Disclaimer: This is a personal story told by a local New Jersey mother. The views and opinions expressed in this blog post do not necessarily reflect the official policy or position of the New Jersey Breastfeeding Coalition.
Everyone told me breastfeeding my second would be a piece of cake. I figured that was true. Not only did I have two years of breastfeeding experience behind me but I’m also a Breastfeeding Counselor at Breastfeeding USA (1). I loved nursing my first and expected things to go smoothly this time around too.
Nursing my first child, Reagan, was one of the only things that made sense during those first early months when motherhood and parenting is brand new and everything feels overwhelming. She was an extremely difficult infant, also known as a “high needs” baby (difficult sounds more accurate to me), but breastfeeding her was so easy. Since I had an unplanned cesarean delivery that included many of the medical interventions I had hoped to avoid, I felt the the odds were stacked against us. When she was born she latched right on like a pro though, even if it was a good twelve hours after the delivery. A story I will save for another time (2). I’m still breastfeeding her THREE years later!
So I knew what I was doing or so I thought. This past November we welcomed Grayson into our family. I had my ideal birth, an unmedicated VBAC, at my local hospital. As soon as Grayson entered this world, I put him skin to skin. I knew this skin to skin contact would help him transition from his life in the womb. Research shows that skin to skin contact help an infant regulate their temperature, heart rate and breathing, plus it puts him “in the kitchen” to promote good feeding (3). Grayson latched on as expected but I could see right away that his tongue was restricted in movement; he was incapable of extending or lifting his tongue properly and I could see the ligament restrictions under his tongue and under his upper lip. He was unable to keep the upper lip flanged out, flipped out like a fish, at the breast. I suspected he had a tongue tie and upper lip tie. My pediatrician and the Lactation Consultant at the hospital told me there was no reason to get his ties clipped as long as he was gaining weight appropriately and it wasn’t painful. I never experienced pain and he was back to his birth weight by the fourth day (typically all babies lose weight after birth and we expect them to regain their birthweight by day ten or two weeks of age), so on I nursed.
By Grayson’s third week, his behavior changed dramatically. He screamed all of the time. There was absolutely no way to calm him down. At his one month checkup, my husband and I were looking for answers. I briefly mentioned my terrible oversupply issue to our pediatrician. Grayson often coughed, choked and sputtered at the breast. He also appeared to pull off and reposition himself frequently at the breast, as if managing my milk flow. That along with his fussy and gassy behavior, had me thinking that I was dealing with an oversupply. I did not have the same issues with Reagan but perhaps she was just able to handle the forceful milk ejection reflex and oversupply more easily than Grayson. After all, every baby is different. My pediatrician didn’t feel my milk ejection reflex or supply was the problem. She believed his behavior may be related to a milk protein allergy and that I should avoid all dairy consumption. I was glad to do this and hoped that this elimination would provide Grayson some relief.
Two weeks later, we were back at the doctor’s office where I met with my pediatrician and a Lactation Consultant. Nothing had changed. This time around reflux was suspected and we were given a prescription for reflux medication. We were warned that if this didn’t work, we may have to put Grayson on formula because he could be allergic to my milk. I was actually told that formula might be the answer several times during that visit. I broke down; I felt unsupported and lost. I loved breastfeeding and after being told by my health care providers that my milk may have been the cause, I felt terrible. Listening to the constant screams of our son, my husband was so eager to immediately try the formula as suggested. I was not convinced though. I wanted more help.
I decided to call a local International Board Certified Lactation Consultant, an IBCLC (4). The consultant helped me put the pieces of the puzzle together:
- My milk ejection reflex was fast and furious and he was drinking from the fountain. This is why weight gain was never an issue. We suspected that the large lactose load at the beginning of the feeding, related to my suspected oversupply, may have been irritating the baby’s gut.
- The tongue and upper lip tie that I suspected from birth may be also be contributing to his fussiness and nursing behavior.
A local health care provider revised Grayson’s tongue tie and upper lip, a laser revision (5). I started to block feed, which is feeding from one side for several hours (It is important to note this was under the care of my IBCLC. Block feedings should only be considered when appropriate under the care of a provider, since it can negatively affect supply if done unnecessarily or inappropriately). A week later, he stopped screaming and was a much happier baby. He is no longer in pain and can nurse effectively.
I learned that every single breastfeeding journey is different. Assuming that you’ll have it easy or hard the second time around because that’s what you experienced with your first baby isn’t always the case. By following your instincts and seeking the right support, you have a better chance of meeting your own breastfeeding goals and having a successful journey.
- For more information about Breastfeeding USA or information on how to become a Breastfeeding Counselor with Breastfeeding USA, please click HERE
- The NJ Hospital Regulations require all hospitals to promote skin to skin care, no separation or mother and baby, feeding at breast within the first hour of life, and milk expression within the first 4 hours of life if mom and baby are separated for medical reasons. You can find more information on the NJ Hospital regulations, including information on how to file a complaint, HERE.
- You can learn more about skin to skin HERE on the American Academy of Pediatrics’ HealthyChildren.org site.
- You can find a list of International Board Certified Lactation Consultants (IBCLC) and other lactation services available in NJ by visiting Zipmilk.org.
- A NJ preferred provider list for tongue tie/upper lip tie revisions can be found HERE.
Post written by by Gina Guariglia Kelly, CLC and Breastfeeding Mom