Breastfeeding Problems... Resolved

So despite my best efforts, Emmy and I have been having problems with breastfeeding. :(

Remembering all the problems Mila and I had, I knew I wanted to do my best to make sure we didn't have the same problems when Emmy was born. So I made sure to have multiple nurses take a look at her latch to make sure everything was alright. Everyone said she was doing great and that her latch looked good! But I was having pain and I couldn't understand why. She was making clicking noises too, and she shouldn't be making any noises, if the latch is right. But all the nurses said everything looked good. So I just figured it was that I was getting used to it again - it had already been about 9 months since Mila stopped nursing.

I was trying to suck it up and deal with the pain, but every nursing hurt so much! Within a day or two of being home, I started pumping and we were feeding her with a syringe (there is a concern that using a bottle with a baby this young could cause nipple confusion and would cause more problems with her taking the breast - the last thing I need is to add to the problems we were already having!) Once my milk had come in (those first few days you only produce colostrum, not milk) I figured I could use a nipple shield to help with the pain (I did this with Mila as well) and that I could put her back on the breast. But strangely enough, she wouldn't take the nipple shield! I didn't know what to do - since I'd been pumping, I was starting to feel better enough to try nursing again but it would only leave me sore again!

To add to the pressure, at Emmy's first pediatrician appointment on Saturday, he said she hadn't gained her birthweight back and was concerned I "wasn't producing enough milk" and he thought perhaps my milk hadn't come in yet. I didn't really believe this, because I knew my milk had come in, but regardless, he wanted me to put Emmy on a feeding schedule (I've been feeding her on-demand) and he
wanted to see her again in a few days. I was starting to stress about it.

That night, I stumbled across this blog post that my Bradley teacher posted on her Facebook page. It was a story of one woman's determination to breastfeed despite difficulty due to something called "tongue tie." I'd heard of it before - it's when the tissue under the tongue, called a frenulum, is tight and doesn't let the baby latch on right. It can cause pain while breastfeeding. I had started reading the story because it was breastfeeding related, but the more I read, I started noticing similarities between Emmy and the baby in the story. By the time I was done reading, I was convinced Emmy was tongue tied and started to do research on it.

I found lots of articles and she had several of the symptoms, the most obvious was pain during breastfeeding, a clicking noise when nursing, she cried with her tongue down (it should curl upward) and when she was on the breast, she'd leave my nipple shaped like the tip of a lipstick. This first article was the most helpful, as it showed pictures of what a baby with a tongue tie looks like and what symptoms to look out for.

Is My Baby Tongue-Tied?
http://cwgenna.com/quickhelp.html

Diagnosis of a Tongue Tie
http://kiddsteeth.com/Does_Your_Child_Need_a_Revision_of_the_Lingual_Frenum2010.pdf

Tongue Tie Assesment
http://kiddsteeth.com/articles/tonguetie%20assesment.htm

After reading all of this, I was even more convinced Emmy had it. I printed out these articles and showed them to Jorge. He wasn't completely convinced she had it. To me - there was no doubt in my mind!!!

The first obstacle is getting her diagnosed. Apparently, it isn't easy to find someone that is trained to recognize the different types of tongue ties. Usually a pediatric dentist or pediatric surgeon would be able to accurately diagnose it. Not all tongue ties are the same and not all pediatricians can recognize the lesser common posterior ties.  The next obstacle is then finding someone that can clip the frenulum to relax the tissue. That's the only cure. I emailed my Bradley teacher, Tracy, to see if there was anything she could recommend and I was so happy I asked! She was amazingly helpful and it turned out that her son had a tongue tie when he was born (he is now 5 months) and she had to get his clipped. She explained that it's a quick outpatient procedure done right there in the doctor's office with no anesthesia and once they clip it, you could nurse right away and you may even notice immediate difference in the latch. She gave me her lactation consultant's phone number to help me get more information on it.

I called her lactation consultant, Pam, who was also very helpful and generous with her time explaining everything to me. She sent me to the some of the same sites I'd just been researching to compare pictures to Emmy. She said based on my descriptions of everything, (pain when nursing, baby crying with the tongue down, clicking noises when she nursed and the strange shape she left my nipple in) she thought it was very, very possible Emmy had a tongue tie. She gave me the information of a pediatric surgeon at Joe Dimaggio Children's Hospital in Hollywood (the one that Tracy used for her son) that I could call and make and appointment with. She said Dr. Long could diagnose as well as cut the frenulum if she needed it. What a relief!! I called first thing on Monday morning and they were able to squeeze me in for Wednesday - which I was so thankful for, but it was two whole days away - that's over 20 feedings!

In the meantime, I had the follow up appointment with the pediatrician. Leading up to the appointment, I had made sure to feed her plenty and I was confident she was eating well. The nurse weighed her, and to my relief, Emmy had gained her birth weight back, but he said expected her to have gained more. He recommended that I should supplement Emmy with formula and he wanted to see her back in a week. Despite what he said - I honestly believed that she was doing well. She'd been peeing and pooing great, her lips were always moist (they dry out easily if they're hungry) and most importantly, she'd been in a great mood!

(Later on, I gave it some thought and I realized I didn't finish nursing her before she was weighed. Perhaps that's one of the reasons she hadn't "weighed enough"? Even an ounce makes a difference at this point!! Plus, they didn't weigh her on the same scale - were all these calibrated?)

I told him I thought she had tongue tie. I explained her symptoms and my reasons why, but he was skeptical and he quickly checked her mouth and said no. He barely looked! Sigh. I felt like he wasn't taking my concerns seriously. So frustrating. I may not be a doctor, but I KNOW my kid. I didn't even bother to tell him about Emmy's appointment at the Joe Dimaggio Children's Hospital with the pediatric surgeon in a couple of days.

Yesterday was finally the day of the appointment. The place was PACKED! Apparently, this doctor sees all kinds of cases. Since they'd squeezed us in, we had to wait - and wait we did! We waited about 3 hours!! Thank goodness Cindy came with us - we definitely needed someone to keep Mila entertained at the doctor's office.

Once Dr. Long saw us, it was quick. I explained my concerns and what symptoms she had. She looked in her mouth and, sure enough - said Emmy had a posterior tie (one of the harder ties to diagnose). She said it wasn't too bad, and should not affect her speech but if we were having problems breastfeeding, cutting it could help. We agreed to cutting it - I was both relieved and terrified! I was thrilled we had discovered the problem, but in just moments she would be cutting her mouth and I knew it would be painful. :(

Thankfully, just like Tracy said, the cut was quick - Emmy cried more that Dr. Long was forcing her mouth open! She cut it and immediately soldered it silver nitrate so it wouldn't bleed. She did it right there and it took like 2 minutes. I nursed her right away, but didn't feel an immediate difference until later that night. She was even nursing with a nipple shield!

I am so happy I followed my instincts and researched the tongue tie! I'm so thankful for friends like Tracy and people like Pam, the lactation consultant! I don't know what I would have done - I'm sure if this hadn't been resolved, I wouldn't have been able to continue breastfeeding, and that would have been heartbreaking for all of us. Since she got her tie cut yesterday, I've definitely noticed a difference with the mobility of her tongue and now that she's able to latch on to the nipple shield, we're almost exclusively back on the breast. Soon - no more pumping!! Hooray!!

Don't mess with the boob!