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April 22, 2008

The April Carnival of Breastfeeding: "Thrush and mastitis and blebs, oh my!"

New_image Welcome to the April Carnival of Breastfeeding!

This month we're bringing you posts on the topic of breastfeeding problems and solutions.  Be sure to check out the posts below for great stories overcoming thrush, blebs, plugged ducts, oversupply, and other breastfeeding challenges.

I'm very pleased to share a story of overcoming a tongue tie problem, written by Lisa, a mother I know and admire.  A picture of him as a baby is to the left.

In the hospital, one of the nurses looked into my son Joe's bassinet and said offhandedly, "looks like he's tongue-tied."* My husband and I were confused because the kid was crying at the time but she was gone before we could ask her what she meant. 

I was determined to breastfeed, and while the milk was there and the effort was definitely there on both of our parts, Joe was not able to get a good latch.  He would get just about in the right place, but there wasn't the right seal and he couldn't stay on the breast.  The nurses told me that I didn't have any of the common problems like inverted or shallow nipples, so surely it would work out fine. We both kept trying and were told that it takes time and is a learned process.

When I took him to his first doctor's appointment after we got home from the hospital, I told the doctor that I was still having trouble breastfeeding.  She told me "Oh, it's easy" and that was the end of it.  I showed her what I was doing and she said it was right, just keep trying.  My mother told the doctor that she thought Joe had "brick dust urine," and she said she'd never heard of that. I said that I had heard that he might be tongue tied, and she said that he wasn't. It was very discouraging because my nipples were cracked and bleeding, I was tired, sore, and now starting to panic that my son was starving.

Luckily, our hospital offered an evening breastfeeding clinic, so I left the doctors and went to see Tanya. She was calm, reassuring and took the panic-y edge off.  We tried different positions, and she suggested trying a nipple shield to see if it would be effective, but nothing seemed to help; he just couldn't get that seal right.  He would try to latch on and then just scream. Tanya noticed that Joe's frenulum (that little piece of skin that connects the tongue to the bottom of the mouth) was very short and it was up near the tip of his tongue. His tongue only moved back; he definitely could not stick it out. When he cried, his tongue looked kind of heart shaped. Tanya also looked up the signs of dehydration, and he had several.

Tanya was worried about Joe, and suggested that I give him a bottle of formula. It took him a very long time – maybe 40 minutes - to take a few ounces from the bottle.

It was pretty late by then, and that night Tanya faxed the pediatrician and told her of the problem. The next morning the doctor called four times to tell me that frenotomies are rare and "major surgery." She said that she consulted another pediatrician, who wouldn't do the procedure, and he in turn referred her to another pediatrician - best pediatrician in town – who also wouldn't do it but might refer us to see an ear, nose and throat specialist.  I immediately made an appointment with the "best pediatrician in town" and he sent me to the ENT specialist.

There was a consensus among everyone that yes, the frenulum was tight, but no one was sure that having it released would have any positive effect.  We did a little research, and decided that we needed to try something. Also, a big factor in my decision to go ahead with it was that I actually dated someone in college who was tongue tied. He didn't have a speech impediment or anything, but he was self-conscious of it, and truth be told...he was a very bad kisser (!).

The actual procedure was a lot like an ear piercing--a little numbing spray, one quick stroke and it was over.  I held Joe the whole time and he only cried for a minute. It took 30 seconds and there was as much blood as a tiny papercut.

Here's the best part:  he latched on perfectly in the waiting room-I could feel the difference.  His lips made a seal this time. He's been nursing like a champ ever since, and he's still nursing now - at 18 months!

The general attitude I got from all of the doctors was that I was making a big deal out of nothing. I heard a story later about midwives in olden days keeping one of their fingernails long so they could just slice through any frenulum that looked remotely tight.  How did we get to this?

Be sure to check out more posts on breastfeeding challenges on the blogs listed below (updated throughout the day):

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Comments

That's just amazing to me... When our pediatrician saw my daughter the day after she was born, he told me she was tongue-tied and had already clipped her frenulum. At the time, it made me a little angry that he hadn't gotten consent before doing it, but I'm glad the procedure was done. We never had any trouble breastfeeding at all!

Wow -- what a story! My heart goes out to you and your perseverance, Lisa. It's astonishing and discouraging how little doctors often trust their patients, but I'm glad you trusted your wisdom and pushed to find experts who could truly help.

wow what an amazing story. Glad things worked out so well. I can related to the frustration and cracked nipples but we went on to breastfeed 2 1/2 years.
Donna

I would love to know how many of the doctors who didn't support clipping the frenulum are also free with the "supplement with formula" advice. It's hard enough to learn to nurse without having to fight professionals who know better.

I'm so glad to hear that the tongue tie was eventually seen to and it's wonderful to know that your son breastfed so easily afterwards. It must have been a very worrying time for you!

Tanya, great carnival, thank you!!

Wow, what a moving story! I love the anecdotal detail of the midwives with the long fingernails. "How did we get to this" indeed!!! Bravo to Lisa for hanging in there and trusting those mother's instincts. I'm so glad it all turned out ok.

Thanks, Tanya for a great carnival!

Well done Lisa for following through and trusting your instincts! Thanks for the carnival Tanya :)

So clipping a frenulum is "major surgery" but circumcision is a "routine procedure"? Think about how mixed up that is.

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