A Pain in the Boob

I am repeatedly saddened at how many people I speak with who tell me they tried breastfeeding but it just didn't work out for them. I understand it, but I hate to hear it. Before I gave birth, I was told that the most important factors in succeeding with nursing are having support and self determination and I agree. While breastfeeding is the most natural and healthy thing you can do for yourself and your baby, it does not exactly come naturally and there are hurdles that can be very challenging with or without loving support. There have been moments where, were I not so determined, I could have felt like I just wasn't good at breastfeeding. This past week is a great example because having a blocked milk duct has definitely been a test in dedication.

I am very lucky to have a husband, mother, friends, midwives and a doula who support me in nursing. Even with this foundation, I have also seen two lactation consultants for help. I believe you can NEVER have too much of the right kind of support. I feel for people who have no one to support their decision to nurse and it infuriates me that someone could be made to feel weird or guilty for wanting to do what is best for their infant. Let me just say that the previous statement is not simply my opinion: breastfeeding, when physically possible, IS what is best for an infant-FACT. I can see how negativity and guilt can greatly effect a new mom as I have also had some unsolicited "help" which was not helpful at all, in fact it was discouraging. So, I believe it is important to follow your gut and have people you trust to ask questions to. I have not yet been to a La Leche League meeting but I plan to because I hear they are a great support system for nursing mothers.

What my newest breastfeeding 'adventure' has taught me:

A blocked/plugged milk duct is when there is an obstruction blocking your milk from flowing. It can either be superficial (on the nipple) or down in the duct. I don't care where it is, it is not pleasant. The symptoms usually include a hardened lump in the breast that may be hot or swollen and feel bruised.  Personally, it felt like there had been an all-out mystery assault on my left breast and I was suffering the consequences. They say it comes on gradually but I did not notice it until it was really there. I am mentioning this just in case someone reading this could be nervous that the symptoms they are reading about on whatever website they googled don't exactly match their own-everyone is different. My biggest worry when my breast began to really hurt was 1) that it was mastitis and 2) it would never go away. Neither of these fears came to pass but they haunted me nonetheless. I learned from our midwife that mastitis is HORRIBLE and you know if you have that because you feel incredibly sick; like death. I never felt sick just like I had a lot of pain in my breast. I am not exactly sure what caused my blocked duct because there is a laundry list of reasons it can happen. I did have a blocked pore which looked like a small white spot on my nipple and it hurt -especially after I tried to open it by poking it with an acupuncture needle (I don't recommend this, regardless of TCM training it just isn't fun). There is a good chance I got this bleb from an improper latch. As I have discussed, buddha baby is mildly tongue-tied and we don't have the best latch. The majority of pain was within the breast and it hurt whenever I put ANY pressure on it including holding buddha baby on that side or trying to sleep on my stomach (which can also cause a plug).

Resolving the problem:

OK, so I had a block, if you currently have one I am sure all you care about is how to get rid of it. I was very diligent in performing all the tasks to rid myself of this wretched thing. Plus, I was motivated by knowing that a blocked duct left untreated can turn into mastitis and that is a game I have no interest in playing. I was told by our midwife to put a Castor oil pack on it with as hot of heat as I could stand- I did this...a lot. That part actually felt good as well as taking hot showers. I massaged my breast, which hurt like hell but I did it before I nursed, after I nursed and in the shower. Speaking of nursing, I nursed and nursed and nursed. I nursed on the painful breast almost every time he was hungry even if it was only a little and this pain made massage feel like a cake-walk. I didn't neglect my other boob but I really wanted this blockage out. I also fed in many different positions, including one where I leaned over him as he lay on the bed. It was a little awkward but I read that the gravity really helps bring out the plug. Something, or everything, worked and I am no longer in pain. I did not see the plug come out but I knew it was gone when I started filling with milk and didn't want to cry when there was a little pressure on my chest. I was expecting to feel it come out and have some big release or ahhh moment. I suppose I didn't feel it plug and thus I did not feel it release.

I just want to take a moment and say that if you are pregnant and planning to breastfeed, please don't be scared by these things. The point here isn't that nursing is hard or unbearable, the point is that at times it takes perseverance. There are challenges that you will face and sometimes you will need support. People will tell you the downsides of breastfeeding even though the upside is the most precious gift you can give to your baby- personalized liquid gold made just for his or her perfect little body. Yes, you are the only one who can feed the baby, unless you pump and bottle-feed which I have not yet been able to bring myself to do. Also, you tend to wake up more often than with formula baby and sometimes your body goes through things like blocked milk ducts or cracked nipples. Is it worth it? ABSOLUTELY!! There is no such thing as formula that is even close to breastmilk-- not even close-- and that is what your baby is designed to live on. Breastmilk is a perfect food. It is a baby's instinct to BF and that bond you create is beyond words....

Tongue Tie Part 1

Choices.

Why does being a parent come with making so many choices?

Although, at the end of the day I guess that is what being a parent is all about. You make the best decisions you can for your child based on the information you have, and hope that you don't royally mess him or her up in the process.

Being pregnant kind of prepares you for this by deciding whether or not you are going to change the pack-a-day/bottle-a-day/cheeseburger-a-day type habits in for a healthy and smoke free womb for your baby. But even still, pregnancy and birthing choices are still about mom AND baby. I think our first real "baby only" decision we had to face was whether or not to keep our baby boy's genitals intact. When I first realized I was going to have to make that decision it was like the roof fell on my head. I am not sure if that is the best analogy but that is how it felt; it was heavy and stressful and HUGE. I know that to some people this decision is simple and is never really even a blip on their screen, but to me and my husband this was a decision that would affect our son for the rest of his life. But, before I get too far off track (this is not a post about circumcision) let me bring it back in, because this is about a choice that certainly isn't as intense as the future genital integrity of our son.

Last week when we went to get our breast pump, the lactation consultant caught a glimpse of Buddhababy's tongue as he was fussing to nurse and she asked me if anyone had talked to me about it. I thought maybe she was going to say thrush because my nips have been a bit sore but she said no, she thinks he could be tongue tied. WTF! How could she even suggest such a thing!?! Wait...what does that even mean?? Yes, that is a little dramatic of a response but that is the immediate stream of thoughts I had at the mere suggestion that there was anything even slightly limiting about this perfect little boy. Not to mention that parenthood has turned me into the most embarrassing type of worry-wart. She asked me about his latch and I told her that he does pull off quite a bit and I do struggle getting a 'proper latch.' But, I know that latching correctly for a first-time mom has a learning period and let me tell you that our little monkey is a chunk, has no problems eating, and I have no issues with supply. He has gained almost a pound a week since birth and he is exclusively breastfed. The lactation consultant explained that tongue tie can cause problems not only breastfeeding but later in life with speech impediments, problems eating and eventually kissing. She gave me the numbers of a couple specialists that would better evaluate his tongue and then, if they said he was in fact tongue tied, they would snip the frenulum. I will refrain from sharing the flow of outrageous thoughts at this casual mention that someone should be snipping something on my son's body. She told me that it is a simple and virtually painless procedure that would instantly improve his latch and give him more tongue mobility. This is all fine and well but I am not just going to let some doctor tell me they need to be snipping anything without a little more research and some trusted opinions (i.e. our midwives).

Here is what I found out:

Ankyloglossia, or 'anchored tongue,' is most commonly referred to as tongue tie and is a common condition that can often be overlooked because so many babies are formula fed. This oversight is because it takes a very different motion of the mouth to feed from a bottle than it does to suckle a real nipple. A bottle will flow pretty much on its own while a nipple needs manipulation and mouth/tongue control. Also, the bottle doesn't get sore from an improper latch and complain.

Specifically, tongue tie is when the lingual frenulum, the cord that runs from the tongue to the bottom of the mouth, is short and restricts tongue mobility. This short frenulum is not always a significant problem and can often resolve itself (depending on who you ask) in a couple years. When it is a problem, it can interfere with breastfeeding, speech, eating and digestion. It can vary in looks and degree from person to person. Classically one looks to see if the tongue makes a 'heart-shape' when the mouth is open- this is often when baby is crying and tongue flexes. What also varies from person to person is the degree of restriction. Some tongue tied babies have trouble latching all together and create a nearly impossible nursing relationship between mother and child (this is not our case). Some people grow to have severe speech problems and some you would never even know. This is where the choice part happens.... is it worth it to go through any procedure if it is not really necessary?

After reading all the information we could find on tongue tie, we were still unsure. Ricky and I decided that we did not think the baby was tongue tied because he doesn't really look like the babies in the pictured examples, but we are also biased and unfamiliar with this condition. So we called Colleen, our midwife, and asked if she would take a look at it and tell us what she thinks. Colleen gladly agreed to help and off to the birth house Buddhababy and I went.

That day I learned not only that Buddhababy does appear to be tongue tied but that our other midwife, Allie, is also tongue tied (with no lisp or articulation issues at all). They both confirmed that the snip was easy and aside from the annoyance of being held down, painless. Also, when compounded with his constant feeding, the pain in my breast from a blocked milk duct and his colic they think it would be very beneficial to have it fixed. At this point I was now ready to ask the pediatrician what she thought. The timing was perfect because today was his 2 month exam. She verified what the lactation consultant and midwives told me and believes that he does have limited mobility and even though he feeds well, it would benefit him to see the ENT (ears, nose, throat) doc and possibly get it snipped. Amusingly, I will mention that the whole time the pediatrician was talking about this I thought she was saying E-M-T and was to embarrassed to ask why on earth an EMT would be better equipped to look at Buddha baby's tongue.

That is where we are today. I saw the pediatrician this morning and I have made an appointment for Monday to see the surgeon. After talking it over with Ricky, we made our choice and I think its the right one. I read that most babies as young as Buddha baby do not need any anesthesia and it is a very simple, minute process. The pediatrician said she isn't sure about that and they may require anesthesia and that will be a big factor in our ultimate decision. It is one thing for a simple snip but a whole other issue if we start talking about knocking out our newbie. I am nervous but will be happy to have it resolved. From what I have gathered, there are no downsides to having it snipped (believe me I searched and asked ad nauseum). I have gone back and forth over whether it is necessary and the pain I feel during nursing right now is probably a heavy factor. I am committed to nursing and have no intention of letting anything get in the way of that-it is too important. So we will see how it goes....


If you think you may have an infant or child who is tongue tied, there is a lot of good information at http://www.tonguetie.net/. Just remember that wach child is defferent and when my husband and I looked, we concluded that our son was not just because we were so used to see his tongue the way it is. Make sure you have your care provider examine your child to be sure but if you are having latching difficulties this could quite possibly be the culprit.