To comment on Karen's mention of tongue tie.....I would strongly suggest
referral to a dentist rather than ENT.  We have a referral sheet listing
dentists who have experience clipping frenuluum (read, we have good
experience with their work!).  The procedure is very simple.  A note from one
mother contained the comment that the only crying was done by mom!  On the
other hand, one of our mothers elected to go to the ENT recommended by her
pediatrician rather than one of the dentists on our list.  The procedure was
involved and included anathesia.  The baby did not nurse well for over 48
hours after.  The mother had to have yet another appointment in the lactation
center.  Our normal experience with the dentist is immediate nursing after
clipping with immediate improvement in the situation.
Pardee Hinson