Tuesday, October 25, 2011

The Sweet Release

You may remember how worried I was about breastfeeding the second time around. We even dedicated a Carnival of Breastfeeding to the topic. I had so much trouble with Miles in the early weeks, from sore nipples and poor milk transfer to weight loss, but I attributed much of that to the fact that I had a hospital birth, he was routinely supplemented and probably had some nipple confusion. I figured a lot of the problems I faced with him could be avoided by having an out-of-hospital birth, but I also assumed that having "been there, done that" would make breastfeeding much simpler and easier the second time around.

So imagine how thrilled I was when breastfeeding seemed to be going swimmingly with Aminah. Although she was immediately put on my chest after birth, she didn't latch on for a good hour and a half. But once she did, she opened wide and was sucking strongly. She seemed to be thriving on my colostrum; babies are only expected to have one poopy and one wet diaper on the first day of life but Aminah had three! She continued to poop and pee well and nurse frequently and my milk came in on the second day (it took until day FIVE with Miles!). Once my milk came in, though, things got shaky. Aminah was having a hard time latching on to my rock hard boobs, she wasn't transferring enough milk and I could feel hard lumps forming in my breasts. My nipples were sore, her latch was extremely painful and she wasn't emptying my breasts. I could get her to open wide but she'd quickly slide back and be sucking only on  my nipple. She was no longer pooping and only having a few diapers with pee in them. I was dreading feedings and wondered if I could make it 6-9 more painful weeks, the way I had with Miles. So I did what I always tell everyone else to do when they email/tweet/facebook me with their breastfeeding problems; I called a lactation consultant.

I am lucky enough to have a wonderful local IBCLC who coached me through a couple of things online before she could come see me the next day. By the time I saw her on day 5, Aminah was down to 8 pounds from her robust birth weight of 8.15 and had the dreaded urine crystals in her diaper. My LC looked in her mouth and determined she was tongue tied. I was devastated. Although I know tongue ties are common, I have heard time and again from the LC community that pediatricians and other doctors don't take this concern seriously and are reluctant to clip.  I also clearly remembered a pediatrician doing rounds when my son was born telling me he had a tight frenulum, but when I mentioned it to my regular pediatrician he waved it off and said it was fine. When my LC looked in Miles' mouth that day, she said his tongue tie was so awful she didn't know how I ever managed to get the kid fed at all, let alone at the breast!

Thankfully I live in a place where I have a lot of options for getting the tongue tie released (you can find out who does them in your area here).  My LC gave me a list of names, including Dr. Denise Punger. I knew of Dr. Punger from her book Permission to Mother and her blog by the same name. She wasn't the closest doctor to me (in fact, she was the furthest away) but I knew that if there was a need for a clipping, that I wasn't going to have to argue with her or convince her why I needed to get this situation fixed. I knew Dr. Punger would "get it" because she is a mother of three breastfed children and an IBCLC herself. Also, she was incredible enough to fit us in the next day! So I packed up the whole family and we drove 90 minutes north to Ft. Pierce.

When we arrived at her office, I broke into a smile when the first thing I saw on the wall was this poster:

In the waiting room were two other moms who traveled almost as far as I had to get breastfeeding help from Dr. P. I wonder if they picked up a copy of her book while they were there?
I know what you are thinking, coolest doctor's office EVER, right? Oh it gets better. Here is the exam room.

I mean, honestly, how many doctors would have a photograph of their footling breech home birth blown up on the wall of an exam room for all of their patients to see? (click to enlarge)

After a short wait, I finally got to meet Dr. P (we've corresponded via email and I read her blog so I felt like I knew her) and she was just as I imagined she'd be. She looked at Aminah, confirmed the tongue tie and went to get her tools in order to release it. When she returned, the nurse placed Aminah on the exam table, swaddled her up tight and Dr. Punger touched her mouth.  I was too much of a wuss to look, but immediately Aminah started to cry and I whimpered. "She hasn't even done anything yet!" my husband told me.

After she clipped her frenulum, she handed her to me so I could nurse her. Her mouth looked like it was full of blood but I later found out it was only a few drops but that when it pools with the saliva, it looks like a lot. As soon as she latched on Aminah calmed down and seemed fine. Her latch was still quite painful, but Dr. Punger assured me it would get better quickly.

After we left I asked my husband what the procedure looked like and he could barely contain his incredulity. He said the doctor had just barely touched the membrane with a small, scissor-like tool and it had spread open. It took a fraction of a second. "We could have done that ourselves at home!" he said. (My hubby is known to be uh...frugal?)

By the time we got home that night, I could feel an improvement in Aminah's latch. By the next day, she had figured out how to use her new and improved tongue and was sticking it out constantly. She was nursing like a champ, removing lots of milk and pooping after every feeding. I'm happy to report that even with our less than stellar start she was back to birth weight by day 13.

If you think your baby might have a tongue tie, please see an IBCLC (check out the signs of tongue tie from Dr. Kotlow, scroll down to "Diagnostic criteria for neonatal tongue frenum revision"....I swear we had every sign!) If I could give advice to anyone facing the decision of whether or not to clip a tongue tie, I'd say get it clipped as soon as possible! It was really such a simple procedure and has completely changed our breastfeeding relationship. I know that some tongue ties are more complicated than ours was, but many dentists can now fix them with a laser and it doesn't require anesthesia and it's not major surgery.

Also, as an aside while I still have your attention. When you are having major issues in the early days of breastfeeding, you really can't go wrong by seeing an IBCLC. Yes it's expensive and you might not get reimbursed through your insurance but it's still worth it. If you are still pregnant, I highly suggest putting away a few dollars every week in a jar as a "just in case" fund. If you don't need to see an LC, you've got a couple hundred bucks to use any way you choose. If you do need one, it won't hurt as bad to hand over the money. And please beware of the advice you might get online from other moms. I can't tell you how many people on Twitter told me that it was JUST FINE that my baby wasn't pooping and peeing, no need to worry at all. When I said I had to supplement her with formula, people came out of the woodwork to tell me it wasn't necessary. Believe me, it sucked having to give her that stuff that is "similar to lactation", but she needed it. As a friend reminded me over the phone as I cried over it, Rule No. 1 is Feed The Baby. A couple of ounces of formula to get her over the hump until we figured out breastfeeding wasn't going to kill her and again, it was necessary. Your twitter followers, as well meaning as they may be, can't see in your baby's mouth and frankly, might not know what the hell they're talking about. Mother-to-mother support is vital and important, but please seek professional help when it's obvious things aren't going well.

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Sunday, October 16, 2011

She's Here! Our Birth Story

The last few weeks of my pregnancy I was absolutely miserable. I was suffering from intense and debilitating pelvic pain, my iron level was extremely low and nothing I ate managed to raise it, and I was working and functioning on about two hours of sleep a night. Suffice to say I was looking forward to hitting 40 weeks and getting that baby OUT. But like my son, my daughter had other plans. As the days ticked by, not only was I frustrated that I wasn't going into labor, I was getting nervous because my licensed midwife was only allowed to legally care for me until 42 weeks. At that point she would be required by law to take me to the hospital for an induction. Since Miles was born at 42 weeks 3 days, I was scared. The whole point of using a midwife was to avoid the hospital and I really didn't want to end up there. So we did all of the usual things to get the baby out: walking, sex, evening primrose oil, homeopathic black and blue cohosh, acupuncture and some root tea prepared by my mother-in-law. At the end of the day I knew the baby was going to come when she was ready and none of this was making a damn bit of difference, but it did help to feel like I was being proactive and not leaving everything up to chance.

I went to my final midwife appointment at 41 weeks, 5 days for yet another non-stress test and biophysical profile. The baby looked great so we made plans for me to come in at 42 weeks for a day of torture....castor oil, herbs, membrane stripping and god only knows what else. During my first pregnancy we had gone into the hospital for the same tests on a Monday and made plans to be induced that Wednesday, but I went into labor that night. So we decided to try and recreate that Monday by going out for spicy Indian food, having sex and going for a long walk. It worked to get the first baby out and it worked for the second!

I was having Braxton Hicks all that evening but by about 10 pm they were accompanied by some cramps that felt like the real thing. I called my midwife at 11 and told her I thought this was it. She asked me to time three more contractions and call her back and let her know their duration and how far apart they were. When I called back and said they were coming every 3 minutes and lasting a minute she told me she was heading out the door and for me to get my butt in gear.

When we met up at midnight she checked me and I was 7 centimeters! I had been walking around 3 cm dilated for the previous two weeks but never thought I would be so close so quickly. The contractions were regular but not bad at all for a couple hours. I tweeted and checked Facebook and talked and laughed with the midwife, her assistant and my mom. At about 3:30 AM I decided to get in the tub because I was getting kind of bored and wanted a change of scenery. I soaked for about an hour before deciding to get out because I felt like the warm water was slowing everything down. The contractions were still so manageable and easy and I thought if I started pacing around the room and hallway maybe I could get everything to speed up a bit.

The walking definitely worked and the contractions started to get really intense and close together, about every minute and a half. After about an hour of hard contractions my midwife decided to check me again and to my shock, I was complete. I hadn't felt the urge to push and I didn't feel the baby drop and my water hadn't broken so I was surprised that it was time. Looking back I wonder how long I had been complete at that point because my body wasn't giving me any clues that I could pick up on that the baby was ready to be born.

We all moved to the bed and I waited for the first contraction to push. That first push was pretty tentative but broke my water. I could feel myself start to tense up a bit because I was afraid of A) pooping and B) tearing. Now, the first was just stupid. Midwives don't care if you poop, they expect you to poop and most women poop during labor. I honestly don't know why the thought of it bothered me so much and to this day I have no idea if I pooped or not and I don't want to know! I was petrified of tearing because of how bad I tore (and was cut) during my first labor and how awful the recovery from it was. But I could feel my midwife's hands in me the entire time helping to stretch my skin so after a few more nonsense pushes, I really got down to the business of getting the baby out.

I pushed so hard and it hurt like hell and I just remember screaming because I was shocked at the pain. During my first labor I felt nothing even though I hadn't had any pain meds. I just pushed for a few minutes and voila! Miles arrived. This time it felt like I couldn't quite get the baby out and wherever she was stuck was extremely painful. I pushed and screamed for about 15 minutes and out she popped! She gave one little cry and was immediately placed on my chest where she stayed for an hour. All told my labor was about 8 hours long. My baby made her debut at 41 weeks, 6 days.

After her newborn assessment, I found out why this labor hurt so much. My baby was born with a nuchal arm. She had her little left fist pressed up against the side of her face, and her elbow poking out to the side.

October 5, 2011
8 pounds, 15 ounces
20.5 inches long

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Wednesday, October 5, 2011

Tamera Mowry Drinks Sister Tia's Breastmilk

Have you been watching the new reality show, Tia & Tamera, that follows twin sisters Tia and Tamera Mowry? In the series, Tia is expecting her first child, while Tamera is planning her wedding. Throughout the season we've seen Tia planning for the birth of her baby by interviewing a doula, considering a home birth and talking about breastfeeding. Unfortunately a breech baby necessitated a hospital birth and a C-section for Tia, which was documented in the series finale which aired recently. We get to see the birth of baby Cree, as well as their early days at home.

At one point, Tia, who is pumping for the baby, highly encourages her sister Tamera to taste her milk.

What do you think, would you taste your sister's milk? I don't have a sister and although I did taste my own milk, I am not sure I'd taste someone else's.

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