Tongue-tied and Twisted
written by Mothers of Change board member, Jen McVittie
I have two daughters. Both born at home. Both breastfed for at least a year – I’m still at it with my fourteen month old. Same midwives (almost). Same approach to parenting – attachment generally, but fairly laid back I like to think.
But COMPLETELY different experiences with breastfeeding.
I know everyone says that the first time is always the hardest, and I’m sure there’s some truth to that. Our breasts are now “experienced” and ready to produce. The learning curve isn’t so steep. We’re more comfortable handling a newborn. But I believe that for me, at least, there were some concrete reasons why the two experiences were so different, and I wanted to share this just in case it might help make for a better breastfeeding experience for someone else.
When my older daughter was born, we started breastfeeding right away – maybe 30 or 40 minutes after the birth. She was born posterior after a lot of pushing and with a significant “conehead” which disappeared shortly after birth. So I imagine she was just as tired as I was at the time. I had a student midwife there helping me get oriented to breastfeeding. She was kind and patient as I struggled to get Caroline to latch. “The breast has to look like a hamburger,” she told me, as I held my breast and tried to get the baby to be interested. No dice. We struggled along that night and all the next day. Midwives came and went in the next few days, all encouraging and always with a helpful breastfeeding hint. Still it seemed like nothing was really happening. Then my milk came in, and although I never experienced engorgement, that’s when the excruciating pain began. Every single time that Caroline nursed, I was in pain. Like razor blades cutting my nipples. I swear. Labour seemed like a breeze compared to the pain I was now feeling every two to three hours, for 40 to 60 minutes at a time.
We went to our two week clinic visit and it became obvious that Caroline wasn’t gaining weight. In fact, she had lost a substantial amount of her birth weight. So much so that my midwife was concerned. Not overly worried, or anything, but concerned enough to suggest breast compressions and milk-enhancing herbs. She went to go check the amounts to recommend, and when she returned I was visibly upset. She told me not to worry. We’d figure it out. We went over latching basics again. She observed me. I told her about the pain, but also wanted to feel like it was okay. So I probably wasn’t completely honest with her about how badly I thought it was going. Or at least, I let myself be easily convinced that everything would be fine with a few “tweaks.”
So I started the herbs and the compressions and soldiered on. And still the pain. There were quite a few nights (always in the middle of the night) when I basically gave up, collapsing into huge sobs and vowing to go formula shopping the very next day. But I didn’t. Not then. The pain continued, but somehow I figured out a system that seemed to work for us, and Caroline began to gain. Still, we were nursing for about 45 minutes at a time, and she’d only stop if she fell asleep on the breast. But, hey, she was gaining, right?
Things went along in this way for a while. At about five months or so, Caroline seemed to change her routines, and all of sudden, it seemed like she was NEVER full. The books were all clear – growth spurt. Oh, sure, no problem. Just a growth spurt. But at the same time, she ended up crying almost every time I put her to the breast, especially at night. And it was getting to me. I wasn’t giving my baby enough to eat. I was failing her. I didn’t know what to do.
Until one day, a package arrived in the mailbox. That’s right – I went to get the mail one morning, and pulled out an entire can of infant formula. Wow – convenient, eh? So I put it in the cupboard. And here’s how it happened. It was the middle of the afternoon and I was at home alone with Caroline. She had nursed, but pulled off in what I had come to interpret as indignation. How dare I not give her enough to eat?!?! What kind of a mother was I?!?! So in tears yet again, I grabbed the one lonely bag of pumped milk out of the freezer (don’t even get me started on pumping) and knew (all the while Caroline screaming) that it would take at least twenty minutes to thaw and warm. Then I spotted the formula canister on the shelf. Boil water, cool, a couple of scoops. I thought to myself, I’ll use whatever is ready first – thawed breastmilk or formula. So guess what won? And, yes, Caroline LOVED the formula. She sucked it down like she was starving. And she probably was. I was devastated, but at least I was feeding my baby.
So pretty soon I was supplementing at least once a day, usually at night just before bed. Three things happened. One, Caroline switched into a longer night sleep shortly afterwards. So, in the tradition of all new parents everywhere, I was NOT going to “jinx” it by changing a single iota of our night routine. The other thing that happened, to my surprise, was that my use of formula caused a bit of tension between my husband and me. He had supported my breastfeeding from the very beginning and had a sort of romantic idea of me being the sole source of nutrients for our child. We talked and talked about it, but eventually had to “agree to disagree.” I was okay supplementing now if it meant a bit less pain, and a bit happier baby. He wanted to try other things – go back on the herbs, more compressions, etc. I had had it. Nothing had really worked, and now things were okay. So there.
The other thing that happened occurred a few months after I started supplementing. Caroline was much less interested in breastfeeding, and I was worrying again that she wasn’t getting enough to eat, even though she was already on solids. I was supposed to be either breastfeeding or formula feeding at least a year, right? That’s what all the books said, right? So I upped the formula intake to compensate for the only one or two breastfeedings she was interested in a day. And then the diaper rash from HELL. Evil, bleeding, festering – regardless of what we did. Ointments, oils, salves, different diapers, lots of “bare bum time.” Of course, I can never be sure that it was the formula. But it made sense when a naturopath I knew suggested that. Her poop from then on became like diarrhea – something that went on years after she had her last taste of formula. And that made the diaper rash worse, of course. So, under nutritional guidance, we dropped the formula cold turkey. Lots of water from sippy cups. Plain fresh yogurt and cheese. A variety of fruits, veg and protein. And the bum got better. Eventually.
Caroline had her last breastfeed the day after her first birthday party. We were both done, and we knew it. I got pregnant again two weeks later.
All through the next pregnancy I joked that I would breastfeed this one until college. I had heard all the stories about how the second time was so much easier. I was looking forward to it.
But then Bea was born and it started all over again. I was devastated. And exhausted. And in so much pain from breastfeeding that I was ready to give up already, even in the middle of the day. I couldn’t do it again. And then a midwife suggested a lactation consultant. Okay, I’d try it – we wrapped up three day old Bea and went to the hospital clinic. The nurse there was very nice. Gave some more pointers. She wasn’t terribly concerned about the slight weight loss. We talked about positions and latching – yada, yada, yada. And then she looked into Bea’s mouth. “Hmmm. Seems to have a bit of a tongue tie. Well, why don’t you see how it goes for a little while before we do anything.” Oh. Okay, I guess.
So another week of the same. Again at the point of giving up. And then seemingly out of the blue, a midwife (angel) from the clinic that I’d never talked to before called up to see how things were going. Well, sniff, sniff, okay I guess. Then I filled her in a bit, and she said “so let’s make an appointment to get that tongue tie released.” And that’s what we did. We went to another consultant who confirmed the tongue tie, and a doctor in the clinic did the release ten minutes later. Just like that. Bea seemed to be more upset about being held down than the actual procedure, which took all of 3 seconds.
I wish I could say that the pain eased immediately, but after my nipples healed over the next few days, I’d say that within a week, I experienced pain-free, pleasurable breastfeeding for the first time in my life. I could feel what a good latch felt like and could also relax, do breathing exercises, and feel my milk let down, and see my baby being satisfied and happy.
Some time later I looked into Caroline’s mouth and noticed a long flap of skin underneath her tongue. Seriously?!? SERIOUSLY?!?!?! Could I have avoided all that with Caroline? Again, I’ll never know, but I swore that I’d do my best to get the word out about tongue ties to anyone who would listen. Obviously, it’s not a cure all for breastfeeding difficulties, but it is a simple procedure, that, if warranted, could prevent a lot of pain and anguish, and save a breastfeeding relationship.
Jen McVittie, MA
The mother of two daughters, both born at home, and a student midwife in Ontario. My previous career and education in the disability field focused on mental health advocacy and policy.