What all causes clicking? Also, tips for nursing with a receded chin?

[smeep]

DD is clicking. She is 7 1/2 weeks old and started clicking at about 3 or 4 weeks (rarely clicked before that). Found she had ankylolabia aka "lip tie" and got that clipped. Pain lessened a little bit, clicking lessened a little bit but is still happening more often than not. Suction just really isn't getting much better. I suspected it was in part due to her not opening wide enough (an issue we've always had, though as I said, clicking was rare for the first few weeks). 

I was researching something about high palates for someone else and learned about CranioSacral Therapy and that it could help with latch. Went to her doctor for a referral and his PA checked her palate and said it was a little high. Went in for the CST a couple days later (on Friday). Her head wouldn't turn to the right and after the adjustment it will now and her congestion is almost completely gone (congestion that started up at about 3-4 weeks and has been persistent until the night after the adjustment, almost completely gone since then). 

So I'm hoping that the CST will help and that things will improve. She is gaining well, on the higher end of average for bf babies, it's just a matter of pain (which is MUCH less than before, I think the lip tie clip helped considerably with that and I think I'm also just getting used to it) and moreso just frustration. I'd like to figure it out, stop the clicking (milk leaking, uncomfortable because my breast gets pushed in and out when it happens, makes her spit up more, etc.), and just solve the mystery. 

So, here's where we're at. Any tips or information would be greatly appreciated.

Lip tie - clipped and done. Doesn't flange perfectly (probably due to not getting a deep enough latch) but isn't as stiff as before, so much better.
 

Latch - I don't know if it was deep enough before, but she's never opened her mouth very wide, seriously MAYBE a couple dozen times in the past 7 1/2 weeks of her life.

High palate - not positive if this has anything to do with it. 

Receded chin - probably an issue, most people think so and I'm inclined to think it may as well.

So, what could cause clicking? What might be the reason why she wasn't clicking often and then suddenly started clicking at almost every feeding? Could the palate have changed then or something? Tips for nursing with a receded chin? What about getting a deeper/wider latch?

TIA!!!

[homemademom]

The high palate could definitely be the problem.  My ds also had his lip and tongue ties clipped, but nursing didn't improve like I thought it would.  We saw another LC and she diagnosed his "bubble palate," which is a high arched palate. Basically, the nipple gets lost up in that little space in the palate so it's not compressed properly.  Oftentimes, the tips is smashed against the palate or bent in half so the baby doesn't get the milk it would otherwise (how is your baby's weight gain?).  We are doing CST with an excellent therapist, but there's only so much she can do.  Eventually their palates will spread out and come down, but it could happen by two months or twelve months.  

In our case, nursing wasn't possible because  my supply is low, therefore, even if I could tolerate the pain (I couldn't), he still wouldn't be getting enough milk at the breast.

There are a couple positions that might work for you, described here: http://www.mother-2-mother.com/nipplepain.htm#HighPalate  They didn't work for us (and every mother and baby pair is different, so you never know what might work). I also suggest finding an LC that specializes in tongue tie and bubble palate.  Good luck!

ETA: Our LC said that they push the nipple out because it doesn't get past the hard palate and into the soft palate. Because of the bump between the hard and soft tissue, they often feel like they're gagging when the nipple goes deep into their mouth. The clicking is a result of them breaking the seal because the nipple is constantly slipping out.  My ds also wouldn't open his mouth wide, which was made more difficult by my large nipples.  I assume that has something to do with how they used their mouth in utero.  It might have been uncomfortable to open wide with their tongue and lip bound down.  

[smeep]

Her weight gain is excellent, on the high end of average for breastfed babies. I now suspect that the reason why she nursed SO frequently in the beginning (every hour, hour and a half if I was lucky). She's still a frequent nurser but it's pretty consistently every 2 hours, rarely 3 or 4, so a pretty big difference.

I'll definitely try some of those positions and see what difference it makes. I'm also going to have our lactation consultant double check her palate and see what she knows, or if there's another IBCLC there who knows more in the area of high palates. Unfortunately I'm broke (as in, I have NO money, just food stamps) so I can't really just search for any LC but WIC's breastfeeding support here is wonderful so that's where I've been going. 

Thank you!

ETA: She has started to choke occasionally in the last few days and usually pulls off. It's not forceful letdown because it's not spraying when this happens so perhaps it is the gagging thing you were mentioning. That would also explain the nipple being pushed in and out.