You may remember how worried I was about breastfeeding the second time around. We even dedicated a Carnival of Breastfeeding to the topic. I had so much trouble with Miles in the early weeks, from sore nipples and poor milk transfer to weight loss, but I attributed much of that to the fact that I had a hospital birth, he was routinely supplemented and probably had some nipple confusion. I figured a lot of the problems I faced with him could be avoided by having an out-of-hospital birth, but I also assumed that having "been there, done that" would make breastfeeding much simpler and easier the second time around.
So imagine how thrilled I was when breastfeeding seemed to be going swimmingly with Aminah. Although she was immediately put on my chest after birth, she didn't latch on for a good hour and a half. But once she did, she opened wide and was sucking strongly. She seemed to be thriving on my colostrum; babies are only expected to have one poopy and one wet diaper on the first day of life but Aminah had three! She continued to poop and pee well and nurse frequently and my milk came in on the second day (it took until day FIVE with Miles!). Once my milk came in, though, things got shaky. Aminah was having a hard time latching on to my rock hard boobs, she wasn't transferring enough milk and I could feel hard lumps forming in my breasts. My nipples were sore, her latch was extremely painful and she wasn't emptying my breasts. I could get her to open wide but she'd quickly slide back and be sucking only on my nipple. She was no longer pooping and only having a few diapers with pee in them. I was dreading feedings and wondered if I could make it 6-9 more painful weeks, the way I had with Miles. So I did what I always tell everyone else to do when they email/tweet/facebook me with their breastfeeding problems; I called a lactation consultant.
I am lucky enough to have a wonderful local IBCLC who coached me through a couple of things online before she could come see me the next day. By the time I saw her on day 5, Aminah was down to 8 pounds from her robust birth weight of 8.15 and had the dreaded urine crystals in her diaper. My LC looked in her mouth and determined she was tongue tied. I was devastated. Although I know tongue ties are common, I have heard time and again from the LC community that pediatricians and other doctors don't take this concern seriously and are reluctant to clip. I also clearly remembered a pediatrician doing rounds when my son was born telling me he had a tight frenulum, but when I mentioned it to my regular pediatrician he waved it off and said it was fine. When my LC looked in Miles' mouth that day, she said his tongue tie was so awful she didn't know how I ever managed to get the kid fed at all, let alone at the breast!
Thankfully I live in a place where I have a lot of options for getting the tongue tie released (you can find out who does them in your area here). My LC gave me a list of names, including Dr. Denise Punger. I knew of Dr. Punger from her book Permission to Mother and her blog by the same name. She wasn't the closest doctor to me (in fact, she was the furthest away) but I knew that if there was a need for a clipping, that I wasn't going to have to argue with her or convince her why I needed to get this situation fixed. I knew Dr. Punger would "get it" because she is a mother of three breastfed children and an IBCLC herself. Also, she was incredible enough to fit us in the next day! So I packed up the whole family and we drove 90 minutes north to Ft. Pierce.
When we arrived at her office, I broke into a smile when the first thing I saw on the wall was this poster:
In the waiting room were two other moms who traveled almost as far as I had to get breastfeeding help from Dr. P. I wonder if they picked up a copy of her book while they were there?
I know what you are thinking, coolest doctor's office EVER, right? Oh it gets better. Here is the exam room.
I mean, honestly, how many doctors would have a photograph of their footling breech home birth blown up on the wall of an exam room for all of their patients to see? (click to enlarge)
After a short wait, I finally got to meet Dr. P (we've corresponded via email and I read her blog so I felt like I knew her) and she was just as I imagined she'd be. She looked at Aminah, confirmed the tongue tie and went to get her tools in order to release it. When she returned, the nurse placed Aminah on the exam table, swaddled her up tight and Dr. Punger touched her mouth. I was too much of a wuss to look, but immediately Aminah started to cry and I whimpered. "She hasn't even done anything yet!" my husband told me.
After she clipped her frenulum, she handed her to me so I could nurse her. Her mouth looked like it was full of blood but I later found out it was only a few drops but that when it pools with the saliva, it looks like a lot. As soon as she latched on Aminah calmed down and seemed fine. Her latch was still quite painful, but Dr. Punger assured me it would get better quickly.
After we left I asked my husband what the procedure looked like and he could barely contain his incredulity. He said the doctor had just barely touched the membrane with a small, scissor-like tool and it had spread open. It took a fraction of a second. "We could have done that ourselves at home!" he said. (My hubby is known to be uh...frugal?)
By the time we got home that night, I could feel an improvement in Aminah's latch. By the next day, she had figured out how to use her new and improved tongue and was sticking it out constantly. She was nursing like a champ, removing lots of milk and pooping after every feeding. I'm happy to report that even with our less than stellar start she was back to birth weight by day 13.
If you think your baby might have a tongue tie, please see an IBCLC (check out the signs of tongue tie from Dr. Kotlow, scroll down to "
Diagnostic criteria for neonatal tongue frenum revision"....I swear we had every sign!) If I could give advice to anyone facing the decision of whether or not to clip a tongue tie, I'd say get it clipped as soon as possible! It was really such a simple procedure and has completely changed our breastfeeding relationship. I know that some tongue ties are more complicated than ours was, but many dentists can now fix them with a laser and it doesn't require anesthesia and it's not major surgery.
Also, as an aside while I still have your attention. When you are having major issues in the early days of breastfeeding, you really can't go wrong by seeing an IBCLC. Yes it's expensive and you might not get reimbursed through your insurance but it's still worth it. If you are still pregnant, I highly suggest putting away a few dollars every week in a jar as a "just in case" fund. If you don't need to see an LC, you've got a couple hundred bucks to use any way you choose. If you do need one, it won't hurt as bad to hand over the money. And please beware of the advice you might get online from other moms. I can't tell you how many people on Twitter told me that it was JUST FINE that my baby wasn't pooping and peeing, no need to worry at all. When I said I had to supplement her with formula, people came out of the woodwork to tell me it wasn't necessary. Believe me, it sucked having to give her that stuff that is "similar to lactation", but she
needed it. As a friend reminded me over the phone as I cried over it, Rule No. 1 is Feed The Baby. A couple of ounces of formula to get her over the hump until we figured out breastfeeding wasn't going to kill her and again, it was necessary. Your twitter followers, as well meaning as they may be, can't see in your baby's mouth and frankly, might not know what the hell they're talking about. Mother-to-mother support is vital and important, but please seek professional help when it's obvious things aren't going well.
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