Breastfeeding Support in Oklahoma City

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Why YOU Need Breastfeeding Support

Free Breastfeeding Support Groups in the OKC Metro Area (including Mustang, Yukon, and other surrounding areas)

Local Online Breastfeeding Support

For Other Professional Breastfeeding Help

  • Ashley Barett is an International Board Certified Lactation Consultant (IBCLC), Registered Lactation Consultant (RLC). I offer breastfeeding consultations in the comfort of your own home.  For more information please email me or visit my website.
  • There is also an excellent list compiled of IBCLCs in Oklahoma available from WIC (this list was updated August 2017 and is updated twice each year).
  • If you need additional help finding an IBCLC near you I’m happy to help you. Please send me an email with your city and zip code and I will send you a list of IBCLCs near you.
  • Oklahoma Breastfeeding Hotline is available 24/7 for breastfeeding questions.  Call 1-877-271-MILK (6455) or visit the COBA (Coalition of Oklahoma Breastfeeding Advocates) website for more information.

If you have information that you would like added to the list or any updates for your group’s information please email Ashley Barrett.

Where do you like to go for breastfeeding support?

What to Expect When Your Baby is 2-7 Days Old

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Whether you are breastfeeding or not your breasts will begin to transition from colostrum to mature milk at about 2-5 days postpartum.  This post is geared toward breastfeeding mothers.  If you choose to feed artificial breast milk (formula) it’s a good idea to manage the swelling in your breasts with expressing your milk to comfort for the first few days and slowly expressing less milk each day after the first couple of days to prevent mastitis (a painful breast infection which can cause you to be very sick).

To learn more about getting breastfeeding off to a good start and know what to expect in the first two hours postpartum please see my earlier post in this What to Expect series.  You can also learn more about what to expect that first night home from the hospital (regardless of the timing of that due to a normal vaginal birth, surgical birth, or bringing a preemie home) here.

In the first 24 hours after birth, your baby is receiving colostrum which is a thick breast milk that is extremely high in antibodies and vitamins because baby has such a small tummy.  The average a baby receives is about 0.35-3.68 oz in the first 24 hours (based on a 7 lb 8 oz baby) (Source: Counseling the Nursing Mother, Fifth Edition).  Your body begins producing this liquid gold breast milk during pregnancy and it protects baby against bacteria and helps jump start baby’s immune system and GI system to living in the world outside of the womb.

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Sometime in the first 2-5 days your body will begin producing more milk as it begins transitioning to mature milk.  I don’t like to use the phrase “milk coming in” because colostrum is also breast milk.  It’s all important and vital to baby’s survival and optimal growth and development.

You may notice some engorgement in your breasts at this time.  Not all mothers experience this and those who do notice varying degrees of this engorgement and time that it lasts.  It typically resolves in about 2 days but it may take about 7 days after milk transitions for it to resolve but it will get better each day.  Not all of this fluid in your breasts is breast milk.  Much of it is lymphatic fluid and blood from which milk is synthesized.  Like if you have an injury, ice packs can be very helpful after a feeding to help take this engorgement down.  The very best way to resolve this is by putting your baby to your breast frequently-a minimum of 8-12 times per day, many babies like to nurse more frequently.

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Your baby’s stomach has increased to the size of a ping pong ball (like in the picture above).  Baby will take an average of 14-19 oz per day of breast milk.  Your milk will slowly transition over the first two weeks postpartum but the components quickly resemble those in mature milk.

Things to Watch For:

  • Baby should be on the breast 8-12 times per 24 hours (or more frequently).  Feedings may last 7 minutes up to an hour or possibly longer.  Expect to spend lots of time feeding your baby and recovering from birth.  Your baby will get more efficient at nursing over time.
  • You should notice your milk increasing in volume and transitioning between day 2-5.  If by day 5 you do not notice your milk increasing in volume or baby has lost more than 10% of birth weight (7% is the number where we really start watching babies closely but if you received IV fluids during labor your baby may lose more) contact your doctor and your baby’s doctor right away and seek help right away from an IBCLC. 
  • Follow the care instructions from the hospital regarding cord care, body temperature for you and baby, and other discharge directions.
  • If you have any breastfeeding questions contact a breastfeeding professional right away.
  • Baby’s stools should become more green in this timeframe as your milk transitions.  Baby should have at least 1 wet diaper in the first 24 hours, 2 the second day, 3 the third day, and so on until baby is having at least 6-8 wet diapers and 3 yellow seedy poopy diapers by the end of the first week. Baby’s stool should be the consistency and color of French’s mustard with sesame seeds in it (the seeds are the curding milk from digestion).
  • Skin-to-skin contact helps babies to breastfeed better.  Many issues can be resolved by making the breast a happy place to be even if baby isn’t latching.  Getting help from a breastfeeding professional is also very important in this process.  If you don’t feel the care plan that you and your professional work out together is working you can always seek extra help or seek a second opinion.  Like doctors, breastfeeding professionals all have different areas of expertise and unfortunately not all are on the same page with evidence-based information because we are continually learning more and more about breastfeeding.

 

What did you find most helpful in the first 7 days postpartum?

If you have breastfeeding questions in the Oklahoma City, Mustang, or Yukon areas I am happy to help.  I offer breastfeeding classes and consultations.  You can find out more on my website or contact me here.

Mother’s Stories: Liz and David

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I had the wonderful opportunity to have an interview with a beautiful mother from my LDS Breastfeeding Families Facebook group about her struggles breastfeeding.  Liz Woodfield published her story on her blog, and I could tell she had a very strong desire to breastfeed from her story.  She went through a lot of struggles and wasn’t able to get her baby to latch for the first five weeks.  You can read more about her story here.

Ashley: Tell me a little more about yourself. Where are you from?
Liz: I was born in Fairfax, Virginia and now live in Salt Lake City, Utah.

A: What did you do before you became a mom?
L: I work in recruiting for a large investment bank. I will continue to work full-time after I finish my 4-month maternity leave.

A: What are your hobbies/things you enjoy doing?
L: I love the outdoors! I especially love to hike, bike, ski and run. I also really enjoy reading and photography.

A: Were you breastfed? Did any of your sisters or sister-in-laws breastfeed?
L: Yes, I have two little sisters and all of us were breastfed. My sisters don’t have any children yet. My two sisters-in-law have not breastfed and my mother-in-law did not breastfeed so I do not have a lot of support on that side of the family.

A: Who has been your greatest support to helping you meet your breastfeeding goals?
L: My greatest support has been my husband. He has encouraged me so many times when I wanted to give up. My mom has also been incredibly supportive, as well as one of my sweet friends, Ally, who has an adorable 11 month old baby and breastfeeds exclusively. Ally is also a nurse and has offered endless support. She came over and helped teach me multiple breastfeeding techniques and gave me a shoulder to cry on.

A: What specialists did you see and why? How did they help?
L: I saw two IBCLCs, a Chiropractor, a Craniosacral Therapist, and a Pediatric Dentist. I saw each of these people because we wanted to take a very holistic approach to breastfeeding. We saw the first IBCLC four days after little David was born. She spent a lot of time checking baby’s mouth and diagnosed extreme tension in his jaw and tongue. She was known in the community for finding lip/tongue ties so I felt confident she would find something if there was an issue. After we left our first meeting with her, we noticed the upper lip tie and we asked her about it at our second appointment. She didn’t think it was an issue for breastfeeding. We did not feel this first IBCLC was very helpful because she did not give us many action items or suggestions of things we could do to make breastfeeding work. I had already planned to see the chiropractor early on and scheduled our first visit the day we saw our first IBCLC – the chiropractor was so helpful in aligning baby boy and he was always so calm after each visit. The Craniosacral Therapist was scheduled quite a ways out and I was unsure that it would really be helpful because I had not heard of it before I met with our first IBCLC but we went ahead with it and I am now a believer! You can see the impact of the work she is doing on the baby in the moment it is being done. She was so sweet and patient with baby boy and key in relieving tension throughout his mouth and head. We saw the second IBCLC right after a recommendation from the first LLL meeting we attended. She was also recommended by another friend. She was so helpful! She gave us a ton of homework to do and exercises to work on with baby to help with sucking and building head and neck strength,which would all ultimately help with breastfeeding. I hesitated to spend the additional money to see another IBCLC but I’m so glad we did. She has been amazing and I have had so much additional support through the breastfeeding support group they host every two weeks.

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A: Tell me about your support network, you mention the support a lot in your post. How has everyone helped you meet your breastfeeding goals?
L: I have had the most amazing support network throughout our journey. I already mentioned my husband, my mom, and one of my best friends, Ally. In addition to each of them, I talked to a lactation consultant early on through a hotline provided by my employer and they said something that really helped me: “Breastfeeding is a natural process and can be very intuitive but many people forget that mother and baby still have to learn – they have never done this before so it is a process to figure things out.” La Leche League was amazing. I went to a local meeting when baby was almost 3 weeks old and I was just about ready to give up. Hearing the stories and challenges that so many other mothers faced made me feel so much better about my experience. LLL gave me a few more resources and suggestions that gave me the motivation to move forward and keep trying. Additionally, I used multiple different Facebook groups to read others experiences and reach out with questions and support when I needed it most. I had to seek out these resources but there are so many people out there that want to see you successful with breastfeeding.

A: You mentioned in your post that you took more than one breastfeeding class. How were they different and what did you learn that helped? What did you wish you would have learned in the classes you attended but didn’t?
L: I took an in-person beginning breastfeeding class from a local lactation consultant. I then took two additional online courses from the same LC. They were helpful and went over everything at a surface level. What helped most was learning the basics: different types of milk, different positions, how to get started. I wish I had learned more about problem-solving – where to go, who to talk to, etc. These are things you often cover one-on-one when you meet with an IBCLC but it would have been helpful to have a general overview of some of the challenges you can face in breastfeeding, aside from the more obvious mastitis, thrush, etc. I honestly did not think it was possible that baby would just not latch at all in the first several weeks! I knew pain was possible and latch could be a challenge but did not expect that baby would just not latch. The LC also did not talk at all about tongue/lip ties but I knew some information from my own research and Facebook groups.

A: What books did you read? Which one was most helpful?
L: I read Ina May’s Guide to Breastfeeding, The Nursing Mother’s Companion by Kathleen Huggins, and Breastfeeding Made Simple by Nancy Mohrbacher and Kathleen Kendall-Tackett. I read each of these books during my pregnancy. I feel that Ina May’s book was the most helpful because she did share the experiences of some mothers and went into a lot of details on some challenges; however, I feel the classes were more helpful than any of the books I read. It is difficult to really follow the books and relate to the content when you have not tried to breastfeed yet. I am now reading The Womanly Art of Breastfeeding by Diane Wiessinger, which is dedicated to LLL, and I would highly recommend as the one breastfeeding book to read during pregnancy. It is funny how you learn these things after you have a baby.

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A: Tell me more about your first hour. What were your goals versus what really happened?
L: My goal in that first hour was to have unlimited skin-to-skin contact and have the baby latch within that time. Unfortunately after birth, I had really bad chills and it was difficult for me to even hold the baby. My doula did help me try to latch for a minute but baby was falling asleep and I was miserable because of the chills. At the time, I did not think much of it but after the fact, I have wished many times that I could re-do that first hour and just push myself to hold him that whole time or wish that I just never had the chills. Hopefully things are different for my second baby.

A: Tell me more about your first week. What were your goals versus what really happened?
L: The first week was a blur. The first 3-4 days, we tried to feed him at the breast every time he was hungry but within minutes, the baby was screaming inconsolably. So after 10-15 minutes of trying to breastfeed, we would start to syringe feed the baby while he was sucking on a finger. I was just hand expressing my milk at this point but started to use the pump on day four, after we went to the first IBCLC. We also started to use the bottle for feedings, still introducing the breast every time he was hungry. I was nervous about using a bottle because of nipple confusion but it was so difficult to use a syringe once he was eating larger amounts (2+ ounces). The goal was to get baby latched at the breast but the ultimate goal was to feed the baby breastmilk, regardless of what it took.

A: How long did you exclusively pump? What helped you get through that time?
L: I exclusively pumped for 5 weeks. The primary motivator for me was that my baby continued to root around on my chest when he was hungry and show interest in the breast, even though he never really latched.

A: Tell me about those first times trying to latch, what would happen?
L: For the first few weeks, anytime we tried to latch, it was the same reaction. Baby would root around, we would cradle him at the breast and he would move his head back and forth around the nipple, search for the nipple with his hands, etc. and then get frustrated really quickly when he could seem to get it in his mouth and he would cry inconsolably. He would continue to cry until he started to get some food from the syringe and/or get to suck on a finger.

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A: Tell me more about your first experience with an IBCLC? What was helpful and what wasn’t helpful?
L: My first experience was a little odd. We spent the entire first apt sitting on a couch trying to breastfeed baby while he screamed, with a few minutes spent where she felt around his mouth and did a little lymphatics to try to loosen things up. She told us to just keep trying and suggested we use a bottle going forward. She didn’t really give us any action items of things to try or work on – this was our biggest frustration. We were especially frustrated after the second appointment because it felt like more of the same…again, no action items. Although she did suggest we switch to using a Phillips Avent bottle to help baby open his mouth more to help him learn to latch – I do think this helped him a lot in his journey to breastfeeding.

A: What do you think was your turning point?
L: There were a few turning points in our journey. One turning point was when we started to do paced bottle feeding, baby seemed a little calmer at the breast and would try a little harder, sometimes getting a little mouthful of breast but he couldn’t get any suction to stay on the breast. Another turning point was when I visited the LLL meeting and they encouraged me to meet with the second IBCLC – the second IBCLC was so encouraging and gave me so many incredible exercises to do and resources to follow-up on. And of course the final turning point was the upper lip tie revision and then when baby latched right on 10 days later.

A: You mentioned that you took your baby to the chiropractor for adjustments. Did you notice any difference with latching after, behavior, anything else?
L: I love the chiropractor! The biggest difference I noticed was in his behavior – baby was so calm after the adjustments. He also had some mucus at one point and after the chiropractor, it cleared right up. Honestly, I never noticed a major difference with breastfeeding after an adjustment but I definitely feel it helped baby boy feel better. He had some bad subluxations in his neck and I think it is more comfortable to move his head and to nurse on both sides now (he did better on the left side before several more adjustments).

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A: When did your baby first latch and breastfeed and what were your feelings about that first latch?
L: At five weeks old, 10 days after his ULT revision, baby was refusing the bottle for 15-20 minutes and my husband suggested I try to breastfeed – he latched right on! And his latch was great. We were both shocked! But SO HAPPY. And so excited! We celebrated with dinner that night.

A: Tell me more about your employer’s “Mothers at Work” program. Do you know where people can go to find more information about the program (employers or employees)?
L: The “Mothers at Work” program is aimed to support working women – it is offered through LifeCare. They provide 24/7 Lactation Consultants to help you establish breastfeeding and then general support for the transition back to work. Here is a link with more info about the program: http://www.lifecare.com/mothers-at-work/.

A: You had thoughts of giving up and even put a date on the calendar of when you wouldn’t try (latching?) anymore. You became neutral about breastfeeding. Tell me about what led you to those feelings? What made them ultimately change?
L: My husband was the one that had the idea to set a date on the calendar. It was around baby’s 3 month birthday. That was when we decided we would stop investing so much money and time into trying to breastfeed and stick to exclusively pumping. Until then, we were pretty dedicated to working with our second lactation consultant, CST, and the chiropractor to see what they could do to help us meet our goal of breastfeeding. I am a very logical person so when we set a date, it helped me to know this period would not last forever. My second lactation consultant also reminded me that baby was not “rejecting” me by not latching and to let go of the emotion because that would make it easier to keep problem solving – I think this is ultimately what helped me to feel neutral about breastfeeding. I also logically reminded myself that baby was still getting breastmilk and the nutritional benefits, which was what was ultimately most important to me.

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A: Tell me more about your experience with the breastfeeding support group meetings that you have attended. What have you found helpful from the other mothers and leaders and would you recommend a struggling mother to attend meetings?
L: The main thing I found helpful was just hearing so many different experiences. No one experience is the same. My favorite support group is the breastfeeding support group hosted by my current lactation consultant every two weeks. These settings are very open and I feel so comfortable openly breastfeeding there and learning from other moms.

A: Your baby had a tongue and lip tie revision-tell me more about what happened with the doctor. Were you able to try latching in the office afterwards?
L: The revision went great! The first 30 minutes with the pediatric dentist were spent doing the initial evaluation of the ties – we determined our baby only had the upper lip tie (no tongue tie) and he asked if we wanted to do the release there. We went into another room where we swaddled baby in a SwaddleMe blanket and then they numbed him – he cried a little when they numbed him with the needle – then he fell asleep while they did the laser cut. They showed us how to do the massages and gave aftercare instructions and we were on our way. We didn’t get the chance to try to latch in the office but baby was so sleepy, I don’t think he would have been too interested. The dentist was extremely kind and patient.

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A: You mentioned skin-to-skin quite a bit in your post. Where did you learn about this? Do you think that it helped your baby ultimately be able to latch?
L: At one of the LLL meetings I went to, one women said “I think most all of the challenges we face in breastfeeding can be solved with skin-to-skin.” I think that reminded me early-on of the importance. I had also read several studies in pregnancy about the importance of skin-to-skin and it was stressed in my breastfeeding classes. I think this did help baby to ultimately latch because he could always smell the milk while on my chest. Whenever I was home, if I wasn’t holding him skin-to-skin, I was often wearing him in a stretchy wrap skin-to-skin.

A: Tell me about your experiences with the Craniosacral Therapist versus the Chiropractor? Was one more beneficial than the other? What differences did you notice?
L: I feel like a CST and Chiropractor are very different. A Chiropractor focuses on the spine while a CST does gentle touch therapy more on the cranium. CST takes much longer as well. I feel like they both served their own purpose and benefited in different ways – the chiropractor aligned baby’s body while the CST loosened the tension in the jaw and through baby’s head. I noticed a huge difference in baby’s behavior after both treatments, mostly that he was much more calm. Although baby did try to latch more particularly after CST.

A: You talk about the first time your baby started refusing a bottle and you ended up latching, at 5 weeks. How did you feel during that nursing session?
L: It was incredible! I was in shock. There was a small part of me that was worried it was a one-time thing so I tried not to get too excited but I just couldn’t believe it! It was very obvious there was milk transfer as well which had definitely never happened before.

A: You also mention that you tried several tips and tools. Which one was your favorite and why?
L: My favorite technique is the “flipple” – essentially holding above and below the areola, holding the nipple between upper lip and nose and then when baby opens wide, flipping the nipple into baby’s mouth. This allows baby to get a big scoop of breast tissue. It works really well for my little one, especially because he tries to latch on really quickly and gets frustrated if it doesn’t happen perfectly soon enough.

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A: Do you have any final words for a struggling mama?
L: My final words…if breastfeeding is important to you, don’t give up. It is so worth it! Everyone has a very different journey but continue to problem solve and make it happen. It is the sweetest experience to successfully breastfeed your little one. And just know, if it is not working, that’s okay and your baby loves you all the same, your bond is just as special. Stay strong, mama! Breastfeeding is such a beautiful gift.

Thank you for sharing your story with us Liz.  If you would like to share your story with me please contact me.  I would love to share your breastfeeding story.

Synchronized Latch On in Oklahoma City

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The Big Latch On has strict rules about where an event can be hosted (Babies R Us isn’t allowed) so we decided that we will be doing a synchronized latch celebration during our Nurturing Bonds Breastfeeding Circle meeting.  Join us at 12:00 PM on Saturday for our meeting.  At 12:15 sharp whoever brought a nursing baby will be latching their babies on at the same time as a way to celebrate breastfeeding.

Happy World Breastfeeding Week Oklahoma!

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I will be hosting a World Breastfeeding Week celebration with Babies R Us in Oklahoma City on Saturday!  More details are available on my website (including a link to the Facebook event).  I will be posting about different events that will be going on throughout the main event over the next few days.  Help us celebrate and educate about breastfeeding in Oklahoma.

Let’s Talk Sucking Issues (and the IBCLC Credential)

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Let’s talk sucking issues. Let’s especially talk to medical profession and future medical professionals. Palpable ridges along cranial sutures and plugged tear ducts. These were two things that really stood out as weird to me with Brendan, my oldest who is now 8, as a newborn. Brendan couldn’t latch at all when he was born and he had a big bruise from the suction cup from the vacuum extractor. He was also taken away from me immediately. That was extremely traumatic for me-no one heard me when I was shouting “I want my baby! I want to breastfeed!” All of those were signs of major problems and I wish that his tongue-tie, the ridges, the bruising would have been identified as issues. The doctor said he had seen worse ties and *I* must be the problem and I must not have been holding him correctly. Guess what buddy? YOU were wrong. YOU should have been more educated in to breastfeeding issues.

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My oldest son had palpable and visual ridges.  We didn’t know this was a unique situation so we didn’t focus on them trying to get good pictures but they are pretty obvious in several pictures.  You can see them on the side of his head in this picture. Taken May 2008 when he was 3 weeks old.

I am currently reading a book called Supporting Sucking Skills. EVERY doctor, midwife, RN, OT, IBCLC, “lactation consultant/nurse” that is around breastfeeding needs to read this book. If you ever have a breastfeeding patient you should read it. Do some self-educating. I get that there isn’t a lot of time in Med school, nursing school, etc to learn about breastfeeding, identify breastfeeding issues, assess mouths and sucking, and diagnose the issues but that’s no excuse to not educate yourself. There are amazing resources out there. Identify your limits. Don’t PRETEND to know what you’re talking about. It can be detrimental to a mother to tell her in any way she isn’t sufficient or to not properly support her in breastfeeding.

Doctors know when to refer to other doctors who are specialists. There are other non-doctor specialists though that everyone needs to be familiar with.

Have you heard of an IBCLC? Most of the general public has not. Many of my friends should have because it’s my passion to be one. An IBCLC is an International Board Certified Lactation Consultant. They’re the boob helpers if you will. Like doctors not all are created equal and there are some crummy ones despite having to complete 14 specific health science courses at the University level, 90 hours of breastfeeding specific education, and depending on pathway chosen up to 1000 hours of hands on clinical breastfeeding support. After all that they must pass a rigorous international exam with an international perspective. They must recertify with a lot of continuing education or resit for the exam every 5 years and for sure sit for the always updated exam every 10 years. They must know how to identify breastfeeding problems. They learn about many diseases that effect neonates and are often a front line to identify possibilities so the doctors can look in to them further. They are experts on poop, newborn and infant sleep, and normal term breastfeeding (hint-if you are not supporting a mother “still” breastfeeding a 2+ year old you need to revisit your perspectives). Many know how to assess for tongue and lip ties and while they can’t diagnose they can refer to specialists that know how to take care of them (although many are bound to refer within the system that employs them even if it isn’t the best option for the mother and baby-one of many reasons why I have chosen to be in private practice). Many recognize sucking issues. Take them seriously when you get a referral or a report from an IBCLC.

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I’ll be the first to admit I didn’t get a very good picture of this tie but you can still see this thick band that was ignored by several providers.  This was my daughter’s class 4 lip tie.  It attached down and around her gum line back in to her palate. (My youngest-taken 1/27/14 when she was 4 weeks old, her revision was in February a week later)

If you don’t know how to properly assess for a tie be honest-remember to first do no harm. Refer to a specialist that actually knows what they are talking about. www.Drghaheri.com has a lot of information about how doctors should be assessing. He has an excellent bedside manner and knows what the heck he’s talking about because he was a father of a baby with sucking issues and he went out of his way to learn how to help his wife, child, and future patients. He teaches other doctors how to revise ties.

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This swollen blistering lip was caused by my daughter’s lip moving in and out (rather than staying stationary) and continually breaking the seal while breastfeeding.  This was taken a week before her revision.

Treat mothers with respect. If a mom has a concern take it seriously. You are not in her home at all hours day and night. If you treat her with dignity and respect and her baby as well you will be well respected. Learn to properly identify sucking issues. They cause a host of problems and are a main reason why mothers give up on breastfeeding. That may not be important to you but it is to her.

Mother’s Stories: Tori and Otto’s Tongue Tie Story

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The following is a story shared with me by Tori Caswell of Oklahoma.  I first heard her story in March this year.  She has shared it publicly before but has gone through more since then.  I am beginning a project to give a voice to mothers and share their breastfeeding stories, especially their tongue tie stories.  The following is the account by Tori.

In her words: I’m a homeschooling mama of 3 boys. I love being outside, walking, biking,  running and swimming. I also love being inside baking, writing and reading. I’ve recently taken up sewing and have a goal of making stockings by December!

Otto is our third child, third son born on September 21st, 2015. This was my third time to breastfeed. I was confident, educated and had worked as a volunteer breastfeeding support person for 8 years. I was committed to nursing him. Our problems started right away and came to a crescendo at 5 ½ months. I am unbearably embarrassed that it took me so long to let in the fact that it was a tongue-tie causing our problems. I carry a deep sadness for the suffering my son endured.

I have this blame in my hands, I keep trying to pass it off, to the pediatrician that told me “posterior tongue tie isn’t real” and that Otto wasn’t tied because he could extend his tongue out of his mouth. I keep trying to hand this blame to the speech pathologist who told me his tongue looked fine and not tied, just after she watched me let tears loose over how desperate I was to feed my baby. We scheduled a swallow study for a month out, the soonest they could squeeze us in. I had tried breastfeeding, 6 types of bottles, a Haberman feeder (which passively drips the milk in baby’s mouth) and ultimately found a syringe was the only way to get the milk inside my baby, even that, I would learn was being silently aspirated into his lungs. If I had I been giving him anything but my expressed milk he would have most likely contracted pneumonia. I wanted to blame the lactation consultant who watched me struggle to feed him in her office and told me that “posterior tongue ties aren’t a thing” and I should try a supplemental nursing system (SNS) which is this little tube you tape to your breast to give extra milk when they nurse. Here I stand though, blaming myself.

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Haberman Feeder example and chart of internal mechanism
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Example of an SNS

I had literally 20 La Leche League Leaders from a Facebook group telling me “his symptoms sound like he’s tied” in response to my posts about how Otto:

  • Pulled off during letdown
  • Was noisy and fitful at the breast
  • Gagged and choked on bottles
  •  Hadn’t gained weight for a month
  • Wasn’t growing out of his 0-3 month clothing at 5 months old
  • Cried inconsolably and often
  • Had persistent thrush
  • Was overall unsettled and unhappy

When I go back and read my posts, I knew it was his tongue, but I didn’t trust myself. I wanted his pediatrician to diagnose it. I did call and make an appointment to see a dentist in OKC (Oklahoma City) who revised ties and had extra training in assessing for them, but that appointment was a month away.

I spiraled into a dark place of exhaustion, superstition, depression and complacency. I slept through my baby’s crying routinely. I spent every waking moment trying to feed him. I was growing shorter and shorter with my 2 older children. My husband would walk around the house for hours with our crying baby, so I could have a break. On March 4th, a Friday, we had yet another weight check with our pediatrician which yet again showed no growth in any way for a 2nd month. I couldn’t hold in my panic or my crazy any longer. She diagnosed him failure to thrive and we drew labs. I got a call the next day saying that his TSH was high and that they needed another sample to test for more serious things. She was thinking a hormonal growth problem. So we went to the ER and found his blood sodium was very low, dangerously low. He was admitted to OU Children’s Hospital in OKC that day.

Otto was physiologically starving, which is what was causing his low sodium. This is the reason anorexia is the most deadly mental disease, starvation is dangerous. When I look back at pictures of him during this time, I have to stop and not let it in, not unless I can go cry.

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Taken 3/3/2016 (3 days before hospital admittance).

 

One thing I’ve learned about OU Children’s as a birth doula is that they are exceptionally good at finding pathology; they will scour a mother and baby to find it and then leap to treat it, aggressively and immediately. I’ve watched the cascade of interventions play out in the context of birth a dozen times; Otto’s hospital stay wasn’t unlike that. They checked his kidneys and found them to be enlarged. They checked his kidney function, all good. They checked if he was having reflux from his bladder, no he wasn’t. They checked his heart, all good. They begged and begged me to allow them to catheterize him to check for UTI, which I eventually did agree to and yes he had one. I firmly believe that his enlarged kidneys were either unrelated to or caused by his starvation and chronic dehydration. The only doctor that would even entertain that idea was the nephrologist (kidney) doctor. The lead pediatrician continued to supplement his sodium orally for the entire hospital stay and sent me home with a prescription for sodium, which I never gave him. His sodium was checked multiple times after our stay and was normal.

3 days tube feeding

Before and After: 3 days of tube feeding, taken day before tongue revision

After 6 hours of testing, Otto’s feeding tube was placed. He had it for 3 days and had to have it replaced 2 times because he pulled it out. After 3 days of more testing, Otto’s tongue-tie was revised by an ENT doctor who came to our room. Even the doctor exclaimed, “Wow, that released a lot!” immediately following the clip he made under Otto’s tongue. It literally took 1 second and his latch was instantly better. He drained my breast for the first time in his life. I had been reading and reading on Dr Ghaheri’s website about how to stretch a tongue revision to avoid regrowth; he called it “active wound management.” (For more information you can see Dr. Ghaheri’s Aftercare instructions here.) I asked the ENT doctor if I should stretch it, he said “no.” I did it anyways.

Then the next day, I asked the speech pathologist, who had done Otto’s swallow study the previous day and found his silent aspiration, if I should stretch his tongue and she said, “no.” I did it anyways. I would have danced in the halls naked if it meant that we weren’t going back to how things were before the revision. The feeding tube was removed the following day.

Otto’s weight went through the roof. It went from 20-30 grams every 24 hours (3 days of tube feeding 2 ounces every 2 hours) to 130 grams overnight, with unlimited access to the breast. I overheard the nurse giving report, “he’s been taking the breast a little bit here and there, 5 minutes at a time.” I interrupted them even though I wasn’t included in the conversation. “He’s actually been gorging himself, filling himself to bursting and it takes him less than 5 minutes to do it.” Blank stares.

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Otto sleeping with a full belly, first feeding after his first revision; he emptied my breast for the first time, I was overjoyed.

Over the following days, I met Otto for the first time; content, fed, happy Otto. My heart was soaring and I will be totally honest, I really enjoyed the break from my older children and from cooking and cleaning. We made friends with the cleaning woman and all our nurses and doctors and even some other patients. I pulled Otto in a red wagon through the halls, smiles everywhere.

On our last night in the hospital, I woke up in the middle of the night having a terrible nightmare, hyperventilating and screaming at the top of my lungs. Deeply disturbing imagery I still can’t speak about. The nurses came running in checking on Otto and finding him ok but stirring because I was being so loud. I couldn’t speak, to ask them to take him out of the room so I could regain my composure, two nurses stood at the bedside, quietly staring at the monitors, which were off because Otto was better and discharging the following morning. I tried to explain what had happened, I called my husband and tried to calm down. Finally a nurse came in and took Otto out of the room long enough for me to calm down. I heard Otto crying from the hallway, the nurse had started undressing him and weighing him because measuring him was their only way to comfort me, to assure me that he was ok despite my terrible dream.

We were discharged 7 days after admittance on a Sunday, the 14th of March.

before and after copy

There are 9 days between these photos.  The After is the day we discharged from the hospital, he had gained nearly 2 lbs.

 

My worst fears became a reality as we settled into our rhythm at home. Otto started pulling off the breast at letdown again. My supply dropped again. I called and made another appointment with the dentist who does laser revision and she got us in that same week. The 2nd revision took place on March 31st. The improvement was much slower and the recovery more painful I imagine as the cut was deeper. At this point Otto had suffered months of starvation, followed by tube feeding, poking and prodding, a scissor revision during a week long hospital stay, 2 weeks of 4 times a day oral stretches and then a 2nd revision (laser) followed by 3 more weeks of 4 times a day stretches. All this could have been avoided had my pediatrician known how to diagnose posterior tongue-tie or I had the guts to treat him for it despite her denial of it.

 

I wanted to believe that our system is set up to help mothers that have breastfeeding problems. I wanted my son’s pediatrician to know how to help us or who could help us, but she didn’t. Suddenly as our whole journey sinks in, the hospital stay, the scissor revision and then laser re-revision, I remember watching babies not latch, not gain, milk supplies tank, mothers battle sore and bleeding nipples and persistent thrush outbreaks. I suddenly realized that most of them were dealing with undiagnosed ties. They had come to me to help, but I had to tell them, “some babies don’t latch”, “some women can’t produce enough”, “some yeast just never goes all the way away”.

My experience with my tongue tied baby has left me humbled, hurting and jaded. I started this journey with very little trust and faith in our medical care system and have emerged with even less.

I feel susceptible to becoming a conspiracy theorist about this topic. I’ve learned that I myself am tongue tied and it’s led to many discomforts and traumas in my life. Colic my first year of life, constant ear infections, tubes placed in my ears, terrible overbite that required 9 years of braces to correct, removal of 4 adult teeth to fit my teeth in my mouth, mouth breathing that has led to terrible tooth decay and removal of another tooth, constant dry lips and neck and jaw tension. All these things could have been potentially avoided had my tie been recognized and resolved in my babyhood, but how many professionals then would have lost me as a patient and my parents as a customer. I’ve since learned that people aware of ties that work in hospitals like NICU staff and lactation consultants are given gag orders to not mention ties because they are not there to diagnose any condition. I’ve since learned that my situation is not unique and that ties are being missed by not just pediatricians but IBCLCs and ENTs and discounted as not causing breastfeeding problems or tooth decay problems or speech problems.
I want to see change. I want ties to be taught to all these professionals and more. I want treatment to be swift and for suffering to be avoided. I made folders containing all the information I could find for every doctor’s office in my town that saw babies and children, for our local ENT physician, for the IBCLC and the Speech Pathologist I saw. It’s how I began my emotional healing. I want to see a film made on this topic. The research is there, it’s been done, more is being done. My story is one of many.

otto happy daddy shirt

Otto, thriving and growing after his 2nd (laser) revision.

Tori is a birth doula in the Stillwater area of Oklahoma.  You can visit her website here.

If you are a mother interested in sharing YOUR story please email me at ashley@nurturingbonds.com.  I would love to hear and share your story.  All stories can help other mothers-positive or negative experiences.

What to Expect: The Realities of the First Night Home

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This picture for today’s post is meant to be ironic.  This picture depicts what society says our newborn is supposed to be like.  We prepare a fancy nursery and bring our perfect baby home and we wear white clothing and the baby never messes up those clothes or our clothes with spit up or poop…baby sleeps so soundly while we snuggle in a lovely rocking chair while our spouse dusts, vacuums, and keeps the rest of our lovely everything-white house pristine.

This isn’t reality.

I’m going to tell you a little story, not to scare you at all, but to hopefully provide an example that your first night home won’t be like.  I hope this post will help you prepare better than we did and have expectations in place before bringing baby home (or if you deliver at home you still have a first night at home).  I also highly encourage you to take a quality breastfeeding class, especially one that talks about expectations and realities because preparing in this way has been proven to support breastfeeding and increase the initiation and duration of breastfeeding.  If you’re in the Oklahoma City area be sure to check out my class details and register here.

korvergoinghome

This adorable baby is my second son.  I can’t find my first son’s going home from the hospital picture to help illustrate my story but we can pretend that this is my first son anyways for sake of the picture (they used the same car seat at least!).

My first son was born on a Friday.  He was never able to latch on in the hospital so he was given formula (we didn’t know any alternates at the time and no one told me that there was an alternate to pumping that is more efficient with colostrum-hand expressing).  I was sent home with no pump, nothing.  I did have instructions when we were released Sunday morning to call a doctor the next day to have his tongue tie clipped and hopefully he’d start being able to nurse.  We sent my parents to pick me up a manual pump so I could try to get my mature milk to come-at the time the term “milk come in” was really descriptive of the situation because I never got even a drop of colostrum out with the hospital pump even though I leaked on my nursing pads and had drips on my breasts.  Things got real when they headed home.  All of a sudden my milk started increasing in volume enough that I was getting a little bit in the bottle.  My son got his first tastes of breast milk and I was changing out bottles so my husband could feed my baby and I could keep pumping milk.  This went on forever because he didn’t want to take formula anymore after having my breast milk.  Finally we tried to settle and go to bed and my son woke up from a nap and wouldn’t go back to sleep.  He kept screaming and nothing would calm him.  We tried walking around, bouncing him, giving him more milk.  He just wouldn’t calm down.  By 2 AM I called my mom frantically asking if it was ok to put my son in his carseat and let him sleep.  At the hospital they drilled so much that it wasn’t safe to let baby sleep ANYWHERE but laying flat on their back and we were scared new parents.  We ended up putting him in his carseat and taking a 40 minute round trip in the car where we both were so exhausted.  I don’t know when we ever got to sleep that night or for how long.  Things got better after that night but I will always remember feeling so helpless and awful that I couldn’t calm my son at all.

Mother with her newborn baby

Realities

If you have a hospital birth you’ll be coming home between your baby’s 2nd and 5th day (depending on if you had a vaginal or surgical birth).  If you had your baby at home your first night will be after your baby is born and you’re all tucked in.  In this case your baby may be a couple of hours old or almost a day old by your first real night depending on when your baby was born.  Regardless, at some point you will have your first night home on your own at some point without a call button for a nurse to help with latching or to help you calm your baby.  Reality sets in when you are in this position.

Your baby will nurse frequently day and night.  Your baby will nurse about every 2-3 hours day and night with maybe a 4 hour stretch at some point between the beginning of one feeding and the beginning of another.  Many babies take 20-30 minutes to nurse, some take an hour.  All of this is within the range of normal.  Every 2-3 hours is just a guideline dividing  up the average 8-12 times per day that baby needs to nurse and some babies will nurse every hour.

Beb mamando

Your milk may be increasing in volume as soon as you get home.  This paired with your baby’s stomach increasing in size, your baby wanting that extra milk, and everything that comes with these things means that you may be experiencing some engorgement and discomfort.  It’s normal for engorgement to happen and it’s normal for it not to happen.  If you experience engorgement it’s important to remember that this is more than just milk.  Other fluids are in your breasts including blood and lymph and if you had IV fluids you may have other fluids resting in your breasts and feet as well.  This can be very sore.  Frequent feeding, ice after feeding, and heat before feeding to encourage milk to flow are usually the best remedies at this time.

Your uterus may be sore from contracting down to its normal size.  When you are nursing oxytocin is released which helps contract the muscles to release your milk and your uterus.  You may also be tender from delivery, especially if you had a tear or a c-section.  Nursing frequently helps your uterus to contract down to normal size quickly though and you can talk to your doctor or midwife about pain relief options if you’re interested.

It’s normal for your baby to wake up frequently.  It’s also normal due to hormones for you to sleep more lightly.  Nursing mothers often start feeling an intense need for a lot of water which means you may be getting up as frequently to go to the bathroom as you were in the late days of pregnancy.  All of this does get better over time and there are some things that you can do to help prepare for all of these things.  Knowing is half the battle though, right?

Dishes may pile up, laundry may pile up, try to put those things out of your mind.

Newborn

Here are some tips for making the first night home easier on yourself:

  • Have everything at hand: snacks, water, your cell phone, a remote for the TV if you wish, a book, etc.
  • Have a lot of pillows handy to help you position yourself and your baby during the night while you’re nursing.
  • Babies often spit up when they’re burping-keep extra burp cloths at hand.
  • Keep diapers nearby.  When your milk is increasing in volume your baby will also start having higher output…pee AND poop.  You may consider keeping an extra sleeper or two close by as well in case of a blowout.  They seem to like to happen during the night.
  • Prepare for baby to sleep in proximity to you.  Babies are more comfortable sleeping near mom because they’re biologically wired to be near mom.  For more information on normal sleep behaviors for newborns, infants, toddlers, and children the book Sweet Sleep is great to read.  The book starts off with quick information for how to prepare your bed for a safe night of sleep in your bed with your baby before you can read more information in the book to do a full set up.
  • Get the bathroom ready.  Have pads on the counter so you don’t have to fumble around.  Consider having a nightlight so you don’t have to turn on a bright light when you’re tired, waking yourself up more.  Keep your peri bottle handy and any other comfort measures as well.

Some other ideas to help during the day and night:

feedingcues

  • Babywear!  Skin-to-skin contact especially helps regulate and stabilize your baby’s body temperature, organize sucking, regulate breathing, comfort baby especially if your baby has gas or is in pain from medical procedures (always check with your doctor to be sure babywearing is safe after a medical procedure-it usually is but not always), allow you to be hands free to sit back and take a nap during the day, reduce stress in your baby because baby doesn’t have to cry (crying is stressful for babies, it isn’t a way to “exercise their lungs”), and also helps you recognize and react to early hunger cues which builds trust with your baby.
  • Call on your network!  People usually offer to help-call them!  Our society, at least in the states, is so against asking for help but they offered so take them up on it!  Let them run to the store or let them hold the baby while you take a shower or take a nap, just make sure they give you baby at early feeding cues.
  • If you are having breastfeeding issues go back to the basics.  Work on getting a deep latch or go back and read my post about what to expect in the first two hours, especially watch the breast crawl video.  Babies in the first couple of weeks especially have very active reflexes to help them breastfeed.  Take advantage of these if you’re having any breastfeeding issues.
  • Call on lactation support if you are having breastfeeding issues.  Call a LLL leader, Lactation Educator, CLC, IBCLC, or other breastfeeding support.  If your situation is beyond their scope of practice they can refer you to someone else to get you help right away.  Many areas have a 24 hour breastfeeding hotline.  Take advantage of it!  In Oklahoma you can call: 1-877-271-MILK (6455).  For urgent calls you will get called back quickly by an IBCLC.
  • To prepare in advance, take a good breastfeeding class.

If you’re in the Oklahoma City area be sure to check out my class details and register here.

What was your first night home like?  Tell me in the comments!

March Class Dates

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Can you believe it’s already almost March?  I can’t either!  Check out my March class dates.  I’m pleased to announce that I will be beginning to teach classes at Babies R Us in March.  Please feel free to share with your friends!  You can learn more about my classes here.

You can register here. Or register on my Square store.

Get Social!

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This is a picture that I took before going on Periscope before my Breastfeeding Basics class on Saturday.  Did you know that I am on Periscope?  I love to answer your questions live and demonstrate breastfeeding equipment and babywearing techniques.  Do you have any questions you would like answered live?  Please feel free to drop me a line with the subject “Periscope” so I can be sure to answer them the next time I go live.  You can find me @nurturingbonds on Periscope.  You can also check out my Katch.me if you miss the replays on Periscope.  Remember on replay on Periscope you can still tap to give hearts!

I also have a You Tube channel where I upload my videos from Periscope and other helpful videos that you can visit here. (Please subscribe!  I need 100 followers so I can request a custom URL on YouTube)

Check me out on Twitter, Instagram, and Facebook too!

I’d love to follow you too!  Leave your Periscope, Twitter, Instagram, and Facebook usernames in the comments and I’ll follow you!