Nigel Farndale writes about the difficulty of naming books (and also children). And, while sometimes publishers will change a title between the hard cover and the paperback, and people will occasionally rename children, for the most part, yea, I can see that being a stressful decision, that you will live with for the rest of your life.
Farndale cites the title changes for Lord of the Flies (nee Strangers From Within and A Cry From Children) and The Name of the Rose (nee The Abbey of the Crime and Adso of Melk). Given how "eh" some of the alternate titles were, does it make that much of a difference to sales and title longevity? Potentially!