I had a rough time with both Bella and Balian. Different experiences, but equally as difficult. With Bella, I only lasted 2 months. With Balian, about 2.5. I wanted desperately to breastfeed, so I tried with everything I had for those 2 and 2.5 months. In the end, we ultimately decided that a happy formula-feeding mommy is better than a stressed-out breastfeeding mommy with low birth-weight babies. That decision still stung whenever people asked me about if I had breastfed my kids, and for how long...It just made me re-live the stress, the pain, the exhaustion, and the feelings of inadequacy every time.
So, this time around, I did all the research I possibly could. I learned more about technique - single side vs. double-side feeding, talked to the breastfeeding moms around me about their experiences, read articles on LaLecheLeague's website, rigged up a way to do a very accurate weigh/feed/weigh at home if needed, talked to the midwife a lot about how to deal with issues, and just hoped for the best, but prepared myself for the worst, I suppose.
When I first started midwifery care, we talked about the breastfeeding drama. The first thing Melody asked was "were they tongue tied?"
Tongue tied? I'd never heard of it, other than a figure of speech. I didn't know it actually existed as a condition - and how in the world did that relate to breastfeeding?
Melody had been trained to check for a tied tongue immediately after birth, and considering my breastfeeding history, she was definitely going to be checking. Sure enough, Isaiah had a VERY tied tongue. Heart-shaped in the front, and connected very near the front of the tongue. She didn't do anything at first, but after Isaiah's first feeding, I already had a blister on my nipple.
So, Melody cut his frenulum a bit - as much as she could with the scissors that she had with her, and said we would go from there.
This is not Isaiah. I got this picture from another blog that posted about a tongue-tied baby. But Isaiah's tongue tie was probably just as severe as this one. Notice the connection from the bottom (and tip) of the tongue to the bottom of the mouth. This is the frenulum.
The next day (Friday) we had a check-up with Melody. Isaiah's birth weight was 6 lbs. 8 oz., and now he was at 6lb. 2 oz. She wasn't super-happy with his latch, so she got better scissors and cut as much of Isaiah's frenulum as she felt comfortable cutting. She said that it looked like there was a lot more that was a lot thicker that needed to be cut, but she couldn't be the one to do it. She said to see how it went with what was cut and to go from there.
That night my milk came in and everything got 10x worse. Not only was I dealing with engorgement, but my nipples were in some serious pain. Each day got progressively worse. I got really stressed out about him not latching on right. It got to the point that I dreaded feeding Isaiah, and I was hurting so bad that I didn't want the kids to come within arm's reach when I was feeding...and there were many tears. I hated feedings. Bonding? What bonding? It was too stressful.
By Tuesday I would burst into tears at the thought of feeding him - and I cried the entire 30 minute drive to the Birth Center for my appointment with Melody. Of course, as soon as she saw me, she asked if I was ok, and I immediately shook my head no. She asked what was wrong and I responded "Just thinking about feeding him kills me." She immediately took me into a separate room to talk to me. We weighed Isaiah - 6 lbs. 2 oz. again. In the meantime, Kristin, the chiropractor, came in and started checking out Isaiah. She worked on his hard palette, because it was pretty high, and adjusted his jaw that was out of line. This definitely helped a lot. If nothing else, it helped Isaiah be able to open his mouth up wider. Melody looked at the condition of my nipples. She saw how blistered and cracked they were, gave me some nipple balm that a client's mom makes out of tons of herbs, and immediately called the lactation consultant. Dierdre agreed to meet us at the Birth Center for a consultation ASAP, which was about 2 hrs. later, since she was driving from Arlington.
The first thing Dierdre did was look at Isaiah. She didn't ask me any questions until she was finished. She concluded that Isaiah did indeed have more frenulum under his tongue that needed to get checked out by someone who could cut it. She also said that his upper lip was tied and his lower lip tight - keeping him from latching on with his lips flanged. Also, because of his tied tongue, his tongue movement wasn't great because he was moving the front of his tongue rather than the back of his tongue.
Next, Dierdre showed me how to get into the laid-back position to feed Isaiah. This, she said, would help him to get as good of a latch as he could, and because it keeps his chin steady, it would force him to use the back of his tongue more to suck, rather than using the front of his tongue and his cheeks. It definitely hurt significantly less to nurse, which told me that I could handle the pain that was there until we got the tongue issue handled.
She referred me to a Pediatric ENT in Dallas, Dr. Biovati, to get Isaiah's possible "posterior tongue tie" evaluated and potentially fixed.
She also told me that if I decided to pump that I would need a larger flange than the one that comes with the Medela pump. Apparently pumping is just like nursing - you have to stimulate a good amount of the areola to be able to get the most milk out - and to keep your nipples from being sore. The standard size would probably only get the nipple in my case. No wonder it hurt so bad to pump before!
I definitely left that consultation with hope and encouragement. Encouragement, because I didn't feel like I was doing everything wrong anymore. In the past I always thought it was me that was the problem. But (this time anyway) I was doing everything right, and the problem was something out of my control. I felt hope, because I left feeling like there was at least a glimmer of hope that I could continue to nurse Isaiah - and actually be successful at it in the end, rather than giving up like I did with the other two kiddos.
Monday, March 21 - We made it through another week - one day at a time - until we could go see Dr. Biovati. He took one look at Isaiah, and said that he definitely had a tongue-tie and that only about half of the frenulum had been cut. I held Isaiah, while Dr. Biovati used this contraption that looked like a metal tongue depressor with a slit in it to hold Isaiah's tongue in place. With one snip, Isaiah was no longer tongue-tied. He had me nurse him a bit to wash out whatever blood was present, and immediately his latch felt different.
The next day, Tuesday, we had a weight check. 6 lbs. 6 oz. He had gained about 1/2 an ounce per day. Considering the issues, not too bad!
Over the next couple of days, it seemed like things got worse. Dierdre had warned me that it may be like that for a couple of days. Isaiah had to get used to the ability to move his tongue more - and regain control of that movement. She said that it would take 36-48 hrs. typically to adjust.
It took us about a week, but at that one-week point, Isaiah started latching on a lot better, my nipples began to heal, and I was definitely in a lot less pain. Weight at this point: 6 lbs. 10 oz., so still about 1/2 an ounce per day.
The next week, he was 7 lbs. 1 oz. We're up to about an ounce per day of weight gain!!
This week, he weighed 7 lbs. 7 oz. at the doctor...again about an ounce per day!!
Things are definitely not perfect, but they're better, especially in comparison to where we were. We are not at the point of pain-free nursing yet, but like I said, it's better. There are still times that Isaiah gets lazy or is tired, and reverts back to lazy tongue-action (using the front instead of the back) which causes some soreness, but I know that over time his tongue will get stronger and using the back of his tongue won't be work anymore. We also still have the upper lip tie issue, which is causing us to still show a lot of the symptoms of a tongue tie. I've just in the past couple of days realized this, so I'm just learning about it. I read this blog, which was very helpful. It has a lot of good information from a chiropractor who has dealt with all the things we are dealing with in breastfeeding her kids.
I'm actually beginning to somewhat enjoy this whole breastfeeding thing. Definitely not loving it, but I'm not hating it either. The little accomplishments are what keep me going. I've never been excited about acne - ever - but when Isaiah broke out with baby acne, I did a happy dance, because I knew that acne meant a good dose of hormones, which meant he was getting a good amount of milk. Seeing the wrinkles in his thighs disappear a little bit at a time, watching him fill out more and more, and finding proof on the scale with consistent weight gain couldn't make me happier.
Maybe this time around I'll eventually get to experience the bonding associated with breastfeeding that I've only heard about. Perhaps we'll keep going strong and I'll be able to meet my goal of nursing for an entire year. We'll see. Right now, it's one step at a time, but I'm loving every step of the way.
Back to the question about the other two kids being tongue-tied:
Balian has a tied tongue and a tied upper lip.
Bella's upper lip is tied, but her tongue is not.
So welcome to my world of breastfeeding challenges. Praise the Lord that this time around we have had people around us to teach us about this thing called a tongue-tie. It has given me hope and demolishes the feelings of disappointment and inadequacy from not being successful with breastfeeding in the past. Knowledge is a wonderful thing!
For more general information about tied tongues go here.
For more detail, check out the blog I mentioned above.
