I just wanted to be up front about that. Because if you don’t want to hear about breastfeeding, both it’s trials and it’s triumphs, then you probably don’t want to read this entry. I’m okay with that — don’t worry. I won’t be hurt or offended, I promise. Okay? Okay.
So now that you’re here because you want to be, here goes.
I have 3 kids, and all 3 of them were – for a period of time – breastfed. I have had issues and more issues with breastfeeding, and I want to share some of that with you now. Not because I am having issues this time around (I’m not) <<knocks on wood>> but because some of the information I have gathered in the school of hard knocks may help someone else who’s struggling.
Connor was born tongue-tied. Do you know what this means? No, I didn’t either. Here’s a picture that perfectly illustrates what Connor’s mouth looked like:
This is what a tongue tie looks like. In fact, this could be a picture of Connor; he cried a lot. Because he was hungry all the time.
The thing is, a tongue tie seriously affects a baby’s ability to breastfeed. This is because the tongue needs to almost hug the nipple in order to get a good latch, which is imperative if the baby is to get a good feed, and then move freely in and out of the mouth to get the milk flowing, allowing baby to gain weight and be happy, making breastfeeding a success.
Connor was born at Women’s College Hospital. The lactation consultant there mentioned the tie, suggesting it could be problematic, and that I should talk to my pediatrician about it. I did, and her advice about releasing it was that it was up to me.
If you are a first-time parent, you know the haze and fog that surrounds the experience. You feel completely inadequate in pretty much every respect, and you haven’t slept since you went into labour. You have a hard time making a decision about what to eat – hell, even determining if you’re hungry! – nevermind serious things like whether or not to release your perfect infant’s tongue tie.
Here’s my advice: if you are a doctor who treats children, or a lactation consultant, PLEASE tell the parents to release the tie ASAP. In the very least, tell them exactly what the impact of their decision is likely to be. Or, if you are a parent to an infant with a tongue-tie, have your doctor release it ASAP. There are 3 reasons for this:
- As outlined above, I could not make a rational, reasonable decision. I needed someone in a position of trust to tell me what to do and why. They did not.
- This meant that I did not release his tie, and so Connor could not latch. When he was 3.5 months old he was just 10lbs (he was born 7lbs 3 oz); I made the very difficult choice to move to formula. This was against my pediatrician’s advice, even though it was clear that breastfeeding was not working for us and he was slowly starving.
- If you release the tie in the baby’s first 6-weeks, it’s a simple procedure in the doctors office, as the capillaries have not yet formed or connected or something like that in you baby’s mouth. After that, it’s an operation with anesthetic and everything, because they could choke to death on their blood. Niicceee…
I AM NOT AN EXPERT. These are simply my opinions, based on my own personal (and very traumatic) experiences. Connor was 15-months old when his tongue was released. It was the longest, most agonizing 5 minutes of my life… Yes, the surgery just took 5 minutes. But I was a wreck. And he was so upset afterwards… he was crying so hard that he slipped a stitch and bled like crazy all over. All over himself, the nurses, the bed, me… it was awful. So do it when they’re young so there’s no blood and really no pain either. So just do it, okay? Okay.
Next point: breasfeeding after a Caesarian section*. All 3 of my kids were born via c-section. Some will tell you that this can interfere with your milk coming in. Whether it’s the lack of hormones that are released during labour and delivery, or side effects of the drugs c-sections require, is anyone’s guess. There are others who will insist that c-sections cause no issue with milk production. I know that with my 1st born he lost a lot of weight, and there was very little collostrum. I rented a pump from the hospital to use at home, helping to get the colostrum to produce, and then to get the milk production happening. We finger-tube fed what was extracted to him, once he had suckled at the breast for an infuriating (for him because there was nothing coming out) 5 minutes. After he consumed what I had collected via pump, he was then put back on the breast to suckle some more. (He enjoyed that round more than the first, because at least he has some food in his tummy.)
The reason for this sucking is that conventional wisdom suggests that the very act of a child suckling from your breast will stimulate milk production. This, combined with the mechanical, hospital grade breast pump did see my milk come in. Instead of the typical 2-3 days, mine happened on day 5. So you see, I know what it’s like to work really, really hard to get your breastfeeding established. It was an hour’s work to get him fed, and then another 20-30 minutes to get all the equipment washed and ready for the next feed. Which was really only 30-60 minutes away. That’s right: I was waking him every 3 hours through the night to eat. For 8 weeks. Which meant that I was sleeping in like, 30 minute increments… it was beyond exhausting…
But I digress.
With my second baby, I asked for the pump on day one. I started to pump while in the hospital, getting the colostrum producing right away. The nurses were a little surprised and skeptical even, but they did what I asked and breastfeed with Sam was great.
Until it wasn’t.
My milk came in on time, he ate well and he gained like a trooper. I was so happy and so relieved after the debacle that feeding with Connor was. And then, when he was 7 weeks old, everything changed. He fussed while at the breast, he was very gassy suddenly, and then he started getting blisters on his bum every time he pooped. His fussiness at the breast turned into rage, and he would slap my breast with his little hands. I thought there wasn’t enough milk. So I gave him the other breast. The behaviour continued, and he almost stopped eating over the course of a few days. At a playdate, another mother saw what was happening and commented that this was the exact behaviour her son displayed before she learned that he was lactose intolerant. Another couple of agonizing days passed, and Sam was put on lactose-free formula when he was 9 weeks old. All of the issues disappeared overnight.
This time around, I did not ask for the pump while I was in the hospital. I didn’t get to hold little Elise for more than an hour, because I was strapped to a table being sewn up and too because she needed to be with the respitory therapist until her breathing sounded more “normal”, whatever that means. As soon as I got her, I put her to my breast. She latched for a moment sucked once or twice, and that was that. For the duration of our hospital visit, every time she cried, or made sounds that might be the beginnings of crying, I gave her my breast. My milk came in on day 3, and she’s been “gaining beautifully” to quote the pediatrician.
One last point to make: know your nipples. “She’s lost her mind,” you may be thinking. No, no I have not. The thing is, there are different kinds of nipples (which I did not know before bearing children), and each can pose a challenge when your child tries to latch. There are flat nipples, there are inverted nipples (which I have) and there are protruding nipples. I assumed I had protruding nipples. I didn’t know they were inverted until I had to squeeze my breast at the nipple area to force it into an infant’s mouth.
In a nutshell, if your nipples are flat or inverted it will be more challenging to get your child to latch. Here’s why: if the nipple does not stick out into their mouth, it’s very difficult for the tongue and lips to form a seal, and suckle effectively. If they are inverted, they look like they stick out until you squeeze them: then the nipples retract. (This is what happens to me). Here’s a link to a great pdf file showing the different types, and what to do to (a) determine what you have and (b) how to work with what you have. For me, I have found pumping as well as “the latch assist” to be invaluable in successfully feeding my children.
So what is the point of all of these ramblings, other than to share my experience? Well, sharing was the primary goal, I’ll admit. As I got writing though, I discovered I wanted to say something about the process I went through each time. We need to surround ourselves with people who know us intimately, support us through the tough times, and encourage us to pick up our load and move forward. Choosing formula was gut-wrenching both of the times. Even though I knew that Connor was starving. Even though I knew my milk was making Sam sick. Even though. In the end though, we all need to “think like men,” as one of my dear, loving supports said as I faced the decision with Sam. We aren’t talking about whether or not to go to war, we are talking about what to make for dinner essentially. Is breast best? Probably. But you know, in the 60’s and 70’s research showed that formula was best, so who really knows? You can read statistics in a myriad of ways, making them say any number of things. At the end of the day, we are talking about what to serve for dinner, and that is not supposed to be a gut-wrenching ordeal at any time. What’s really best in my opinion, is a fed, healthy, happy baby and a mother who’s satisfied knowing that she’s done her best.
*The first because he got stuck in the canal (who knew I had a small pelvis?) and I got stuck at 7 cm’s for something like 10 hours. My second was supposed to be a VBAC (Vaginal Birth After C-section), but he had other plans. At 37 weeks the little joker turned breech. My placenta was at the front, and lower-lying (not exactly previa, but close) and I had a LOT of amniotic fluid. My OB said that if my water broke, the gush of fluid could dislodge the placenta and deliver it before the baby, since the head is not in position to block the path. Given this information, MOMD & I decided that we would much rather have our baby alive, and so a c-section was booked. Because of the other 2 sections, my 3rd was non-optional.