Our Long Road to Breastfeeding: part 2 (from his caringbridge)

This entry is not meant to shame, upset, or cause guilt. Some will be uncomfortable, label it controversial. Others will call it myth and dismiss it. That's okay. But for those who want to understand and listen to the evidence and how it ties in with my son, please continue reading.

The Kick In The Head & The Pain Relief

Silas came home on August 12, 2012 at almost 2 weeks old. He went in for his follow-up weigh-in on a Friday and he had lost more weight. He was still a very sleepy eater and tired quickly. His Pediatrician prescribed formula supplementation immediately. And immediately, I began seeking alternatives. Having nursed 2 children already, I knew there had to be other options.

On Saturday morning, I attended a la leche league meeting with my friend who has twins and I told her what the Pediatrician said. She introduced me to Norma, an ICBLC who has been a God-send. Norma told me how to separate the hind milk and fore milk using my own pumped milk and feed it to my son. He went back for a weigh-in on Monday and he had gained a good amount of weight! The Pediatrician asked if he was doing well on the formula and I shared with her what we had done. She said she didn't even know that was possible. One point for breasmilk, formula zero!

When I came home from the hospital, I had to return my hospital-loaned pump. To rent a similar kind was going to cost me $60 for 60 days. Instead, I met with Norma at our local office and was able to loan one, for free, through our local WIC program. By the time the appointment arrived, Silas was 4 weeks old and because I didn't have a great pump at home, I was having no choice but to supplement, unable to maintain my supply with pumping alone. At that appointment, Norma didn't just pass me a pump and send me on my way. She talked, listened, and helped me work on latching Silas at breast. We made observations about his demeanor, position, appearance. We weighed him, attempted to latch him, and weighed him again. We discovered he wasn't transferring enough milk to be effective. We scheduled another meeting.

At the second meeting we worked with a shield and supplemental nutrition system. He still was not transferring a ton, but it was small progress, enough to keep me going. The new pump was helping but he was still having some formula. By now he was 8 weeks old. Here is where we became concerned and things started adding up. I am going to try and detail our observations as best I remember them.

1.) Low amount of transferred milk indicates poor latch/inability to feed effectively which leads to exhaustion

2.) Uncomfortability causes pain, inability to position baby properly, and upset.

3.) Feeling inside baby's mouth with gloved finger reveals high palate, tongue motion abnormalities, unbalanced suck ability, tight upper lip frenulum, possible tongue tie. Could explain symptoms above.

4.) Baby is clench-fisted, rigid body, curled posture. Could indicate delay.

5.) Baby drools out side of mouth, does not stay awake for full feeding, makes clicking noises while eating, tucks in lips which creates improper seal/latch on breast and bottle, which further aggravates poor feeding issues.

Because of all these things, we decided to ask for Silas to be referred to an OT for suck training and further evaluation. We continued to work with his latching, nursing, and widening the base of his bottle nipples to widen his latch. Some days he had a feeding or two that were great, other days he acted like I was the plague in human form. To say it was trying is an understatement, exhausting, mind-boggling, defeating sums it up better. I felt like I was failing him as a mother. We had no idea he had a neurological condition compounded by an intolerance to formula and a possible (still undiagnosed) tongue tie. We just knew things looked bleak.

So, the Pediatrician and I agreed to pursue the OT evaluation. Enter Kacey Trout, a wonderful and very experienced therapist who could shed some light on my son's feeding issues. At the very first visit she discovered his tight lips, small chin, and possible tie. She sent me home with exercises. I did them religiously. Silas began nursing consistently once or twice a day. I continued weighing him but he still wasn't transferring enough. We continued to wean him off formula. Things were progressing, even when they should not have. He was still overly exhausted, a *sloppy* bottle feeder, noisy when at breast/bottle, and rigid.

Just before his three month birthday, Silas stopped eating. He refused his bottles, wouldn't nurse, and became very lethargic. His wet diaper count was down, his soft spot was sinking. I took him to the ER. We were admitted. We met with a GI about his uncomfortability and reflux. We met with and had assistance from lactation consultants every shift and were able to get him latched. It literally felt like the proverbial light bulb moment. Something clicked. I wasn't doing anything I hadn't done before. But for whatever reason, my son could all of a sudden breastfeed. It was nothing short of a miracle and to this day, there is no explanation. After 5 days of working with lactation every day multiple times a day, having a swallow study and barium contrast study completed to check his reflux, and getting that under control, we returned home happily breastfeeding and formula free. But this is just the beginning of the story, and this is where it gets good, really good- so keep reading.