Things to tell my new parent self

This great post from Mommypotamus was inspired by Mother's Day, and I have to say I couldn't agree more.

Number 2 really resonates with me right now... to be "suspicious of the quiet toddler."  Last week when I was getting ready in the morning, it was suspiciously quiet for a minute or so, after which point Calvin said, "snow!!!" ... and then he walked into the bathroom carrying an upside-down and now empty box of breadcrumbs.  I dashed into the kitchen to clean up the "snow" only to discover that the "snow" was trekked all throughout our (this time thankfully) tiny apartment.  Be suspicious of quiet toddlers.

In addition, I'm so happy to see her mention to check your babies for tongue ties and lip ties yourself.  Unfortunately, most docs are not properly trained in this area and don't diagnose them most of the time., and right now, a lot of parents are just having to advocate hard for themselves.

Anyway, check it out!

11 Things I Wish I Could Tell My Pre-Momma Self

Tongue Tie and Lip Tie Survey

https://www.surveymonkey.com/s/tonguetiesqualitativesurvey

Hi there!  If you have a child who has/had a tongue tie or lip tie, please consider taking 15-20 minutes complete this survey about your experiences.  

This kind of research is key to promoting the importance of getting tongue ties and lip ties checked and potentially getting pediatricians properly trained and informed on the significance of tongue tie and lip tie.  Currently, there is a strong body of clinical and observation evidence as well as a growing body of experimental evidence, but not much in the way of survey data.  

Continue to Tongue Tie and Lip Tie Survey

Guest Post about Tongue Tie and Lip Tie

As word about tongue ties and lip ties grow, I wanted to reshare this post from Vasowhat?!?!  about her journey working to breastfeed her kiddo with tongue tie and lip tie -- and what she went through to get the ties diagnosed. 

We Made It! From Vasowhat?!?!

Continuing on with Tongue Tie Awareness Raising

This article from Parents.com highlights tongue tie as one of the top breastfeeding issues.  That's great!  This is a step in the right direction.

But I gotta tell ya: I am disappointed not to see lip tie on this list as well.  As awareness raising about tongue tie continues, a lot of people haven't heard of lip tie, which was my son's issue.  In addition, if there is a posterior rather than anterior tongue tie, there is almost always a lip tie.  If unaware providers don't look for it, how in the world would you ever know?

That said, I'm glad we're getting there.  Let's keep up the good work!

Check all the babies! Raising awareness for tongue tie and lip tie

I am part of Advocates for Tongue Tie Education, and the group has been working on coming up with easily share-able images to post on social media.  So.  This is me, bombarding the internets. You can be sure I'll be blasting Facebook and Twitter, too.

Please share.  It's such a quick thing to do, and you never know who this information will help.

Breastfeeding is Rainbows and Unicorns. Oh yeah, and a lot of work.

"Milk drunk" by MamabytheBay is the follow-up article to "A Second Chance at Breastfeeding" which I had originally read on the Huffington Post.  This article sort of captures how I felt when realized I finally had enough milk for Calvin after a long three months of supplementing with formula after every feed.  Oh, the relief and amazement and triumph of a woman's milk fully coming in!

In public health efforts to increase breastfeeding, the campaign strategy seems to be "don't tell them this can be hard!" -- because otherwise, there's a risk that mothers might not even bother trying to boobfeed if they're ambivalent about the whole thing anyway.  Except, no.  I can't accept that it's ethical to promote breastfeeding without the caveats.  It's unethical to tell women that breastfeeding is natural and easy without telling them that, sometimes, there is a lot of work involved, but that a lot of mothers find it to be worth it.  That sometimes, it doesn't come naturally, but you'll probably get better at it.  How many mothers stop because they've been told that it's easy?  How many mothers would have kept breastfeeding for longer if they weren't under the false impression that it was like rainbows and unicorns from the start?

In closing, I'll leave you with my favorite excerpt:

Breastfeeding is kicking my ass.  It’s not easy, it doesn’t always feel natural, and for me, it hurts like hell.  Where were the rainbows and unicorns and happy nursing fairies that you all kept telling me about?

Somewhere in between a 3 am nursing session and surfing the internet for “nursing camisole size large” I realized that I had misunderstood all of you breastfeeding moms.  When you chanted “What’s your superpower? I make milk!”, I used to secretly scream at you to go f--- [sic] yourself.  “Oh look!  My little angel is milk drunk!” you’d coo.  And I’d want to puke.  There was nothing cute about posting a picture of your baby drooling milk out of their mouth while fast asleep.  It all just seemed so self-congratulatory and boastful to me.  Until I realized how damn hard it is to actually succeed at breastfeeding.

Increasing Tongue Tie-Lip Tie Awareness

Maybe I was all wrong about how to increase awareness about tongue tie and lip tie.  My academic perspective, of course, thinks that we need to start with pediatricians, OB/GYN nurses, and lactation consultants.  Of course, that would be nice, but there are plenty of practicing pediatric dentists who have this knowledge.  

This morning as I was scrolling through my facebook feed, I saw this ad that a pediatric dentist placed in Charlotte, NC, shared originally by Carol Bowman Russell on the Tongue Tie Babies Facebook page:

Imagine if all the qualified (well-trained) pediatric dentists who are doing this work advertised their services -- that would probably do way more to quickly impact awareness than attempting to change the arcane system of academia from the back end.  

Sleep / Training

Our 16 month old boy is still co-sleeping and nursing at night.  This arrangement is not what we had in mind.  We didn't start out co-sleeping.  In fact, we didn't begin co-sleeping until he was around 2.5 months of age, and we did it out of pure desperation for any sleep.  He woke up whenever we set him back down, and his then-undiagnosed lip tie prevented him from being able to eat enough to go more than an hour between feedings.  Rather than trying to set him down for 45 minutes in order to get a measly 45 minutes of sleep before the next waking, we gave up, brought him into bed with us, and got much more sleep this way.  Once we got his lip tie diagnosed and fixed around 6 months, he started sleeping for longer stretches -- mostly 2-3 hours, which -- don't get me wrong -- was a godsend compared to waking up every hour or so.  But now at 16 months, we are realizing that if we're going to get this kid sleeping through the night any time soon, we are gonna have to do this ourselves.

Let me say this before I go further: there are a zillion approaches to infant sleep.  If you are a parent, you are certain to know this and to have been subject to people telling you what the best way to do it with your own damned family is.  In my experience, and probably in yours, it varies by family and by child.  Some people co-sleep for years and are perfectly happy with that arrangement.  I have to be honest and say that most nights, I'm fine it and enjoy it.  But my husband is truly getting the short end of the stick.  Calvin is a light sleeper... and so is Dan.  When one of them doesn't get a good night sleep, NEITHER of them get a good night's sleep.  And that means that I don't get a good night sleep.  And that stinks.  And I'm not interested in kicking Dan out of bed for the sake of this arrangement.  So, then.  Sleep-training.

For those of you who have not read a lot about infant sleep or whose chldren magically slept through the night before you needed to put too much effort into it, pretty all the methods boil down to co-sleep versus not co-sleep, and cuddle/sooth versus crying.  Sometimes crying and soothing happen at the same time; it may not be the infant's desired form of soothing, but the parent is still present.  We have tried the "No Cry Sleep Solution," the Elizabeth Pantly method of slowly changing the circumstances while the baby magically doesn't mind that there isn't a boob in his mouth when he is falling asleep. We tried this method around 10 or so months, and there was crying.  Oh, there was crying.  That said, he eventually got the idea that he could settle on his own and was able to at least go to sleep without nursing during the falling-asleep part.  He still woke up and nursed, but he'd eventually roll over to get into a more comfortable position, and so would I.  That was 6 months ago.  Slow progress has been our M.O.

Every method I've read, Ferber, Pantly, Sleep Lady, lots more, and this guy Dr. Jay Gorden, the full spectrum from cry-it-out to cuddle, all recommend not instigating sleep changes while the baby is teething and waiting until you are at a point where you have a couple of weeks of the same schedule with no vacations and/or visitors coming.  I'm sure there are families out there whose stars have so aligned, but not us.  He's always teething.  And we have visitors.  And we go places.  And I am in grad school, so I definitely don't have anything resembling a steady schedule.  And he's always teething.

That said, I think Jay Gorden's approach is the closest to the one that seems to be working for us.  We didn't do it on purpose, and we haven't chosen a 7-hour stretch wherein Calvin will not nurse (it's more like 4.  I know.  Pathetic.).  We are basically doing his variation over a period of months instead of days.  We're in the stage where we sooth him in his crib next to our bed (where he sleeps for four hours, anyway).  During the day, Dan reads to him or holds his hand.  The funny thing is that Calvin is far more willing to accept comfort from Dan than he is from me.  If I'm in the room with him while he is falling asleep and he's not next to me in bed, it takes him far longer to work through his feelings and go to sleep than it does if I'm in the next room.  

We knew from the time that Calvin was 3 months old that the process of getting him to sleep more independently would involve crying.  That's because he was 3 months old when he stopped screaming in the car and would consent to go to sleep.  So.  He now falls asleep like an angel in the car, as long as there's no one talking with him to keep him interested in being awake.  Some of our friends say, "you're so lucky."  Ha!  Are we?  It was hard-earned.  And I was hoping to avoid the crying thing with him since it hurts my nervous system, but I've realized that, with this kid, that's what it's gonna take.

Though his strategy is similar to what we are doing, I can't stand reading Jay Gordon's sleep piece because it's sooooo attachment-parenting judgy-judgy. I may have turned out to be sort of an attachment parent, but it wasn't on purpose. It's what worked for our family with this child. But this article does make me feel better about hearing Calvin cry. He writes, "Now, he will tell you that he is angry and intensely dislikes this new routine. I believe him. He will also try to tell you that he’s scared. I believe he’s angry, but a baby who’s had hundreds of nights in a row of cuddling is not scared of falling asleep with your hand on his back and your voice in his ear. Angry, yes. Scared, no, not really."  That made me feel better.  But in the real sense, I know my child, and I know him well enough to know that he cries when he doesn't get what he wants.  And this is definitely not what he wants.

But it's what he needs.  We as a family need to be getting more sleep.  And that involves a separate bed.  And, for now, some crying. 

Long Way to a Lip Tie Diagnosis: How breastfeeding went from awful to awesome

Introduction.  Here’s the beginning and end.  Beginning: nursing Calvin was painful and emotionally fraught for the first 6 months of his life.  I was surprised to make it that far and certainly couldn’t have possibly imagined that he’d still be nursing at 16 months.  Which he is.  Blissfully.  Much to the utter surprise of me a year ago.  Thanks to getting the lip tie fixed that his pediatrician didn’t believe he had.

Here’s what I wrote when he was just shy of 3 months old:

Crying Over Spilled Milk.  If you don't want to re-read it, just know that breastfeeding was awful, so I pumped after every feeding for three months, and I got mastitis, which caused a severe dent in my hard-earned milk supply and a full-blown emotional breakdown.  There.

In a turn that seemed like a miracle, my milk supply came back in full force just a few days after I healed from mastitis.  I didn’t realize then, nor did I realize for the next few months, that my supply had stabilized pretty well by that point.  I didn’t realize then that the problem wasn’t my body, so I spent the next couple of months continuing to agonize over the length between feedings to keep up my supply.  But I had enough for him, at last.

OK, that’s fine, but what about getting him to nurse instead of drinking from a bottle?  I’d seriously had it with pumping while I was caring for him at the same time, so I figured out a way to get him to latch.  I’d tempt him back to the breast by taking the edge off his hunger craze with an ounce from the bottle, and then I would hold him close with lots of skin on skin, lightly bouncing him until he would eventually want to nurse.  I’m not going to say it was a pleasant experience, but it worked.  Finally, he would latch, finally he would eat, and steadily, he gained weight.  After a few weeks, I no longer needed to take the edge off with the bottle.  He consented to nurse if we were in a quiet environment.  So we didn’t go too far.  The thing is, he’d eat and sleep at the same time.  Like, for HOURS. 

Certain times of days were better than others.  Like nighttime…  Yes, this boy got really used to eating while he slept.  We got into a rhythm.  He’d nurse to sleep, and then he’d keep nursing for a couple hours until he was done sleeping and eating at the same time.  Then he’d be awake for a couple hours.  Rinse and repeat.  24-7.  Nighttime became a co-sleeping sleep and eat fest, where he’d wake up every hour or so, nurse, and go back to sleep.  It was kind of like hell, except that he was gaining weight and I was getting more sleep than I’d get if I were putting him back in his crib.   And I loved snuggling him.  And this is how he ate.  So I kept going, all the while wondering just how long I could keep this schedule up, knowing that, yes, my supply was now OK as long as I was around him all the time, but I still had pain in my breasts all the time.  And that can’t be good. 

Looking back on it, I have to wonder: was I completely insane?  Had I lost my mind?  What on earth compelled me to keep going with this even though his latch was awful and the constant pain I was in (not to mention the sleep deprivation)? I have two answers:

The first answer is that I was unbelievably emotionally connected to nursing Calvin.  I don’t know why.  I didn’t have any friggin’ idea how important breastfeeding was to me before I birthed him.  I did no research on breastfeeding whatsoever.  I wasn’t particularly intellectually invested in it – I’d just always seen myself as breastfeeding, and I think that’s a more compelling connection than an intellectual one. 

The second answer is that my husband didn’t have much success getting him to drink from a bottle everything that I had pumped while I was away at my internships.  Calvin would eat an ounce or two, and then, on no uncertain terms, push the bottle away.  It was confounding and puzzling, especially from a baby who had so often refused the breast in favor of the bottle.  Oh, he’d be hungry again in another hour or so, but he just wouldn’t eat very much at a time. 

So I kept going, though the repeat diagnoses of nipple thrush and continual pain, knowing that it was fulfilling my emotional needs and getting him fed despite my crazy lack of sleep.  Another point for carrying on this way was the knowledge that for however much nursing might have hurt, the pump hurt more, and my supply was always negatively affected by a week of pumping during the day.  Fridays were by far my least productive day pumping.  By Monday after I’d been around Calvin all weekend, my breasts and my supply were both in better shape.  So I carried on.  

All this time, I was religious in my dairy avoidance because of his acid reflux (note: I don’t eat much dairy anyway, but yogurt is a relatively regular part of my diet).  It seemed to help a little, but not much.  He still needed his twice daily dose of baby zantac, and even still, he’d have spit-up that smelled like bad heartburn.

It shouldn't be a big surprise that this all started to feel truly ludicrous.  When Calvin was around 6 months old, the whole thing felt like too much.  Not only the nursing, but also the fact that he would only sleep while eating and vice versa.  The fact that the baby zantac did’t get rid of the acid reflux altogether like it should have.  The fact that he would wake up 7 times in one night to eat.  The fact that he still only ate an ounce or two from the bottle while other people’s kids were eating several.  The fact that he was only getting further away from sleeping through the night, not closer to it.  Not to mention that breastfeeding was still painful and took such a long time even though he was a lot bigger and should have been more efficient by this point.  It just all seemed wrong. 

So I did what any mother whose child is not functioning properly would do this day in age: I took it to the internets.  I asked other moms about it.  It started with questions about sleep.  Other mothers sensibly recommended getting the dad to help night wean or comfort at night.  But, of course, I countered that I worried Calvin wouldn’t get enough to eat if we nightweaned since that’s when he did the bulk of his eating because he sleeps at the same time as eating, and…  I mentioned my concern, which led to me explaining the rest of the horrors. 

…which got a few moms’ attention.  The general response to my problem was, “WOW… that sounds like my experience before we got our child’s tongue tie / lip tie fixed.”  Huh?  I’d seen 7 lactation consultants and 3 pediatricians and not one of them had mentioned him having either one of those.  And yet… their stories sounded like mine.  I listened more, but I was sort of in denial – I mean, how could I have seen that many professionals with none of them noticing?  Again, the Mom’s board resounded, “Yeah…. That’s extremely common.  People don’t check for it because they either don’t know or they don’t believe they can pose problems.  Find someone who will help you.  Advocate for yourself and your child.”  It was a hard pill to swallow.  But then I looked at the links of pictures from articles they were sending me.  And yes, Calvin had quite a lip tie.  Or at least, it looked it to my untrained eye.  And no, none of the professionals I’d seen had diagnosed him.  I didn’t know what to do. 

Around the same time, one of my best friends had a baby, who, incidentally, had no troubles breastfeeding whatsoever.  At one point, the newborn smelled the milk on me and attempted to nurse.  I noticed her upper lip curled out in a way that Calvin’s never had.  Calvin’s upper lip always curled under and in, preventing him from getting a good suction.  I’d attempt to flange his lip out to fix it, but it would pop right back under.  My friend’s newborn’s lips just did it on their own and had none of the problems Calvin had. 

So what to do now that I thought Calvin had a lip tie?  I felt like I needed a diagnosis from someone who had seen these before.  One wonderful mother on a Mom’s Facebook group found an IBCLC (Institution Board Certified Lactation Consultant) in my neck of the woods who didn’t think tongue ties and lip ties were unfounded myths.  I really have to thank her a million times for the rest of eternity because I’d already seen so many people who hadn’t correctly diagnosed Calvin’s lip and tongue tie that I had no idea how to find someone who could or would in this area.  Thanks to a friend of a friend, Terry Anthony, an IBCLC, came over one day late August, took one look in his mouth and said, “oh yeah, that’s quite a lip tie.  Yeah, he has a posterior tongue tie, too.  Can I see in your mouth, out of curiosity? … yup.  You’ve got the same thing.  These tend to run in the family.”  Whhaaaaa?…. So that explains why my mom had all these problems breastfeeding me!  My mom always told me that she got “cauliflower nipples” with me – a visually evocative description of vasospasms, common to mothers breastfeeding a kid with a tie.  It was like a big light went on, and everything started to make sense.   I  have all the lifelong complications of untreated ties.  The jaw pain, acid reflux, the malformed jaw that narrowed in my attempts to establish a suction, and chronic oral health issues.  I even needed to get a palate expander before my adult teeth came in because there wasn’t room in my jaw for all my teeth.  It’s highly likely that is all related to my untreated ties.  I didn’t want Calvin to have those problems.

The next question was a question of what to do.  Terry was honest with me that getting tongue ties and lip ties fixed when they’re 6 months old is usually helpful for breastfeeding, but not 100% of the time due to the fact that it can be hard for them to change their muscular nursing patterns at that age.  At the least, it would probably take more time to improve than it would a newborn.  But, she said, it often does help. 

What convinced me was all of the other longterm consequences of untreated ties.  They don’t only have a negative impact on breastfeeding, but they also frequently lead to lifelong digestive issues (such as acid reflux) and dental problems as well as occasional speech problems through the malformation of the jawbones that occurs when the babies are working so hard to establish a suction on either a breast or a bottle.  Knowing that I have those very problems galvanized my determination to get his corrected.  I figured that even if it didn’t help breastfeeding at this stage in the game, at least I could hopefully prevent some of the chronic illness that I’ve had to deal with because nobody ever caught my lip tie. 

From my consultations with the scholarly literature, I concluded thus: tongue ties and lip ties don’t always lead to problems (breastfeeding problems and/or chronic digestive and dental issues).  But if breastfeeding is problematic and your kid has a tie, it’s most likely going to translate to lifelong problems, so it’s worth getting it fixed even if you’re not breastfeeding anymore.  Or at least, it was for me and Calvin. 

Armed with information, I called the world expert in Albany, Dr. Kotlow, to see if he could recommend someone in my area who is any good at fixing ties.  He could.  Dr. Martin Kaplan at Kid Care Dental in Stoughton, whom Dr. Kotlow personally trained himself.  They use lasers, which are able to remove more of the excessive frenulum than scissors can, which seems to related to a lower risk for re-attachment.  That sounded good to me.  I called Dr. Kaplan’s office and made an appointment for a consultation. 

In hindsight, this all sounds so reasonable, but I assure you that it’s a terrifying process to go through, especially knowing that it’s a re-emergent field of medicine and there aren’t very many people who even believe that ties are a problem.  But I was pretty sure this would help, so I moved forward.  The day of the consultation, Dr. Kaplan looked in my son's mouth and went, “oh yeah, that’s a good one.  Do you want to have it fixed?  If so, I’ll push back my next appointment and fix it right now.  This is a quality of life issue.”  After a moment or two of feeling completely overwhelmed, I consented. 

His bedside manner was wonderful.  He showed me pictures of previous revisions he’d done, and assured me that he has seen none that have re-attached.  That made me feel better.  He also gave me the choice of staying in the room while it was done.  I couldn’t do it.  I couldn’t watch my baby get held down while a laser was in his mouth.  But Dr. Kaplan explained to me what would happen: that he would use a topical, localized anesthetic rather than general anesthesia, that it would take less than a minute do actually do the procedure, and that he’d carry Calvin right out to me afterwards so he could breastfeed immediately, which helps babies feel better and relearn how to breastfeed.  Well, that’s what happened. It was terrifying.

Just as Dr. Kaplan said, Calvin nursed immediately after the procedure.  It wasn’t the easiest nursing we’d ever done given his recent trauma and the fact that his upper lip was numb, but it was the best latch he’d ever had.  I noticed that immediately.  Dr. Kaplan explained to me the aftercare; I would need to gently stretch the site of the correction using vitamin E oil or olive oil three times a day for two weeks.  He sent me on my way, and Calvin and I went home to nurse some more. 

Before moving on, I want to address the fact that I chose not to have his posterior tongue tie treated.  Dr. Kaplan thought that Calvin had excellent tongue mobility and that it wasn’t worth fixing it if the lip tie took care of the problems.  He told me that if nursing, Calvin’s acid reflux, etc. weren’t all better in three weeks, then I should call him back and he’d fix the posterior tongue tie.  That seemed reasonable to me.  As you might have guessed by this point, we did not need that done because, as Dr. Kaplan suspected, everything was better within three weeks. 

No seriously, everything. 

Though Calvin’s latch was immediately better, it wasn’t all sunshine and roses during his recovery.  Not only did he get his first teeth, but he also needed to relearn how to nurse.  He was a little clumsy with it for the next couple of days, which frustrated him.  But I also had to relearn how to nurse and learn how to trust my baby when he said he wasn’t hungry.  The fact is that this correction transformed his ability to remove milk from the breast, and he went from taking an hour to drink an ounce to taking 10 minutes to drink three or four ounces.  I’d get so upset when he refused the breast because, for the previous few months, it was because of a bottle preference.  But now it was because he truly wasn’t hungry because he was better at eating!  He continued to gain weight beautifully, nursing every 2-4 hours as he desired.  So I needed to learn to stop offering to him every 45 minutes.  He had other things to do. 

And within three weeks, everything was better.  No, really – everything.  Fixing the lip tie changed every aspect of parenthood with this child.  The latch was better immediately, which means that the pain during and between feedings went away.  It also means that his acid reflux went away as soon as that little flap of excess skin was gone.  No more baby zantac!  And the fact that he could go longer between feedings revolutionized life in general.  He no longer woke up every 45 minutes at night; it was every few hours instead.  I was SLEEPING MORE.  I felt like a new person!  Not to mention that we could leave the house and go about daily life without nursing every hour.  Car trips were suddenly a hell of a lot easier.  And from there, life turned into something kind of like maternal bliss.  He preferred breast over bottle (though he still took it at daycare if he was hungry), and I didn’t have to pump as often because he wasn’t feeding as often anymore.  I could go back to eating the small amount of dairy I dare to eat (yogurt) without fear that it would irritate my baby’s acid reflux.  I felt like I was supposed to feel when breastfeeding went well.  Like a human being.  And I was finally enjoying motherhood.  

And what about Calvin?  He was a much happier kid.  Wouldn’t you be if you suddenly were able to eat a whole meal instead of just bites and you weren’t hungry all the time?  Wouldn’t you be if you were able to sleep longer?  Wouldn’t you be if your acid reflux went away?  Meanwhile, he loved nursing.  As he was simultaneously approaching mobility, he had fun getting to decide when he felt like nursing and initiating it himself. 

Getting his lip tie fixed transformed our lives.  So why is it that I went 6 months before anyone caught this abominable thing?  Most professionals aren’t skilled in diagnosing tongue tie and lip tie, and some haven’t even heard of the latter.  Lip ties are even less frequently identified than tongue tie.  To quote some hearsay, some attribute the lack of knowledge to an overdiagnosis in the 70s, which led to a bit of a backlash against diagnosing it.  So now, even some trained IBCLCs are under a certain amount of academic pressure not to diagnose them even if they see them.  But probably the biggest factor is that the knowledge of how to do it properly has passed out of common practice due to bottle feeding and a change in birthing practices.  In the early twentieth century, bottle feeding became the norm at the same time that midwives were being replaced by physicians.  There’s an old joke that midwives kept one fingernail sharp to clip ties shortly after birth if breastfeeding wasn’t going well.  But between their replacement and the discontinuation of breastfeeding as a cultural norm, the knowledge passed out of our cultural expertise. 

The result is that even though there might be a certain level of knowledge about it, many people still don’t really believe that it’s a potential real problem.  One physician looked me square in the eye and said, “I don’t believe in tongue ties.”  I went and found a new pediatrician.  It’s totally possible for a frazzled mother at her wit’s end to visit several physicians, midwives, and IBCLCs and still not have any clear answers.  In the face of THAT, I’d recommend she check out the Tongue Tie Group on Facebook and otherwise prepare herself to do an informal diagnosis if she suspects something is amiss http://www.mommypotamus.com/how-to-diagnose-tongue-and-lip-ties/.  But if she doesn’t know about those resources, she's screwed.  So once I got over the shame and emotional trauma of the horrors of it all, I got vocal.  I’ve been telling every new mother I can.  Who knows who I’ll help just by sharing my experience? 

I look back on the first six months of Calvin’s life, and I have to wonder: how much of this would have been totally different if it weren’t for the tie?  I mean, he was a fussy, difficult, colicky baby who always had reflux, wouldn’t really sleep, and couldn’t really eat.  How different would have disposition have been?  Might he have slept better?  I really think so.  I also have to wonder: how many other mothers and babies have gone through this, are going through it, and will go through it?  How many mothers stopped nursing because they were having an awful experience with it that can be traced back to undiagnosed ties? 

Since I made my short post about how breastfeeding improved, I have received a staggering number of private messages, emails, and a couple of phone calls from women experiencing the same thing, and that’s only the ones who decided to contact me.  So I know it’s not as rare as people think.  I’ve heard numbers bandied about like “this only affects 2% of the population.”  Well, if I already know 100 women whose kids were born with a tie in Massachusetts and upstate New York without even trying, it must be more prevalent than that.  I definitely don't know 2% of the population.  I think it’s time people know more about it.

Further reading:

Norma Ritter, IBCLC  https://breastfeedingusa.org/content/article/tell-me-about-tongue-ties. 

Dr. Kotlow’s website http://www.kiddsteeth.com/articles.html

Infant Feeding Parity

In a lame attempt to balance all my recent posts about breastfeeding lately, I dedicate this post to formula feeding.  I am officially "coming out" as an obsessive reader of the "Fearless Formula Feeder" website, whose tagline is "standing up for formula feeders without being a boob about it," which I just LOVE.  The writer of this blog struggled to breastfeed, and after repeat bouts of all the pain that comes along with a baby with poor latch, she decided to switch to formula and write about it.  The thing is: in her demographic, she was just about the only person she knew having these problems, and she felt so guitly.  If you read my post from last May, "Crying Over Spilled Milk" lately, you may recall that I went through that guilt.  I decided to press on.  But only because I was so emotionally invested in it and knew the health implications and am in nutrition and public health school blah blah blah.  But not everyone does.

The fact is that it's not right for every family, and there would be a lot more sick/dead children in the US if it weren't for formula as a back-up.  To paraphrase childhood nutritionist Ellyn Satter and author of "Child of Mine: Feeding Your Child With Love and Good Sense," the benefits of breastfeeding are small, but real.  Breastfeed for as long as you can.  And then know that the vast majority of babies do just fine on formula.  What's most important is that you are happy with your choice because your baby will know if you're unhappy and absorb your stress.

I think the reason I'm so into that website is because I am still recovering from the experience of 6 months of breastfeeding and supplementing hell before Calvin's lip tie was diagnosed and fixed.  As a side note, I have to wonder how many other mothers out there went through this still not knowing that their kid simply had tongue tie or lip tie OR were told by a pediatrician that there's no sense fixing them. (I'm here to tell you that there is.)  In any case, it's sort of healing to know that I'm not the only person who struggled in the beginning, regardless as to the outcome of whether I continued to breastfeed or not.

That's not to say that we don't still need to promote the health benefits of breastfeeding.  Breastfeeding does legitimately have public health and individual health benefits related to cancer and diabetes, some of which come down to your chances of developing certain diseases if you weren't breastfed or didn't breastfeed and some of which are related to how long you were breastfed or breastfed.  Breastmilk is awesome stuff that we'll probably never be able to replicate exactly because mother's bodies are programmed to respond to their babies' needs even after they are out of the womb.  Breastmilk was recently shown to kill the AIDS virus and also recently shown to increase antibiotic sensitivity (read -- good in the battle against antibiotic resistant drugs).  I'm kind of obsessed with breastmilk.

But I'm kinda also obsessed with FearlessFormulaFeeders.com because of its message of promoting infant feeding tolerance one way or the other.  The reality is that infant feeding gets criticized one way or the other, so we need to be understanding of each other and not leap to judging people because we don't know what they've been through. Breastfeeders have it hard because so many people expect breastfeeding mothers not to nurse in public.  Formula feeders have it hard because people gawk at them and tell them what horrible parents they are if they formula feed.  So please keep this all in mind next time you see someone feeding a baby in public.  In any manner.  You don't know what they've been through or what courage it is taking them to feed their baby in public at all.

The unintentional "extended breastfeeder"

The following post is reposted with permission from the original post at spokeschicken.blogspot.com

A friend shared this article "Weaning My Toddler" from the Science of Mom, and it got my mind gestating about how I am now in the class of women technically considered "extended breastfeeders," or women who breastfeed beyond the one-year mark. The funny thing is that it wasn't a decision at all. It was a natural progression.

When Calvin was one year old, it would have felt entirely abrupt to discontinue nursing. What is more, it would have taken me work. Sure, I dropped a pumping session and went down to once a day when I'm away from him, which is now more like a relaxing break from school and a chance to watch more "RuPaul's Drag Race" than a burden. If I had decided to wean, I'd have had to distract him and simultaneously deal with an upset baby and leaky boobs, and I just wasn't up for that. I'm still not. It's not right for me. It feels right to continue to nurse.

If you've been following my blog at all, you might know that Calvin and I had a tumultuous nursing relationship before his lip tie was finally diagnosed and corrected at 6 months, after which point, I was overjoyed that the situation turned around. Now, we have a wonderful nursing relationship. Moreover, he is such an active toddler that I treasure those moments where he wants to just lie down and nurse for 15 minutes or so. It's a much-needed, relaxing break for both of us. Before having his lip tie fixed, I never imagined that I'd be nursing for even 8 months, let alone 14 or more. But here are the facts: I like it; he likes it; it's good for him; I'm not messing him up by breastfeeding this long; it's no one else's business.

I have a couple of friends who weaned earlier or are planning to wean soon, and you know what? That's awesome, too! Breastfeeding is the mother's domain, and no one but the mother can determine how long is right for her, her baby, and her family. And I'm not just saying that: I firmly believe. I do think this is a feminist issue about women's choice, and we can be our worst enemies when it comes to that arena. So even though I'm technically what would be considered an "extended breastfeeder," please don't take that to mean that I expect any of you to be extended breastfeeders. Breastfeeding, extended breastfeeding, and bottle feeding have become highly politicized, when, at the heart of it, it's part of a family relationship that should not be interfered with by outsiders one way or the other.

A humble request

The following post is reposted with permission from the original post at spokeschicken.blogspot.com

Somewhat to my surprise, my blog is getting real traffic for the first time in years. This tells me that there are a lot of people out there having a tough time breastfeeding and are looking for leads.

I am making it a mini life mission to spread the word about tongue tie and lip tie because it had such an impact on me and my child. I don't think that anyone who hasn't attempted to nurse can begin to appreciate the emotional and physical agony that accompany ties for both mom and baby. The first six months of my baby's life were my hardest, and not just for the usual reasons that infants complicate life. And all it took to turn it around was a 3 minute laser surgery. I want my experience to benefit others.

So. If it turns out your little one has it, and fixing it helps, please tell others about your experience. For me, it took some time to heal from the emotional roller-coaster before I was ready to spread the word. I fully appreciate that will be the case for a lot of you. But please, do it. Your story just might make someone else's life easier. Knowledge alone cannot fix everything, but it's a start.

The short version of how breastfeeding improved

This post is long overdue. For those of you who supported me in the early days of my breastfeeding difficulties, I wanted to share that in September when Calvin was 6 months old, we saw a new lactation consultant who LOOKED IN HIS MOUTH and said, oh yeah, "this isn't you -- he has a lip tie." That explained EVERYTHING. Lip ties and tongue ties are related to problems in the baby (difficulty latching, failing to establish a good suction and therefore gets a lot of air, causing acid reflux and other indigestion -- eventually leads to malformations in jaw that can narrow the jaw, leading to dental and orthodontic issues) AND problems in the mother (sore breasts, mastitis, under or over supply issues). Lip ties and tongue ties, I am discovering, are highly undiagnosed. We had it corrected with a laser, and within two weeks ALL those symptoms in both me and Calvin were GONE, and breastfeeding become so much easier. So did pumping. It was like a miracle. Within three weeks he preferred breast over the bottle. Who saw that one coming? Certainly not me. I feel so fortunate.

Knowledge about Tongue and Lip Tie passed out of the realm of common medical knowledge in the early 30's when formula was considered better than breastmilk and women were encouraged not to breastfeed. I have scholarly articles from well-respected medical journals if anyone is interested in the research, but for those of you out there who either are having problems breastfeeding, had problems breastfeeding and are curious about a possible cause, or are pregnant and would like some information about something that could affect your infant feeding (whether you plan to bottle- or breast-feed), please check out this link.

How to Diagnose Tongue and Lip Tie

Just to be clear to everyone, I didn't post this hoping to villainize my friends who have opted for formula. I have posted it as a general PSA. The fact is that I have a lip tie, too (it can be heritable) and I still have all the acid reflux, dental, and orthodontic problems that are the later-in-life possible consequences of untreated ties. I would love it if someone had caught it when I was a baby.

Crying Over Spilled Milk

The following was originally posted on my personal blog, spokeschicken.blogspot.com on May 30, 2012.

Anyone who knows me knows that I meet adversity with determination.   And if it’s not working, I assume it means I’m supposed to try harder.  I am accustomed to success somewhere along the way.  This is the story about my milk supply – still not quite enough to feed my lad.  “Big deal,” say some.  “No, that’s not possible – keep trying!” say others.  But here’s my journey from producing nearly no breastmilk to producing almost enough to producing maybe 60%  of what my baby needs.   I have never felt more like a failure in my life.  But after everything I’ve done and gone through, I have to accept that my best is good enough.

I wanted want more than anything to breastfeed my baby.  I always saw myself as exclusively breastfeeding him from the beginning and couldn’t imagine that I’d have troubles with it.  After all – it’s natural.  It’s how we all got here, right?  And animals don’t seem to have problems with it.  Let’s start from the start.  Calvin and I had a rough delivery despite my plans for an easy, natural childbirth – a story for another time – and he was in the Level 2 Nursery for the first 29 hours of his life.  I was recovering from a fever and an infection, too, so it didn’t occur to me to ask for a breast pump in the hospital to initiate my supply in that very critical period.  Despite the hospital’s excellent staff and care, no one thought to offer it to me, even the lactation consultants on staff.  I didn’t breastfeed him until about 18 hours after he was born, and, even then, the schedule was nowhere near the recommended “every 2-3 hours or on demand” because of continued care (injections and IVs on both of our parts).  Why do I bother recounting this part of the tale?  Well, according to the lactation consultants I saw later on, that first couple of days is really crucial to establishing the hormone receptors that tell your body how much milk to make.  That’s a window of opportunity that we missed.  “Keep trying!  It’ll work; it’s biology!” was the message that I went with.  My knowledge from my nutrition program, from the nurses, from lactation consultants, and from well-meaning friends and family all dictated that if I just kept nursing him often enough, my milk would come in. 

But it didn’t.  It turns out that we had what is called an “inefficient eater.”  So even though he would spend up to an hour on each side, he was getting very little indeed.  Some milk was there – he just wasn’t drinking it.  As a result, I became painfully engorged – and not just for the usual 24 hours.  For 3 days.  I did everything you’re supposed to do: warm compresses, hot showers, leaning over basins of water, massages, and above all, continuing to nurse while hand-expressing, but it was bad news for the milk supply.   Two weeks later, we found out he still wasn’t gaining enough weight despite my very best efforts…. He still didn’t eat.  This kid loves to breastfeed! … or at least to be on the breast.  But he just wasn’t eating. 

So I became determined.   I tripled my protein intake.   I doubled my already considerable water intake.  I took really expensive supplements.  I ate more oatmeal (considered a galactogogue).  We paid to have a lactation consultant spend a long couple of home visits with us.  The scale she had told us that he was only getting  .6 oz of milk from me after an hour of eating.  What?!  That’s not much at all!  Two weeks in, he hadn’t literally sucked enough to establish any kind of milk supply.  So we rented a hospital grade breast pump and eventually bought the best home model of it that money can buy.  I started pumping after every time he ate – even if that meant I was pumping 14 times a day for 20 minutes a pop.  Dan was home with me, so I had help during that time.  I was on a mission.  “It’s biology!  Supply and demand!”   That’s the message I ran with. 

Meanwhile, rule number one of low milk supply is “feed your baby!”  So we did.  We used a supplemental nursing system for the first three weeks, but he could take a half-hour to work through a mere half ounce, so that wasn’t a good weight gain option.  Plus, it was such a stressful contraption that it took all the joy out of breastfeeding him.  So we started using nipple-friendly, slow-flow bottles just to get some food into him. 

Well.  He LOVED that.  And soon he started refusing the breast.  But he was a much happier baby.  Not being hungry all the time will do that to a person.  That said, I can’t possibly describe the emotional anguish I experienced every time he screamed at my breast, knowing that there wasn’t enough milk to feed him – despite my slowly- building supply and my increasing optimism that someday I still might be able to exclusively breastfeed him.

I won’t go into the rest, but I just want you to understand how hard  I was working despite knowing that he still had no interest in breastfeeding, and I cried every single time he refused my breast.  (That’s a lotta tears!)  I desperately wanted this to work. 

After pumping after every feeding for 6 weeks, (and with great effort to trick him back onto my breast by luring him with the bottle) he took my breast again and started breastfeeding.  We noticed that he started turning down the bottle after breastfeeding, indicating that he had had enough.  Then we noticed that, when I was at school, Dan was able to give him enough breastmilk from the prior day’s pumping that he didn’t have to use formula every day.  In other words, it was working. 

Two weeks later, school ended, and I was home alone with Calvin every day.  And to my surprise and great delight, he seemed cool with exclusively breastfeeding.  I had the best week with him!  I was feeding him all the time, and he seemed full.  And for a week there, he was a good eater.  I was cautiously overjoyed!  ….Then, things started turning.  He started sleeping more and crying more.  And refusing the breast again.  And getting seriously crazy similar to how he behaved before we realized he was starving all the time.  And then it hit: mastitis in my left breast.  He never did like lefty as much because it’s slower (lefty’s the one that was the most engorged and blocked at the beginning, and I don’t think it ever fully recovered), so he doesn’t totally drain it most of the time.  But YOU try pumping after every feeding when you’re home alone all day with a kid who screams when you put him down.  I just don’t have the gumption or resilience or whatever to say, “Hey, kid.  I know you’re miserable right now because your cries are hurting my eardrums, but try to chill out in your bouncy seat for another 20 minutes until your mom is done pumping.” 

Oh, yeah – mastitis is bad-news-bears for milk supply.  A 32-hour fever of a 102 before you recognize what’s going on will do that to ya.  So it’s back down again to about 60% of what he needs.  And I am devastated.  No, seriously.  Devastated.  I am in mourning over my milk supply.  That’s where I finally broke down enough to need to write about it. 

The number of times I have broken down and cried for 2 hours at a time about this whole thing is absurd.  Let’s not go into the full-scale meltdowns I’ve had when he spits up a lot of what I just fed him.  No matter how much I tell myself, “I just have to accept that I have what I have,” I can’t seem to feel OK about it.  The fact is that I had enough for him – he just didn’t drink it.  And he’s simply too much of a handful for it to be realistic me to keep up with the pumping while I’m home alone with him all day. 

Why am I recounting his?  To deal with the number of times I have thought that I had finally come to terms with my situation only to have a complete emotional breakdown about it 2 days later.  To publicly announce the shame I feel so I can try to get past this.  Partially, it’s so that other mothers out there who might have low milk supply who have also tried this hard can read something they can relate to.  Partially, it’s to address the people who don’t understand. 

How many more times do I have to answer the question, “well, did you see a lactation consultant?”  Yes, two.  And I had several hour long home visits and lots of phone calls from both of them.  “Are you eating oatmeal?” … yes – around 2 cups a day.  “Are you eating enough protein?” “Drinking enough water?”  “Taking fenugreek, fennel, golacta?”  “Drinking nursing tea?  Beer?” “Co-sleeping?”  “Nursing all the time?”   Yes, yes, yes!  Well-wishers say, “Just nurse more often!”  Well, given what a lazy breastfeeder he is, that’s what got me into this mess – twice!  For the love of god, I’ve done everything a person can do. 

Through it all, I’ve had every nipple and breast ailment that accompanies breastfeeding that a poor woman can have.  Engorgement, cracked nipples, two cases of nipple thrush (yeast infection), vasospasms that make my nipples turn  cold and white, milk blisters, blood blisters that exploded in his mouth and made him spit up blood (absolutely frightening!), blocked ducts, and finally, a breast infection (the mastitis).  My husband pointed out to me that this is the first time in his recollection that I have not listened to what my body was telling me.  But it’s more complicated than that, see?  My maligned nipples might be telling me one thing, but my every biological and emotional impulse is telling me “feed this baby from your boobs!”  I desperately want to provide milk for my baby.  Furthermore, I like breastfeeding.  The connection is wonderful.  But the look on his poor face when he realizes that the bulk of the milk has run out before he’s full is not. 

Oh, yeah, did I mention that my milk was giving him bloody diarrhea?  We’re working on that one – presumed cow allergy, so I’m cutting out all dairy.  Really, it was just yogurt since I am sensitive to dairy, too.  Still, it’s too bad because it seemed like eating a lot of yogurt increased my supply.  Add that one to the list of “Oh, well”s.

I hate feeling implicitly judged by people who tell me it should work, not because I think they’re actually judging me (though I am sure some secretly are), but mostly because I am judging myself.  I have wanted so much for this to work for the last three months.  I have worked so hard, and I am used to things working out when I try hard enough.  But what I have to remember is that breastfeeding is a two-person job, and three months in, he’s still asleep at the wheel.  No amount of hand-expressing and poking and prodding to wake him up can drain my milk into his mouth.  And to those of you who say, “pump while he’s sleeping!” – what am I supposed to do when the kid only sleeps on me?

The fact is that I have been so obsessed with my supply that I haven’t enjoyed what a fun and engaging baby he is.  And I think that, finally, I think I have to accept where we’re at so I can get on with my life and enjoy my kid and prevent him from getting so hungry that he goes insane.  I will provide him with milk as long as I can, whether it’s 6 months or 3 years, and I have to feel OK with what I can do.  My breast may be his absolutely favorite place to enjoy a warm snack and take a long nap, but it is not where he gets enough food to eat.  And it’s not for my lack of trying.

P.S. Appropriate responses are messages of support.  Please don’t ask me if I’ve tried anything or offer advice.  I’ve done my research and tried everything.  At this point, it’s important for me just to feel good about what I have.

UPDATE: 
Please read my post at http://spokeschicken.blogspot.com/2013/03/the-short-version-of-how-breastfeeding.html
Believe it or not, things improved because of a lot of support and help from a friend of a friend.  I'll write the whole story up one of these days, but in the meantime, I just wanted all you out there who can identify with this process all too well that there is hope.