Hellobee

Laura of The Zhukeepers shared Part 1 of her breastfeeding saga here.  In Part II below she shares how she overcame her many obstacles to eventually breastfeed successfully.

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If you recall, what we have on breastfeeding’s side so far:

• eats only a few seconds at a time
• needs awkward nipple shield which is a hassle and makes me feel like I still can’t do it “right”
• painful even with the nipple shield
• acts hungry after eating no matter how many times I try to feed him
• suffered from dramatic weight loss well beyond the expected amount for the first few days
• ended up severely dehydrated and jaundiced

Meanwhile… feeding him pumped breastmilk with an occasional bottle of formula:

• eats for many minutes at a time
• seems satisfied and full after feedings
• falls asleep happily after eating
• we can keep track of exactly how much he’s eating
• gained tons of weight, increased his output, recovered from jaundice, looked plump and healthy

After we got home, it took me a little while before I got up the courage to try breastfeeding again. Still zero success without the nipple shield, and extremely limited success with it. I only had a manual pump at this point, which I couldn’t even get to work the first day, resulting in the loss of quite a lot of milk and my first (and still worst to this day) total mommy breakdown. Both my mom and my mother in law were in the living room when I lost it in the shower. I texted Mr. Z to come back and he came and talked me down from the “not only can I not breastfeed, but I can’t even do anything to provide for my baby” ledge, while the grandmothers took care of Sam. Then we came out and ordered an electric breast pump with overnight shipping 5 minutes later.

Once that arrived, my average feeding was spent like this:

• heat up bottle for Sam (5 minutes)
• feed Sam (20 minutes)
• pump for next feeding (30 minutes)
• wash pump parts (5 minutes)
• with every 4th or 5th feeding starting with about 5 minutes of attempting to nurse with the nipple shield

Mmmmmm milk

Several days in, he was nursing for maybe 3 minutes at a time with the nipple shield (but popping on and off a few times during that period). It was still extremely painful, and he was still hungry afterwards, but he was nursing! Sort of! I kept trying to replace one feeding with nursing only, since I was only able to sleep 1.5 hours MAX out of every 2.5 hour period (and we had to wake him every 2.5 hours minimum to eat because of his earlier problems.) But he couldn’t ever get full enough off of nursing, so I would spend longer trying to nurse than before, but still have to do the rest of the cycle before the 2.5 hours was up. It was completely exhausting, to say the least, and kept getting more and more painful, until my nipple finally cracked and started bleeding. Ow.

For a little while now, people had been suggesting I see a lactation consultant. I liked the idea, but I was so sleep deprived that I had trouble imagining how to find the time to track down a lactation consultant let alone see one, plus I had seen several at the hospital who all gave me the same advice over and over again. While the nipple shield had helped a bit, I had read some negative reviews of the idea online since coming home, and it clearly wasn’t solving the problem entirely since Sam couldn’t eat enough to get full and my nipple was, um, not good at this point.

Cozy in his bath towel

Then, when Sam was about 2 weeks old, we had our postpartum follow up with our doula, Stacey (who is awesome by the way!). She has had some lactation training, but mainly enough to tell that something clearly was not working. She agreed that he appeared to be latching correctly… so why couldn’t he eat? She left our meeting and sent me a list of local lactation consultants that afternoon, strongly urging me to see one as soon as possible.

We made an appointment with Catherine Watson Genna, one of the lactation consultants Stacey recommended, when Sam was about 3 weeks old. I have to admit that as much as I hoped this would be the magic solution, I was not optimistic at all. But when we stepped into Cathy’s home (where her office is located), I could feel the stress dripping off me. The atmosphere was so comforting, and Cathy seemed so sure that we could figure this out together. After watching Sam breastfeed and carefully studying him, which largely consisted of her being completely enamored of him – I love it when you can tell that people who work with babies often actually like babies!! – she said she was confident that Sam’s problem was a tongue tie.

We discussed many different options, and to her credit, she didn’t even bring up the one that seemed the most extreme at the time until last: a frenulectomy. Basically, it is an extremely quick and simple procedure whereby a pediatric ENT essentially cuts the tongue tie itself with surgical scissors, thus releasing the tongue to move freely. Initially, I was horrified that she was suggesting someone come at my newborn with scissors, but the more we learned about tongue ties and the procedure, the better the idea sounded. A tongue tie prevents the baby’s tongue from the full range of motion which is required for breastfeeding by “tying” the tongue to the bottom of the mouth with a too short/tight/misplaced frenulum (that little web-like thingy under your tongue).

For thousands of years, clipping tongue ties was extremely common, but since midwives would routinely clip them with a sharp fingernail on all babies, it got a bad reputation since obviously this could cause infection, and the vast majority of babies didn’t need it done. There were a variety of reasons they were done on all babies, but since most babies didn’t have tongue ties and most of the reasons were either invalid or irrelevant since the baby would outgrow the problems from the tongue tie at a later age, popular opinion swayed to thinking this was an archaic, and even cruel, unnecessary procedure to afflict on a baby.

Right around this time, baby bottles and formula were increasing in popularity, with the pharmaceutical and medical companies arguing that they were actually better for your baby than breastfeeding. So, since the only proven problem that tongue ties could cause in infants being difficulty breastfeeding, everyone just said “well you certainly shouldn’t have this procedure done; formula is better for the baby anyway!” and very few people still practiced or endorsed frenulectomies. In the past 20 or 30 years, however, as breastfeeding has become the generally recommended method of feeding babies again, lactation consultants and doctors came to realize that while giving every baby a frenulectomy was still blatantly unnecessary, in certain cases it could be a godsend.

So, after analyzing all our options with Cathy and doing a bunch of internet research, we decided to go for it. We made the appointment with the pediatric ENT that Cathy recommended, and went in for our consult. She took one look under Sam’s tongue and said, “Oh yes, that’s the most obvious and easiest to treat type of tongue tie. Do you want to take care of it right now?” Like…. now now? She had me hold Sam’s head, and my mom held his arms, and she held his tongue up with a little gauzy clamp, and snipped with surgical scissors. Sam’s tiny tiny mouth started filling with blood (ohmygod this was so traumatic) and he started screaming. The doctor stuffed more gauze in for a couple seconds while telling me to get ready to breastfeed him. “With the nipple shield?” I asked? “Nope!” I put my poor screaming bloody baby to my breast and… he latched on! For thirty minutes!!! They needed the room for something else, so they let me take him to a conference room after a couple minutes, but he instantly latched on again there, and nursed and nursed until he fell into a deep and satisfied sleep.

Wow.

Wow.

By the time he stopped nursing, the bleeding had totally stopped. There is no anesthesia necessary if the procedure is done in the first month (or 2?) of the baby’s life, and the best way to heal the wound is by applying… breastmilk. Seriously, nature is so cool. It took us a little over a week of occasional bottle feedings and nipple shield use before we were able to wean him off of those tools and get him to nurse exclusively au naturale, and nursing is honestly the best thing ever now!!! After weeks of “well maybe this isn’t pain exactly?” trying to determine what that “when breastfeeding is working properly, it won’t hurt at all” thing really meant, I finally got it. There isn’t even any hint of discomfort! It just feels cozy and intimate and there is nothing I love more than seeing my little baby fall asleep quietly nursing and playing with my bra strap in one hand as he dozes off. It is honestly one of my absolute favorite parts of being a mother.

Everything working smoothly finally

Which is not to say that everything was 100% perfect after the frenulectomy. Twice more I have had cracked nipples that ended up bleeding, most likely caused by incorrect latch when Sam and/or I was too tired/frustrated to get it right, and one of those times it developed into what we believe was a staph infection. Cathy told me that up to 30% of staph infections can be healed simply by frequent washing with soapy water and, you got it, breastmilk, so I should just try that and if it didn’t get better in 2 or 3 days go to a doctor for a prescription. I also found that the fuller my breast was the more it hurt (crazy insane intense shooting pain, way worse than labor), so as much as it hurt for Sam to be sucking on the cracked part and thus keeping the skin from healing over, it felt so much better to let him drain the breast completely as frequently as possible. Both of those injuries healed within a couple days, and now I am much more aware of every single latch, and will frequently pop him back off and on again if I’m not positive that he’s in exactly the right position. Makes him a little grumpy at the time, but better for everyone if he always latches correctly.

Now that he has teeth, I am also at the mercy of his little chompers. Luckily, he very rarely bites, and if I just say “No biting” in a firm voice, then remove him from the breast, he generally gets so annoyed that I won’t let him eat for that few seconds that he eats in a more dedicated fashion when I put him back on. Except for the other day, when he bit me so hard I bled. OW. I was certain that would take a few days to heal like the cracked nipple injuries had, but somehow sucking doesn’t aggravate this type of cut as badly, so it felt completely fine by a few hours later!

I love this guy so much

At this point, my greatest concern about breastfeeding is that I’ll have to stop sooner or later!! I actually got teary eyed the other day telling Mr. Z how unfair it was that I had this beautiful experience with my son now, but that when he’s older if I try to tell him about how wonderful it was and how close we were and how much he loved it (he’ll crawl towards me and lunge open mouthed to try to nurse while I’m getting positioned)… his response will pretty definitely be, “EWWW MOM, GROSS!!” So not only will I have to stop nursing him sometime over the next few months? Year? Year and a half? But I won’t even be able to keep the closeness of this relationship up with my son once he necessarily deems the whole concept disgusting. Sigh. Why can’t they stay babies forever, again?

A Recent Full Family Portrait: Sam (nursing), my knee, Mr. Z’s hand, Albi

If anyone has actually read this far… wow! Thanks! Haha. I hope this story might be helpful for a couple of you!