Two posts in one week? You can tell that the little man is in bed and that Mr P is away!
Following on from my post yesterday, I've been meaning to write a post about tongue tie in babies and share our experience with Master P as it is something that we really struggled with, and something that we felt we didn't get a lot of support with. I am hoping that new parents find my honest and reflective post useful.
Tongue-tie, what is it?
Tongue-tie is a problem that occurs in babies who have a tight piece of skin between the underside of their tongue and the floor of their mouth. Tongue-tie is a birth defect that affects 3-10% of newborn babies. It is more common in boys than girls. The medical name for tongue-tie is ankyloglossia, and the piece of skin joining the tongue to the base of the mouth is called the lingual frenulum.
Normally, the tongue is loosely attached to the base of the mouth with a piece of skin called the lingual frenulum. In babies with tongue-tie, this piece of skin is unusually short and tight, restricting the tongue’s movement. This prevents the baby from feeding properly and also causes problems for the mother.
To breastfeed successfully, the baby needs to latch on to both breast tissue and nipple, and the baby's tongue needs to cover the lower gum so the nipple is protected from damage. Babies with tongue-tie are not able to open their mouths wide enough to latch on to their mother's breast properly.
They tend to slide off the breast and chomp on the nipple with their gums. This is very painful and the mother's nipples can become sore, with ulcers and bleeding. Some babies feed poorly and get tired, but they soon become hungry and want to feed again. In most cases, these feeding difficulties mean the baby fails to gain much weight.
For more information, check out the NHS website.
To set the scene, Master P was born three weeks early as I was diagnosed with preeclampsia. Luckily, I was able to have a natural birth. With the birth plan rapidly going out of the window, I was hoping that after delivery, our new arrival would be placed of my chest to breastfeed, allow the cord to finish pulsating and to deliver the placenta naturally. This went out the window as well. No sooner as our new arrival had been delivered, he was quickly taken from me and given to daddy as I suffered a substantial postpartum hemorrhage.
It wasn't until a good few hours after he was born that Master P was returned to me to try to establish breastfeeding. During my pregnancy I was adamant that I wanted to breastfeed for as long as possible and had no worries about feeding in public. That's what my boobs were for, a source of nourishment for our baby. Plus you cannot avoid the constant bombardment of, 'you are going to breastfeed aren't you, breast is best!'... yes I know that!
The first few days we couldn't get Master P to latch on. I had more midwives manually 'milk' me than I can remember, collecting precious drops of colostrum via a pipette to give to our new baby.
We finally got Master P to latch on, but his weight had dropped substantially so we had to stay in hospital to allow him to regain weight, deal with his jaundice and allow me to have a blood transfusion. Due to his weight loss, we were advised to 'combination' feed him so we had to top him up with some formula after each feed. The midwives were happy with his latch by the end of the week after watching him feed. But I was still waiting for my milk to come in and I suffered with terrible cracked nipples.
After a week in hospital, we were allowed home. I was suffering with anaemia which took me a good 6 weeks before I even remotely started to feel human again, and I was still combination feeding Master P. Each feed was taking an hour and a half as I was breastfeeding from both sides and then having to top Master P up with formula as he never seem satisfied with breastfeeding. I just got on with it and accepted it.
The community midwives and health visitors were happy with viewing Master P's latch when they came to see me, yet I just didn't feel right. Something wasn't right. Call it maternal instinct, I don't know? I expressed my concern to the health visitor that I wasn't convinced that my milk had come in. I was told 'not to be silly dear, all women have milk and you can feed your baby'. Yet Master P would fuss at the boob, latch on, latch off, suck hard, fall asleep, get frustrated, cry and scream at me.
Now, I don't have the biggest boobs in the world (as my dear father would say, more than a handful is a waste), and I had hoped that during pregnancy I might have grown in that department. They stayed the same. Nothing changed. Even after childbirth. I would hear other new mothers talk about 'the let down', waking with swollen and hard boobs, leaking all over the place, expressing and filling up a beaker with 2-6oz into 10minutes. I had nothing and experienced nothing. Whether this was related to the anaemia, I'll never know.
Yet the health visitor ensured me that my milk would come in. I tried massage, lactation diets, eating this eating that, hot showers, drinking plenty of fluid, staying calm and relaxed, expressing between feeds to encourage supply. After 20 minutes of expressing, I would end up with 10ml.... I even went on a 'babymoon' with Master P and I hid away in the house for a few days for a nursing vacation! It ended up with both mummy and baby being very unhappy, mummy experiencing painful blanched nipples and both of us in tears. My baby was hungry.
Whilst this was going on for 5 weeks, I spoke to several breastfeeding consultants over the phone, the midwives at the hospital and the health visitors, who all advised me to keep going and that everything was normal. Yet deep down, my instincts were still telling me different.
I was desperate to breastfeed. I wanted to solely breastfeed Master P, yet we still had to top him up with formula after every feed. I felt like a failure and a prisoner in my own home as each feed was taking forever.
I couldn't breastfeed my own baby.
As a mother, that is one of the most awful and gut-wrenching emotion that I have ever felt. I started to dread Master P waking up. I started to resent having to feed him. I didn't feel the maternal bond when he was on my breast. I felt like a bad mother. I felt a failure.
I was broken by the end of the fifth week. I don't think Mr P could cope with any more tears. We debated if we should go over completely to the bottle, though Master P, even on the bottle, would dribble and have problems feeding. The guilt about going over to the bottle was unbelievable.
Enough was enough. I called in the cavalry and spoke with our local NCT lactation consultant who invited me to her house that very day to assess the situation. Within 15minutes of being there and watching us breastfeed, she informed me that Master P had posterior tongue-tie. This is why I was having blanched nipples; why my baby wasn't feeding from me. She recommend me to the feeding specialist at the hospital.
So, the next day we saw the feeding specialist who did a raft of tests on Master P and confirmed that he had quite a severe posterior tongue-tie which is why he wasn't feeding and why I had very sore nipples. Basically Master P's tongue was flat and couldn't reach forward to cup the nipple and he would just suck with his mouth.
Sadly, there was no-one at the Great Western Hospital who could perform the simple operation of snipping the frenulum and that the only other person in Wiltshire who was qualified couldn't take any more referrals. We were informed that the Ear, Nose and Throat Department in the hospital might do the procedure, but this was very unlikely as they weren't really familiar with the procedure and the impact on infant feeding. Not all NHS Hospitals offer this procedure. We were advised to go private if we wanted it dealt with and found a suitably qualified lactation consultant who could provide the support and carry out the procedure for us in our own home. We are now proud owners of the most expensive pair of surgical scissors which carried out the procedure...£180.00!
The lactation consultant came out to see us the following week, and carried out the procedure at our home. We were asked lots of questions about the pregnancy, the birth and what had been happening over the past 5 weeks. When it came to the procedure, Master P was swaddled and held by Mr P whilst the consultant did the quick snip on his tongue and Master P was placed straight on my boob as breastmilk is sterile and ideal for healing the cut. It was quick, and relatively painless. Master P was very good and didn't cry. The cut healed very quickly. Over the next few weeks we had to do various tongue exercises with Master P and encourage him to stick his tongue out. Basically, he had to relearn how to suck and latch on.
The lactation consultant advised us to take Master P to a cranial osteopath as he had a tendency to favour the right side and we also discovered that his jaw was very tight which had an impact on feeding and latching. After a few sessions, Master P was 'realigned' and much happier and more comfortable with feeding.
After the procedure, I tried to carry on breastfeeding, but sadly, the milk wasn't there. We made the decision to go over to the bottle completely which for me, was a very hard decision. But at the end of the day, we needed a happy baby and a happy mummy. And now we have that, and I enjoy feeding Master P.
Hindsight is a wonderful thing. If I knew what I knew now and could go back, I could have prevented a lot of stress, tears, and frustration. I wanted to share my experience with you as whilst I was going through this living nightmare in the first few precious months or our newborns life, I couldn't find much information on the internet of other peoples experiences.
I asked for advice and help on some of the parenting websites and forums who all shunned me for combination feeding and even considering moving to the bottle completely. I felt unwelcome at my local breastfeeding group for having to combination feed as the bottle was 'sinful' and 'unnatural'. I was informed at the hospital that Master P didn't have tongue-tie. How was that missed?
Last month, a very interesting article regarding tongue-tie, its recognition and support for parents was published on the BBC News website, after being raised as a significant issue by the NCT.
And funnily enough, the more new mothers I speak to, the more stories of similar experiences I am uncovering. There seems to be a lot of us out there suffering in silence, and we shouldn't be. I do think that there is a gaping hole in the information given to parents at feeding workshops regarding problems that you could experience with feeding.
Even though I still have a deep guilt embedded in me for having to bottle feed our son, and admire those women out there who are breastfeeding, we should never judge those who are bottle feeding babies as we do not know their circumstances. Clearly, breast is best where possible, but sadly it isn't always possible for every mother to do so.
Go with your maternal instincts if you feel that something isn't right when it comes to feeding. Seek help and actually see in person, a lactation consultant. You should have someone in your area who can come and see you, either NCT or Le Leche League, and they don't charge.
Stay strong. You are never alone.