I went back to the LC for evaluation. My DD could also stick her tongue out past her gums, but had a posterior tongue tie nonetheless. The LC pulled strings for us to get in and have it clipped that day because she was worried about my supply tanking if the problems continued. It's been just over a week since we had it clipped and things are MUCH better now. It takes awhile for babies to re-learn how to nurse after the tie is clipped, so don't be alarmed if it's not a magic fix -- but I'm so glad we had it done because DD is much happier (less air intake so not as gassy) and more efficient at getting milk out. Good luck getting your LO evaluated and hopefully resolving the problem!

I thought this post was extremely helpful:
http://boards.hellobee.com/topic/talk-to-me-about-tongue-ties#post-930588

@MrsDragon: I also think it's worth it to do the clip--even if it doesn't fix the problem 100% it will improve the situation, whereas not doing can make it difficult for improvements to be consistently made with other methods, you know? The procedure is super easy and fast!

@MrsDragon: If you have more information about the suck training I would be interested to read it! We found it 100% helpful to have N's Lip and tongue tie clipped. We had to look to find an ENT that took care of tongue and lip ties, but we found one about 1.5 hours from them. I love his ENT she is the nicest lady! I will set up with her again if LO#2 has the same issue. (Which is likely because it runs in our family like crazy)

@MrsDragon: like you said, doing the clip WILL NOT make anything worse at all, and can ONLY improve things. Your LC is not the one nursing, so don't let her pressure you if you feel like clipping is the way to go. I was also told that my LO's case was borderline based on the Hazelbaker scale, but it definitely helped, ALONG WITH doing the tongue stretching exercises.

Definitely advocate for yourself!! It sounds like you are informed about posterior tongue ties, which is great!

@MrsDragon: I think you made a good decision. It's been almost two weeks since we had my DD's clipped and I'm seeing a huge difference in her ability to stay latched, transfer milk, and she spits up way less than before. I initially felt guilty because I felt like I was putting her through pain for my own benefit, but we're both so much happier now that I'm really glad we did it. An added bonus is that she can now hold a pacifier in her mouth rather than having it immediately pop out, which has been great for those times when she wants to suck but not eat. Incidentally, the doctor who clipped DD's tie only recommends pacis with straight nipples, like Soothies, because she said the other shapes don't promote good sucking habits -- just thought I'd throw that out there.

Good luck with the clip, I found it to be far less traumatic than I expected. It took about 30 seconds and then she nursed a bit and was totally fine. Just be diligent about the aftercare!

@MrsDragon: oh hun it will be fine!!! the procedure is literally 30 seconds and then she'll nurse and be totally fine. I know it's SO scary--I was literally in tears when LO went through it but it was fine! Hugs and good luck!

@MrsDragon: don't feel that way! Honestly, the sooner the better. My LC said prolonged latch/transfer problems can lead to decreased supply so if we'd had to wait, she wanted me to pump after every nursing session to make sure that didn't happen. And it takes a little while for LOs to re-learn how to nurse properly, so there's really no upside to waiting. It seems crazy that 1-2mm of flesh can make THAT much difference, but it really can.

@MrsDragon: looks like there is definitely some improvement! It will also take time for her to learn her tongue's full range of motion, so don't get discouraged if she's not keeping her tongue out while latching on yet--she will! Just keep doing the exercises! She is ADORABLE!

Also, when you say that you're having pain--is it like a throbbing pain that comes and goes after you nurse? And do you ever notice that your nipples/areola are slightly lighter after she unlatches?

I also used APNO and loved that stuff!

@MrsDragon: you could get her a probiotic as a precautionary measure and it might be a good idea to sterilise any paci's, shields or bottles you're using.

Thrush sucks so hopefully you get on top of it soon!