Warning - "graphic" imagery for those uncomfortable with the natural art of breastfeeding!
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So...over the past six weeks, I think I've experienced almost every up and down possible while trying to breastfeed my Jayden James. Neither my mother nor my grandmother breastfed, so I was in a whole new world where I was sinking hard and fast. My goal was to have a natural childbirth, lots of skin-to-skin contact with baby, and breeze through breastfeeding.
My goal was off.
I did have a natural childbirth at WBWC (Women's Birth & Wellness Center) in the tub...a water birth if you will. He was placed on my chest when he was born, we delayed cord cutting, and while I was being taken care of he was on dad's chest. Well, our first breastfeeding encounter was...lacking. We couldn't seem to get it right while we were at WBWC. The notes in my chart state that he wasn't latching, only sucking. They showed me how to hand express colostrum and gave us a syringe and cup to try to feed him expressed milk with to avoid the bottle trap. My midwife and doula voiced suspicion that he had a tongue tie, though neither were completely certain. This was March 6th. The next day I was to have a visit at home from our doula to help with positioning and latch, and a two-day visit from one of the midwives at WBWC.
birth 3/6 - 6lbs 11oz
We ended up having our postpartum appt the next afternoon since they were backed up and concerned about his nursing, and it was either the next day or 3-5 days from birth instead of the usual 2-3 day window. Well, after having his weight checked and being pricked for the PKU testing, he decided that he was tuckered out and too tired to nurse, so I never got to show the home-visit midwife his nursing, but I was still feeling pretty confident that everything would work out, and only mildly concerned about his suspected tongue tie that my doula and delivery midwife mentioned. After all, no one else was backing it up, right? And his "brown fat" weight loss was spot-on...but technically it had only been 1 day.
postpartum 3/7 @ 4:30 pm - 6lbs 4oz
Well...let's just say that things went surprisingly quickly downhill after that. While I was doing great physically from labor, nursing was...a challenge. When our doula dropped off my encapsulated placenta and tinctures the following day on 3/8, she helped me "remember" the side-lying position, which helped a TON with our latching issues, since I just couldn't get him to stay on sitting upright. She also took another look at how he was sucking, and reiterated that she believed he had a posterior tongue tie. By the 9th or 10th of March I was becoming resigned that perhaps this tongue-tie thing was a real problem, and I finally wanted it FIXED. My nipples were going straight downhill. I was starting to cry every time Jayden cried because I wanted to want to nurse him, but I didn't want to do it myself! I was damaged, physically and emotionally, and something had to be done. Well, the birth center (WBWC) happened to call me to check in amidst my frenzied text messages with my wonderful doula, and they scheduled me an appointment with Dr. Laura Brown, an ENT (ear, nose, and throat doctor) to have Jayden checked for tongue tie since I was becoming adamant that this could be contributing to our issues. Hmmm...
3/11 appt with Dr. Laura Brown ENT - inadequate knowledge of 3rd degree anything - milk came in day 5 evening
***NOTE: personal opinion of actual experience***
Well, meeting Dr. Brown was...pointless. A complete and frustrating waste of TIME and MONEY. I left her office in tears while describing to my loving in-laws the way I was spoken to and that I was ASSURED that "there is absolutely nothing wrong with his mouth" while having his "perfect" mouth and tongue movement demonstrated with hand-puppet gestures, as though I was mentally incapable of understanding what she meant. Really. Because my nipples are cracked, scabbed, bleeding, and full of vasospasms because I'm hallucinating. Not having a medical degree does NOT make me uninformed. Apparently, it makes me better informed than some specialists.
-End Rant-
Well, I immediately began calling around. I'd already scheduled a back-up appointment with Dr. Heffron at Carolina ENT just in case this happened, but it was almost two weeks out, and I was desperate. I tried to get in with a specialist at UNC since I'd heard they have a laser for the difficult to both see and reach cases, but I couldn't get past the recording, and apparently the LCs I'd spoken with at the birth center thought the issue was positioning or some foul-sounding alternative to a new mom whose nipples are sore and baby wasn't gaining weight anymore. And they couldn't get past the recording.
Well, I'll skip through some tedious and painful details and say that I had to start a healing regime with the help of a TALENTED IBCLC, also named Jessica. I also had home visits with same IBCLC to help with latching him the best way possible, which were pretty much the exact ways he wasn't supposed to latch, but they hurt the least and got him the most milk with what we had to work with. I also had an appointment to see the head of lactation at the birth center because of the concerns I'd been voicing...
At the appointment with Nancy, head of lactation at WBWC, she suggested different latching positions, weighed him pre and post nursing, and showed me a nipple shield which I said I didn't want. That's pretty much the un-useful gist of that appointment. It made me really glad that I'd already met my insurance deductible and wouldn't have to pay out of pocket. On a later date I found out that she'd noted in our chart that our nursing issue was a "positioning" issue. Because I'm going to buy her couch to figure out the best way to nurse on that particular chair. Right.
SO, on 3/12 we also had our first appointment at the chiropractor, since during one of the IBCLC *home* visits we noticed that laying on one side of his body made his latch MUCH worse that the other, and figured he was a little banged up from, well, birth. Dr. Donna Hedgepeth at Keystone Chiropractic...besides being a GODSEND herself, adjusted my little bean and pointed out his unusually high palette (probably from the tongue tie) and did suggest seeing an ENT also...which created some surprise for her when I told her we'd already seen Dr. Brown, but that we were going to be seeing someone else as soon as possible. We also began a brief chiropractic regimen to help sort out the physical stuff that was also affecting his latch.
3/14 appt with Donna
Healing regime starting around 3/15: pure lanolin (Lansinoh brand) before nursing to lubricate and protect, the following after nursing (EVERY TIME):
- rinse with white wine vinegar
- soak <1 min in normal saline solution (same salinity as tears)
- breastmilk
- AIR DRY COMPLETELY
- tiny dab of all-purpose nipple ointment (which you can get HERE made by me - all natural, in place of the all-chemical with steroid version...I wasn't comfortable with my INFANT eating bits of a steroid cream lol...if you're local send me an Etsy conversation so that I can create a listing without shipping and just have you pick up!)
- cover with hydrogel pads
3/18 appt with Dr. Heffron @ 11:30; appt with Donna at 2pm (both) - clipped posterior submucosal tongue tie and severe lip tie
Lo and behold, a PROFESSIONAL familiar with POSTERIOR SUBMUCOSAL TONGUE TIE!!! After about a 30 second evaluation from Dr. Heffron, he clipped both the tongue tie AND a severe lip tie that almost wrapped around his top gums...because, as we were previously told, there was "absolutely nothing wrong with his mouth." Sorry, the sarcasm will have an end...I think :-)
Well, now that the physical issue was fixed, it was up to us to get Jayden's weight back up, since we were almost at 2 weeks old and still not up to birth weight. Jessica and I began working on methods to increase supply and weight WITHOUT introducing formula or anything disruptive to his improving sucking pattern.
3/19 - I got a hospital grade Medela pump rental from WBWC to start Jessica's suggested regime to get Jayden's weight and my milk supply up. It varied every few days, and I didn't follow as strict a regime as I probably ought to have (being emotionally drained and all), but here's the best gist of what I think worked:
- fenugreek capsules - 3 capsules 3x a day
- Milkmaid tea as often as I remembered
- pumping BOTH sides between every nursing (as often as I could manage it)
- supplementing with expressed milk in a Medela Haberman/Special Needs Feeder bottle a few times a day, between on-demand feedings
A little bit about the Medela Haberman/Special Needs Feeder - to be added! - picture below
At the above appointment, I spoke with Maureen Darcy afterward who'd taken a personal interest in my issue. Since we were at 2 weeks and still not at birth weight, she suggested a supplementing regime very similar to Jessica's, but much more difficult to juggle (makes sense when you have an extra pair of hands, which I didn't for most of the day) after I went through our story to-date:
Nurse (side 1) -> pump both -> supplement side 1 pumped hindmilk with syringe -> Nurse (side 2) while adding pumped side 2 milk from previous alongside nipple with syringe and tubing -> repeat
Maureen also scheduled me an appointment with a speech therapist at Carolina Pediatric Dysphagia to help improve Jayden's sucking since it was still a concern, and I was still damaged, and his weight gain needed to remain stable or increase.
4/2 appt with occupational/speech therapist in Raleigh @ 8:45am
Let's just say that I'm pretty sure the therapist thought I was crazy, because the feeling was mutual. She thought using the Haberman bottle was a HORRIBLE IDEA, though I'd seen improvement in his suck with it, and suggested I use a normal bottle only with pacing training then come back in a week and see how he nurses. Right. When I questioned her abhorrence of the Haberman, she suggested that since I like to get all the facts I can (my words) I should research/Google it. Go figure. Oddly enough, when I told Maureen about this (during a follow up call around 6pm that evening), though she didn't understand her reasoning, she suggested blindly following the suggested regime because this therapist had a high success rate with breastfed babies. Did I mention that the therapist called me at 8pm to check in on my plan for the weekend? This was a Friday evening that Joan Comrie told me to Google information and that when parents do what she says they're successful. I never went back.
That was the last straw.
I decided that, besides occasional assurance that I'm not crazy and that my baby is remaining healthy with my nursing from Jessica (IBCLC, remember?), that I wasn't accepting any other suggestions or opinions. My seemingly high-needs, boob-loving, breastfed baby would have to figure out the rest on his own. He even began refusing his supplements from the specialized Haberman bottle on his own. I wasn't in dire pain anymore, and weaned myself from the healing regimen and hydrogels. Or rather gave up because I didn't seem to be getting re-injured and it was exhausting. Things were going to work out.
4/16 - appt at WBWC (6-week pp) - 8lbs 8oz
4/24 - 9lbs 1.5 oz
**He began gaining about an ounce a day and continues to! He's doing great exclusively nursing on demand!
http://www.cwgenna.com/
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