From:  Pat Martens IBCLC, MSc  (Winnipeg, Manitoba, Canada)
re:   tongue clicking and the case study re possible yeast infection

tongue clicking: you mentioned "good weight gain". How good? Is it more
than average (ie, more than 6 or 7 oz a week)? If so, you may be seeing
a baby who is trying to cope with a very abundant milk supply. If the
mother has been switching back and forth a lot, she may have induced a
large milk supply, which results in a forceful letdown. Babies coping
with this often break suction while breastfeeding. Suggestions: look at
the suggestions regarding overabundant milk supply in the book,
"Bestfeeding: Getting Breastfeeding Right for You", by Mary Renfrew,
Chloe Fisher and Suzanne Arms. The other good reference is the LC series
on "overactive letdown" , by Frances Andrusiak and Micelle
Larose-Kuzenko (actually the writers of that were LLL Leaders in
Winnipeg, so we were well-informed of this problem in the early
1980's!). I believe someone recently posted other good references for
this problem. (my personal pet peeve, however, is calling this situation
an "overactive letdown" or "hyperlactinemia" - sounds too clinical and
scary, when most situations like this are simply a matter of watching
what the baby is telling you, and ignoring well-meaning advice to switch
breasts too soon). Clicking can sometimes be helped by elevating the
baby during nursing, so the baby "looks down" slightly at the breast,
and the milk then flows somewhat counter to gravity. For example, have
baby diagonal , with head looking slightly down at breast, feet at
mother's waist, and mother reclining - baby is then sometimes able to
cope with the fast milk and won't break suction (click) as much. It's
worth a try!

2. re Judy Dunlop's heart-wrenching case history: if the mother is
experiencing internal throbbing, then a topical yeast medication
is ineffective - an oral is probably required, while
simultaneously treating the baby (there have been a million wonderful
postings regarding oral thrush medications recently) . The baby's mouth
may be hurting due to yeast. Swabs, according to physician friends of
mine, often don't pick up yeast.

pat martens