ok here is more:
My son was born March 2nd 2009, four years and 7 months after my surgery. I breastfed his sister for the 3 years prior to his birth (and she still insists that one is hers and one is his). Her story involved formula given by finger feeder, SNS, and eventually sippy. I hoped that with my son it would be different.
He was born in a birth center, but due to some breathing issues (diagnosed later as “prolonged transition to extra-uterine environment”) we had to be transferred to the hospital. Wanting to take advantage of the situation and hopefully pre-empt any breastfeeding issues I talked with just about every lactation consultant there. They seemed like they wanted to help (especially the first one up in the NICU), but except for one none of them actually checked his latch, and none checked his suck. One nurse even tried to tell me that he had to take a bottle. I refused and told her I would be feeding him. He lost some weight those first couple of days as most babies do. But he only went from a birth weight of 9lbs .5oz to 8lbs 5oz.
Remembering supply problems and formula with my daughter I started on shantavari right after getting home from the hospital. I also kept taking my pregnancy tea which contained alpha and nettle. The pediatrician checked his weight at 8 days old. They weighed him with his clothes on (8lbs 10oz) and told me to subtract about 2oz for his clothes. At the two week check (15 days really) they weighed him with his clothes off (8lbs 12oz). Since he had not regained his birth weight at two weeks, and due to the ‘only gaining two oz’ thing she suggested “topping off” with a bottle of formula after nursing him. I argued saying that I could pump after he ate and get several ounces, what would be the point in formula? Plus the variance in weighing techniques the “two ounce gain” couldn’t be relied on. I almost felt like I was pleading, even though I was just presenting the facts and I was the one to make any final decisions regarding my son.
I had noticed him sort of sticking out his tongue since birth and it had the tell-tale heart shape to it, but it wasn’t a classic tie attached at the tip. At his third week weight check I asked his pediatrician about it. She said something about him having a natural prominent indentation on his tongue and didn’t seem concerned. Fortunately for me I live in the age of Google so I set off to find all I could about tongue ties. I found a very helpful article by Dr. Brian Palmer DDS. I also learned about lip ties. I checked my son and was sure his lip was tied. I found different classes of lip tie on Dr. Lawrence A. Kotlow DDS’s site and guessed my son probably had a class III which may cause dental issues later down the line as well as contributing to latch issues now.

He stopped pooping when he was 17 days old. At his 3 week appointment (22 days actually) the pediatrician didn’t seem too concerned about that and was more worried about his weight gain. I went to see the lactation consultant at the birth center. I just asked her about his lip at first and she said it was defiantly tied. She checked his suck and his tongue too and said he also has a tongue tie. She is not sure which type but it is defiantly there. You can tell the easiest when you let him suck on your finger he will suck a little bit then his tongue will slip back and you can feel his gum. She said that is because it is hard for him to stick his tongue out like that and he gets tired quickly. That is probably making him get tired from nursing and then he is only getting foremilk so he is not getting much fat which can lead to low weight gain and not pooping. The next day for his 4th week appointment he still had not pooped. I told the pediatrician what the LC had said. She suggested giving him corn syrup to draw water into the intestines and make it easier for him to go since she was convinced he was constipated. She did give me a referral for an ENT that worked in the same building. But the ENT didn’t have any openings for another 6 days, which would be my son’s 5th week. Five weeks old before even being looked at for something that should/could have been fixed when he was first born.
When we saw the ENT he was very nice but said that he didn't think there was much there and that it probably didn't need clipped. He kept commenting on the fact that my son could stick his tounge out of his mouth. I showed him how my son’s lip would turn in when he sucked on my finger and he went to get another Dr. to look. The 2nd guy was much older and barely looked at my son’s lip before saying "yep, snip it". On the way out the first guy said "have you seen this before" and I heard the other guy say "yes". They couldn't clip it that day because it was late and they need to contact the insurance company so we had to wait another day. He didn’t seem to think there was anything he could clip under the tongue.
The next day we got up early to go and get his lip tie clipped. It was very quick, but there was some blood. No nummer was used and the Dr. just cut it with some sterile scissors while he sat on my lap and a nurse held his head. He could eat after the nurse was done applying pressure to it.

A little after he turned 6 weeks my daughter and I went to the dentist for our cleanings. When the dentist came in to check mine I asked about my son’s tongue and lip ties. She said he defiantly had them and that it could be causing him issues. She said she checked her son (a few weeks older then mine) for ties as soon as he was born. She said my son defiantly needed his tongue clipped. She suggested I make another appointment with the ENT. She mentioned that the youngest she had clipped was 2.5 years. She asked me how the lip clip was done, if there was any nummer used, if he just used scissors, etc. Then she said that if it was ok with me she could clip it right there. Ok. So she got some topical lidocaine and put that on it first and then clipped it. There was some blood, but not a lot, not as much as his lip even. Then she said that I should try to feed him. I tried, but he didn't latch. After the lidocaine wore off he latched better then ever.
now we wait and see if his weight gain/pooping frequency improve. I am not currently taking any galactagauges, nor is he taking any formula.