Sunday, December 1, 2013

Breastfeeding : Round 2

It's happened again! I did everything right this time. Ate healthy throughout pregnancy, had a homebirth with no intervention, skin to skin with baby for 48 hours and I still got a baby with a dysfunctional suck. I now know the reason for this dysfunctional suck was a wonderful little thing called posterior tongue tie.

Lane's first latch on after birth

After I had Lane I was so so excited and nervous to start breastfeeding. I tried biological nurturing and had him skin to skin for 48 hours and let him self attach. However he would never really do it correctly. He would go down the the nipple and sloup it in. From the start I was feeling something was off. Then one night he started the dreaded chomping. I remember so vividly with Scarlett this action. He would do fine drinking the first letdown all the while flicking my nipple (which I now know means he held it in his high palate and wouldn't bring it back to the soft palate) and then he couldn't get anything more. So he began to use his gums. It is one of the most awful feelings in the world!! My nipples and areola were getting bright red and sore from the dysfunctional suck pattern. He would also gag, choke and gulp on the letdowns. He could not coordinate his suck swallow breathe. After the first week of oversupply and engorgement we started the 3 hour long nursing sessions in the evening along with the fall asleep after 5 minutes at the breast only to be hungry again 5 minutes later. It was exhausting! Plus his poops were continually green which is a sign he was getting too much foremilk and not enough of the fatty hindmilk. He gained fine in the beginning because I had a slight oversupply  to begin with and he got enough on the first letdown. All the while I was trying to keep it together but was failing miserably.  I could feel the anxiety and depression creeping in. It was so reminiscent of Scarlett. Everyone kept reassuring me everything was okay but I knew in my gut it wasn't. They told me maybe I had a lazy baby who was efficient and got what he needed quickly. But I just knew something wasn't right.

 I was doing lots of research to try to find the answer and came up with posterior tongue tie (PTT) and upper lip tie (ULT). I had never heard of it before but all of my struggles with Scarlett and all of Lane's struggles seemed to point to this problem.

The problem with PTT and ULT is that many ENT's are not aware of it or don't feel it is of any benefit to cut it. Many of them also use scissors instead of lasers so sometimes they have to put the baby under general anesthetic to get deep enough. We visited the ENT in our hometown just to see. He told me that Lane did have a minor tie but it would not cause issues because he could stick his tongue out. So being the persistent person I am I found the website of a great dentist, Dr. Kolow who deals a lot with PTT and ULT. I emailed him the best pictures I could take of Lane's tongue and lip tie and told him all of the things we were experiencing. He said based on these symptoms and the pictures he would expect to find a PTT and ULT. So I got on a plane to New York by myself with a 2 week old the day I talked to the doctor. We had to quick book tickets and drive fast to make it to the airport. Thankfully my flight was delayed or I wouldn't have made it in time. I kept thinking that I couldn't believe I was doing this and my anxiety was high. What if I was flying all the way to New York just to be told there was nothing wrong. But I also knew if I didn't I would never have been able to give up breastfeeding without feeling like I had done everything in my power to make it better.

So we arrived  in New York at close to midnight and made our way to the hotel. I barely slept because I was so anxious. The next morning we made our way to the dentist office. I was given a room right away, filled out paperwork, and Dr. Kotlow came in not long after. He did a quick check of Lane's tongue and upper lip and said he definitely had both and lip and tongue tie and couldn't believe the ENT wouldn't cut it. I then was given a video to watch on what they did during the laser surgery and the post op instruction for stretching the site. They then came in and took Lane. My heart was beating so fast watching my little man leave the room with the nurses. Not even 10 minutes later I heard his little cry coming around the corner. They brought him to me to nurse. I was slightly disappointed when I didn't feel much of a difference. I was hoping I would be one of those that I was reading about where things got better right away. However, I knew I had to be patient. After the appointment we were back on the plane home. Lane slept pretty much the whole time and for this I was glad.

Lane is now almost 7 weeks old and I wish, oh how I wish I could say things have gotten better. I have had a few pain free feeds here or there but mostly he is still nursing incorrectly. Also despite stretching the site (so awful to do) it re healed 3 weeks after the surgery and I had to open it back up and start the stretches again. Also he refuses to do suck training (which is basically finger feeding) to help him strengthen his tongue and learn to move it right. I thought by this point we would be nursing well but we are still struggling. My supply decreased a lot at 2 weeks postpartum and Lane didn't gain much weight from weeks 3-5 so we are now supplementing with expressed milk doing "paced feedings" from a Dr. Bronners bottle. The haberman which we used with Scarlett to strengthen her suck is still too difficult for him. He poops out really quick on it. I am mostly pumping and doing the paced feedings. I put him to the breast a few times a day after I pump. I have been working with a lactation consultant online who works with tongue tie babies and she says this is the best way because he is struggling with the suck, swallow, breathe and reverts back to old habits (bunching up tongue in back, flicking nipple into high palate, and chomping) when the letdown is to strong for him and he chokes. I know for sure I definitely don't have oversupply but might have a strong letdown due to the herbs I have to take to keep my supply up. I wonder if I will have to continue them if he ever nurses correctly? However, if his oral motor skills are off even a normal letdown is too much to handle. We have also been doing craniosacral therapy and chiropractic care which is helping so much with his latch and tension. He still has a sensitive gag reflex and won't bring my nipple back to the soft palate but craniosacral is supposed to help with this by helping the high palate to come down.

So at this point in time my nipples are still sore, my milk supply is decreasing, and my baby still isn't nursing correctly. I have my days where I seriously consider giving up. I have had my days where all I do is cry and cry. Where I feel like it is all to much to handle and is affecting my bonding with my son. I so desperately want to give him the best and I so desperately want to just nurse him. To be able to nurse him at night without having to move him to get up and pump afterwards. To throw the pump out the window(I have seriously considered this) and just nurse him to maintain my supply. I am feeling myself slowly falling into the deep dark pit of depression. It is so hard for me to stay optimistic sometimes because of what I experienced with Scarlett. It never got better with her and it is hard for me to think it will with him. The thing that keeps me going are that he got his ties fixed so there is hope for retraining and strengthening his suck. I am hopefully going to get a referral back to the speech therapist and continue to work of suck training. I have to be content now to just keep pumping, feeding him the bottle so he gains weight and strength, and nursing him a couple of times a day.

1 comment:

  1. Oh, Megan...I'm sad for you because of how hard this has been---again.