Yes, Taryn! Great point! And lots of docs believe that tongue ties don't interfere with breastfeeding, so they dont want to give a referral for a frenectomy. The reality is that sometimes even a small tie can make breastfeeding difficult, depending on the situation.
However, if this is something you suspect is an issue, it may be helpful to show the doubting doctor the the article by Elizabeth Coryllos on The Impact of Tongue-tie on Breastfeeding - written for the AAP (American Academy of Pediatrics): http://www2.aap.org/breastfeeding/files/pdf/bbm-8-27%20Newsletter.pdf
I know that tongue ties are something we are seeing more and more in our area, although they probably arent becoming more frequent, but, rather, more women are educated in breastfeeding nowdays and determined to breastfeed and more of these obstacles to breastfeeding are being caught and diagnosed.
Lilac, I am not in any way discounting the education requirements that go into becoming an IBCLC, but just wanted to sound a word of caution about what kind of experience an LC, doula, midwife or other breastfeeding counsellor may or may not have. All these people may be great at helping moms get breastfeeding off to a good start, but its not necessarily true. We have a local LC who has a reputation for getting her clients to rent her pumps, rather than fixing breastfeeding, I've helped a mom whose midwife gave her some truly wrong breastfeeding advice, my own doula with my first did not have a lot of experience breastfeeding her own kids successfully...and I know that there are lots of people out there in those professions who have a wealth of knowledge and experience with breastfeeding