Tag Archives: posterior tongue tie

Nursing: the struggle continues

3 Oct

I am using Daphne’s hard-won morning nap time to pound out a long overdue blog post, rather than dealing with the laundry bomb sitting in front of me. Our sweet baby is just over three months old and is a total delight. She spends more and more time awake and alert. She smiles readily and has developed this hilarious and adorable squeal/laugh. Caitlyn and I are actually getting a reasonable amount of sleep (usually no more than two wake-ups) and I am slowly returning to a reasonable level of fitness. That is, I was until I threw out my neck last week. While I am starting to feel more calm and competent as the parent of a small baby, one issue still nags at me and remains unresolved. It’s also the cause of my seized up neck and shoulders.

I’m not going to lie. Breastfeeding is still really hard and I am not sure how long I am going to stick it out for. It’s the one aspect of parenting that fills me with anxiety and doubt. I know I am doing the best under difficult circumstances, but I question myself daily, wondering if I am still doing the right thing for both of us.

The great thing is that Daphne is thriving on my milk. She is gaining weight steadily and is more and more alert every day. But every feeding is a struggle and it’s exacting a significant toll on my mental and physical health. At 15 weeks old, she is still using a nipple shield and insists on being held on a pillow, in the exact same physical position. This means that I must contort myself into a really uncomfortable angle to get her to stay on the breast. I threw out my neck last week and it doesn’t seem to be getting any better. I don’t think it will until something changes.

We solved part of the mystery a few weeks ago when we put her on medication for reflux. She stopped arching her back and pulling away during most feedings. At first it seemed like she would be more willing to latch without the shield because she was suddenly more relaxed. I booked a session with a wonderful lactation consultant and it looked like we were about to have a major breakthrough. But the LC confirmed a suspicion of mine — the tongue tie has grown back. And since then, she has been totally resistant to any change. I can see her struggling to stick her tongue out and her tears of frustration tear at my heart.

On top of all of this, nursing in public has become a complete nightmare. She is now more easily distracted, leading to a lot of flailing. We had to leave a restaurant on the weekend when she became hysterical with frustration when I attempted to feed her. She was screaming, I was crying, the nipple shield kept falling off, and my boob was exposed for everyone to see. Fun times.

It didn’t help my morale when I received a condescending and ridiculous response to my plea for help from an internationally recognized breastfeeding expert. He told me that the way I’ve been feeding my baby is “an illusion” and that nipple shields “should be banned.” How helpful. Shaming women is an excellent way to promote breastfeeding!

So we are at a standstill. The status quo is unsustainable and not good for my mental and physical health. The current plan is to take Daphne to have her tongue tie assessed one more time. We will have it zapped if necessary and hope that this proves to be the final step toward a functional and enjoyable breastfeeding relationship. And if it doesn’t make much difference, I am going to to start mixing in a couple bottles of pumped milk and/or formula per day, to help protect my back and my sanity.

I have received nothing but support and encouragement from the people around me. But I still feel such pressure from the medical establishment and the breastfeeding advocacy community. My original goal was to nurse her for a year, but now I have my sights set on six months. Because the nursing mother’s mental and physical health is just as important as the food source.

 

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More on nursing and economic privilege

11 Jul

My last post sparked some lively discussion, but much of it was on my personal Face.book wall, so I thought I would summarize some of what we discussed. First of all, a few clarifications. As one commenter pointed out, I probably should have given the post a different title — perhaps “what is costs when your baby doesn’t latch.” Because it is absolutely true that breastfeeding is the most affordable way to feed a baby. No question. That’s why it’s so evil when corporations like Ne.stle give out free formula samples in poor countries. Because once your milk supply dries up, it’s gone. And then you are left forever dependent on a product that comes in a can. That being said, I don’t think it’s wrong to bottle-feed a baby. Formula is not poison. I respect parents’ choices when it comes to feeding their children. Full stop.

My intention in spelling out what it cost to get Daphne on the boob was not to imply that breastfeeding is a choice that only rich people can make. It was to be totally transparent about the steps we took and recognize that those decisions were influenced by our economic/class position. There are lots of free resources in the city, and I look forward to exploring them soon. I was fortunate to be able to access in-home help during the most desperate, teary-eyed days. But I know that there are lots of peer-to-peer supports (including La Leche League) that could have provided similar advice.

Also: in pointing out my relief over not having had a c-section, I certainly did not mean to imply that a vaginal birth is the key to a good breastfeeding relationship. I have many friends who successfully latched their babies after a surgical birth. I just cannot imagine what it would have been like to struggle through the last two weeks, if I hadn’t had physical mobility. Kudos to anyone (especially single parents) who manage to heal from major surgery while dealing with a newborn. My hat is off to you. You are truly amazing.

The economics of breastfeeding

10 Jul

The title of this post may seem counter-intuitive. Because breastfeeding is free compared to buying formula and bottles, right? So it should be the cheapest and easiest option for women to feed their babies. But if anything, my two-week struggle to get our baby on the boob has encouraged me to reflect on how my own economic and class privilege is allowing me to persevere, with many excellent resources at my disposal. According to Statistics Canada, 87.5% of mothers attempted to breastfeed their babies in 2009, if only for a very short time. But the disparities are more apparent when you dig deeper into what the numbers tell us:

  • Women with a postsecondary diploma or degree were more likely to begin breastfeeding their babies than those without a postsecondary diploma or degree (90.4% compared with 81.9%).
  • Of the 12.5% of new mothers who did not attempt to breastfeed, 28.4% cited medical factors (e.g., C–section, premature birth, multiple birth, or medical condition of mother or baby) as the main reason for not breastfeeding.
  • Of those who did begin to breastfeed, 6.9% stopped after less than one week and by one month 21.4% had stopped. However, in terms of those who continued to breastfeed, 53.9% who initiated breastfeeding continued for six months or longer; 15.9% breastfed for more than a year.

This all makes sense to me. Without a rock-solid support network, an involved and attentive co-parenting partner and a significant financial outlay, I don’t know if I would still be working so hard to get Daphne to nurse.

I am passionate about breast feeding, because I have read the research. I know that breast milk is the best possible food for my baby, tailor-made to her physical and neurological development. I am a married middle class Caucasian woman with a  graduate degree, a mortgage and a full-time job with excellent benefits. My employer is topping up my government maternity benefits to 93% of my full salary. I am literally being paid to parent, so I am not terribly concerned if I spend most of the next few weeks teaching my baby this crucial skill.

I also shelled out a significant amount of money over the last two weeks, to help facilitate Daphne’s breast feeding ability. Here’s a list of what we did and what it cost:

  • Two chiropractic appointments: $130 (will be covered by workplace health benefits)
  • Tongue tie laser surgery: $500 (will be covered by workplace dental benefits)
  • Two sessions with a lactation consultant — one in a group setting, one at home: $150 (not covered by insurance)
  • Rental of hospital-grade breast pump: $75, plus $50 worth of bottles and non-reusable parts (not covered by insurance)

Total financial outlay: $905 — so by no means free.

In reality, there are many free breast feeding resources in the city I live in, including daily drop-ins at community health centres in lots of different neighbourhoods. Some of these centres also lend out breast pumps for free. But I only heard of this after the fact, through word-of-mouth. And accessing these free resources means having to leave the house in the very early postpartum days. It also means that you need to have access to a car or be willing to take the bus with a three-day old baby. I would hazard to guess that by the time most new moms are ready to leave the house, the precious window for establishing a solid latch and an adequate milk supply have probably passed.

Also: I can tell you that if Daphne’s birth story had ended in a c-section. I cannot imagine that I would be persevering. I am convinced that I largely avoided a c-section because I was under the care of midwives (there is a shortage in Ontario) and because our amazing doula helped me hold off on getting an epidural for as long as possible.

Thanks to all of the (expensive) professional resources that we accessed in the first two weeks of Daphne’s life, I am now happy to report that she is nursing — finally! We are using a nipple shield for now and it seems to be an excellent tool to transition her off of the bottle. I don’t plant to use it forever, but it seems to be doing the trick to help kick-start her mouth reflex. Two weeks and $900 later, we finally have a baby that sucks.

Our baby does suck!

My baby doesn’t suck

4 Jul

I alluded to some of the challenges that Daphne and I are experiencing with nursing in my last post. I’m not going to lie, it’s been a rough go of it so far. Here’s the full story on my baby’s continuing strike against the boob.

After Daphne was born, she was immediately whisked away to be suctioned and only placed on my chest a few minutes later. We didn’t really establish an initial latch in the hospital, but I wasn’t terribly worried. I knew it would take a while for my colostrum to come in and that babies don’t need to eat for the first 24 hours of their lives (they are still full of the nutrients and fluids they received on the inside). But 48 hours after she was born, she was still uninterested in breastfeeding, and she started to get a bit too lethargic for my taste. I tried to perk her up by stripping her naked and placing a cold, wet towel against her skin. She barely stirred. I felt a mild sense of panic.

I called our midwife, and she insisted that I feed Daphne some formula, as she was at a birth and couldn’t come over immediately to help out, Luckily, our heroic and amazing doula was able to come over in a flash, arriving with a breast pump, bottles and bags of her own frozen breast milk. She also brought her eight-month old daughter, put her to bed in our guest room, and spent the night getting up every two hours with us, to bottle feed Daphne and encourage her to get on my breast. Caro even nursed our daughter herself and noticed right away that her suck reflex seemed weak.

Being a super hero, our doula managed to arrange an appointment with a chiropractor who came to our house the next day. She did some gentle cranial sacral work on Daphne and also checked out her palette and her sucking reflex. She agreed with our assertion that something wasn’t quite right.

I kept bottle feeding donor milk to the baby, pumping my own milk (which fully came in on day 4), and took Daphne to a lactation clinic at a local centre. Two lactation consultations took one look at her mouth and identified that she had a posterior tongue tie. Our midwife noticed the same thing when she visited the next day. Our doula was present for that appointment and immediately got on the phone to the one dentist in town who does laser surgery to correct tongue and lip ties. He agreed to stay late and see us at 7 pm the day before his vacation. So before I knew it, we were packing up the car and driving Daphne to the suburbs to get this thing checked out.

The dentist diagnosed her as having a “severe” tongue tie and recommended that we have it clipped. We made a gut-wrenching but very quick decision to allow him to do the laser surgery. It took only a moment and the Moms cried way more than Daphne did (she let out a short squawk and that was about it). He gave us a series of exercises to do with her mouth to help ensure that the tongue tie doesn’t grow back. And we returned home in a daze, hoping we had done the right thing.

A week after having the procedure done, Daphne’s suck reflex seems to be improving, but she hasn’t properly latched on to my breast yet. Which means each feeding session is rather exhausting. First, she roots for my breast, chomps down a couple of times, lets go, and then wails in frustration. I let her do this until she gets too upset, then I bottle feed her my pumped breast milk. Then I need to balance her on my chest (or hand her off to her other Mom), while I pump enough for the next feeding. It’s enormously sad and frustrating to have to feed her a bottle, when my milk is literally running down my chest as I do so.

The question of whether or not to give a baby a bottle is a controversial one in the breastfeeding community. I know that she is doubly frustrated, because the milk clearly doesn’t come out of my breast as fast as it does from a bottle. But I am confident that we made the right decision on day 2 of her life. She immediately rebounded and became bright-eyed again. We avoided dehydration or jaundice and she was nearly back at her birth weight after a week.

My first priority is to feed her and make sure she is getting the nutrients she needs. The second is to get Daphne on the boob. The extra step of pumping and washing bottles makes each feeding a major challenge. And I am basically housebound until we figure this out. Breastfeeding is portable. The hospital-grade double electric pump is not.

Since posting about some of these challenges on Face.book, I have received dozens of messages from other parents who faced similar challenges. Some took weeks to establish a functional breastfeeding relationship with their babies. I am trying to be zen about the whole thing and remember that Daphne is only 9 days old. She is also learning to use her mouth in a whole different way. I can tell that she is getting frustrated too and I feel like a breakthrough is just around the corner. Until then, I have a baby that doesn’t suck.

We are both tired, but coping okay.