Tongue Tied

Turns out, I was right. In short: Claire had a pretty obvious tongue tie, which was 70% restricted & affecting her feeding.

Her checkup with the paediatrician was fairly boring - which was a good thing! Even after telling him about my breastfeeding concerns, he brushed off the idea of a tongue/lip tie, and barely even looked inside her mouth. I thought he might take me seriously when he weighed her & she was showing fairly slow growth on the charts.
She was 4.1kg at birth, 3.8kg on hospital discharge, and at 7-weeks old, she weighed in at 4.8kg. That means, she's gained an average of 100g a week (a 700g difference) which is under what they'd like her to be at. She's gone from being on the 97th percentile at birth, to under the 50th percentile now. It's not that average is bad; it's just that the drop has been consistent every week. 
Despite this, and despite me sharing that the pain from post-breastfeeding was bad enough to consider giving up, the paediatrician told me to 'just persevere until she hits six months, as that's a good age to aim for while feeding.' 
Are you kidding me? I left that appointment fuming. To disregard our breastfeeding troubles like that, to a Mum who has done this before and KNOWS something isn't right... well, it wasn't a great feeling.
That same afternoon, I rang a qualified Lactation Consultant who specialised in feeding issues and ties, and got an appointment for the following week. That was on Monday.
We had a lengthy consultation, and she spent a lot of time watching Claire feed, and performing an oral examination to see what was going on inside of her mouth. She commended us on feeding and gaining as she had been, and declared that Claire was working the hardest she could to feed well - but despite all of our efforts getting her latch as deep as possible, it was still too shallow to be fully effective.
Claire had a tongue tie that was fairly restricted. She could poke her tongue down, but couldn't reach it up or sideways. She wasn't forming an adequate seal at the base of the breast while feeding, and she was constantly running out of energy because of all the reattaching she had to do to keep up with the feed. She's also got an extremely high palate - likely not helped by the tongue tie - meaning she was never able to draw my nipple as far back as it needed to be.
The LC showed me a few tips to help us continue as we were, with Claire opening her mouth as far as she could to feed; but she also gave me the option to get information about the frenectomy procedure too, so that I could make a decision as to what to do next. I decided to go ahead with that option, and we had it done that same day.
The procedure itself was over with quickly, but not particularly pleasant. We opted to go the scissor route, and so it was fast - but bloody. Claire was a real champion; I was a mess! She fed straight after it was done, and fell asleep not long after that - leaving me covered in breastmilk mixed with blood. (I forgot how much mouth wounds bleed!)
It's been four full days since her tongue tie was revised, and she's definitely feeding better. Her mouth is open, her latch is wider, and she's coming on/off the breast a lot less. It's too early to say whether it's been a lifesaver for myself, but it'll take time to perfect everything - the trick will be whether we can encourage her to change her habits and become more efficient, which should in turn help with the overuse of my nipples that has been leading to vasospasms. We will see! 
All in all, it's been a good learning experience - and it's shown that I need to trust my mama-bear instincts more. :)

Update: I forgot to mention- they observed her upper lip too, and while she has quite a thick frenulum, it is not impacting her feeding and is very flexible, so that was declared completely normal & did not require revising.

Boob Talk

I'm going to talk about boobs for a bit, so if that's not your thing, feel free to skedaddle for a bit. :)

So - breastfeeding.

A bit of backstory: When Georgia was born, she ended up in special care from that first day. We never had skin to skin time at the beginning, and when we were finally allowed to attempt breastfeeding, she never mastered how to latch on to the nipple. It took her a long time to develop her suck reflex, and we were never able to feed without a nipple shield. Due to this combination, our journey was always going to be a rocky one. We battled on though; expressing for top ups after each feed, 3-hourly feeds for what felt like months, using messy shields - and we happily made it to that magical 12 month mark.

Needless to say, I was wary of how feeding would go with Claire. It was different this time; we had a good hour of cuddles post-birth, she latched straight on to my boob immediately, and even though there were a few days in special care with formula bottles, she still managed to breastfeed too - and my milk came in just before we were both discharged from hospital.

It's been anything but easy, though. So far, we've gone through extended engorgement, crappy latching (adjusted thanks to lots of help), on/off feeds, forceful letdowns, oral thrush, and breast pain in the form of nipple vasospasms - agony!

It's been a bit of a vicious cycle:

Wear breast pads all the time, so you don't leak all over the place with every letdown.
Don't wear breast pads, or change them frequently, because they can hold in moisture & exacerbate thrush.
Let your nipples dry naturally after breastfeeding to help the thrush disappear.
But then don't do that, because dry cool air will cause you to have painful vasospasms.
Use lanolin cream as soon as you're done feeding, to keep nipples from drying out.
But then we're back to wearing breast pads, in fear of ruining all of your clothing.

Good lord, this is ridiculous! Boobs, man. What's a girl to do?

Anyway - we've done our thrush treatment and both of us seem fine now. We're back into the 'keep boosies warm at all times' stage, meaning as soon as I'm done with a feed, I whack on the lanolin ointment, and make sure I have breast warming pads in my bra to keep things at a warm temperature. I've also been prescribed nifedipine to see if that helps combat the circulation issues that are causing the vasospasms

Her feeding has definitely improved since those early weeks. When Claire was two weeks old, it was bad - really bad. There were multiple nights where I was up in the wee hours, sitting in the rocking chair and sobbing my heart out, because she was hurting me, my breasts were throbbing, and couldn't we just do formula? My poor husband felt so helpless. Lack of sleep makes everything seem so, so hard. I got a lot of help after that point, and we kept moving forward - making sure she is only feeding with a deeper latch, taking her off if it's even slightly uncomfortable, and feeding off the least sensitive breast first.

It's a lot better now.

The only lingering issue I have is the vasospasms - but I'm trying to combat that with everything I've got. It is uncomfortable, but it's manageable.

I'm meeting with Claire's pediatrician next week & we're going to re-examine her for tongue tie, to see if that's been the cause of some of the issues - but we got the all clear at birth and at our 2-week check, so I don't expect much to come of it. The research seems to be varied; some practitioners don't believe it to be an issue, others don't bother with them unless they're very severe. We'll see what he says.

Whatever happens, I'm grateful to so far have a decent supply that is feeding Claire nicely, and I'm happy she's not stuck using a shield constantly. I've also been expressing (just once a day, after her morning feed) so I have a little bit frozen in case I need a break. We're six weeks in & still going, and that's something. Now to see how the journey goes from here on in!

Did you struggle with breastfeeding? Any hints, or tips, or suggestions for this mama? :)

One Month Old

I think it's safe to say that this past month has been the fastest one in history.

Claire turned 1 month old - and is an absolute delight.

I was so excited to be taking her monthly pictures, like I did with her big sister - and even more so when she decided to take that opportunity to turn some tummy time into roly-poly time. Best of all, I caught it on video. Such a clever little chicken. :)

These next few weeks are likely to be pretty busy. We have both her and my 6-week appointments with our specialists, and Georgia has an appointment of her own, visiting an ENT specialist that she's been on a waiting list for.

One thing's for sure - second babies have to learn to go with the flow. I've carted Claire out and about constantly, and the infant capsule has been getting a great workout between the car and the pram. Definitely worth the investment!





All content (C) Breathe Gently 2006-2015
Blog Design by Splendid Sparrow