Posted by Naomi de la Torre on Oct.31, 2009

©iStockphoto.com - abu

I would love to tell you that nursing is all ponies and rainbows. But it isn’t. Don’t get me wrong. I am a huge breastfeeding advocate, but that doesn’t mean I’m going to lie to you. Breastfeeding can be hard work, just like the rest of parenting. When people say that nursing is natural, they don’t mean easy. They mean natural in the sense of hemorrhoids and labor pains and PMS. All these things are natural too, but you won’t find them in a Hallmark card.

When my second son Diego was born, I was sure I was going to have a magical and uncomplicated breastfeeding experience. I had faced and overcome so many difficulties with my first son Nino including nipple blisters, latch issues, positioning problems, thrush, recurrent mastitis and alien body-snatching that I was convinced we had dealt with every possible problem imaginable.

Despite all the difficulties we experienced, I nursed Nino for almost three years and was delighted with the nursing relationship we enjoyed. I do believe that breastfeeding laid the foundation for the loving attachment we now share.

Just like my first son Nino, Diego was born in a hospital via C-section, despite our desire and intentions to have a natural birth with a midwife. Thankfully, Diego was born completely healthy with no complications whatsoever. I had been very careful to make sure we didn’t receive any drugs like Demerol that could impair his ability to breastfeed effectively.

As soon as we were in the recovery room, Diego latched on and began nursing like a champ. However, when he came off my nipple, I noticed that the nipple itself was compressed as flat as a pancake. This had never happened when Nino nursed and I was confused as to why my nipple was being compressed this way.

The hospital we gave birth at was supportive of nursing and even had several lactation consultants on staff. I immediately requested a consultation because I figured something was probably not right.

The lactation consultants were kind and friendly. They breezed into the room like sorority sisters during Rush Week, tossing out simple, watered-down breastfeeding tips that might have come from The Idiot’s Guide to Breastfeeding. It may have been the morphine or it may have been a fear of confrontation that caused me to continue to nod and smile while my nipples became more mangled by the hour. For some reason, I really wanted to believe my lactation sorority sisters when they told me over and over that all we were dealing with was a simple latch/positioning problem.

Twenty-four hours after giving birth, my nipples had become so bloody and damaged that you would have thought I was nursing a baby wolverine. After each feeding, it appeared that I had been given the nipple version of an episiotomy.

Between feedings, the blood would scab causing my nipples to become attached to my hospital gown so that each time I needed to nurse my baby I was literally ripping the scabs off my ravished nipples. The pain became so intense, I felt like I was going insane. I slept fitfully and had dreams about wrapping my upper body in plastic wrap. I sent my husband on a wild goose chase around the hospital, in attempts to find some kind of breast shield that would effectively protect my nipples from my clothes. But nothing was helping.

In fact, the gel shields that my husband finally found in the hospital breastfeeding store seemed to cause some sort of bizarre reaction that made me feel like I just performed a chemical facial peel on my already destroyed nipples.

The sorority sister consultants kept breezing through to give friendly, uplifting tips about latch and positioning, while I tried my hardest not to growl and bite them. But no one seemed to be able to solve my problem. I was afraid to make too much of a stink with the nurses about my situation, because I didn’t want them to have a U-Haul quantity of formula delivered to my room as a solution.

Finally, I suddenly remembered my wonderful lactation consultant, Sharon Mattes, IBCLC, who had helped me several times over during the three years I nursed my first son. Why it took me two days to think of her I will never know, because she was such incredible help with the plethora of other nursing problems I had already experienced. Maybe it was my own ego that prevented me from accepting that I really had a serious nursing problem once again or maybe it was the morphine haze, but when the genius idea of calling Sharon finally graced my brain, I was on the horn with her before you could say “Breast is best.” Amazingly, she answered on the first ring.

Sharon asked me some simple questions over the phone to determine the nature of our situation and within 10 minutes she told me that she suspected that Diego was tongue-tied. When a baby has a tight or short frenulum under his tongue, it can greatly impair the baby’s ability to breastfeed, she explained. She told me to ask the nurse to check Diego and see if he had ankyloglossia.

I called the nurse and told her what Sharon had suggested. I asked if she or the doctor would please check Diego’s tongue. She looked inside his mouth and said in a chipper voice, “Nope! He’s just fine.”

I was totally confused because now I felt I had nowhere left to turn. I left the hospital the next day feeling like World War III was happening inside my bra. I threw my chemical peel breast shields in the trash, went topless inside my house and scheduled an appointment with Sharon for a home visit.

By this point my nipples were so damaged that I had to stop breastfeeding entirely because I could no longer bear the pain. I wanted to keep up my milk production regardless, so I pumped instead and the milk that poured out of my breasts was red with blood. Not pink. Red. It made me feel sick to my stomach to look at it and I couldn’t bear to feed it to my baby. I felt grateful that formula existed, but simultaneously angry and betrayed as I fed a bottle of it to my infant son.

Later that day, Sharon came to see me in my home. When she showed up at the door, tears sprung to my eyes because I was so relieved to see someone who I felt might finally help me.

She examined my nipples. She examined my son’s mouth with her finger. She looked at his tongue and observed its function. “Diego appears to have a restricted tongue,” she told me within a matter of minutes. “It is difficult to believe they didn’t see this problem in the hospital. Apparently a ‘visual check’ is not always enough. You can take him to see an ENT. They can do a tiny procedure to cut the piece of skin beneath his tongue and hopefully he should be able to nurse, afterwards.”

Even though it was a little frightening to think of Diego having an operation on his tongue, I was extremely relieved to hear her assessment. Finally, someone was able to pinpoint what was really going on and it wasn’t just some bizarre latch problem that five hospital lactation consultants couldn’t solve.

I did what she said. We took him to an ENT the very next day and sure enough, he had ankyloglossia. The ENT did the small procedure of cutting under the tongue right there in the office and I was very hopeful that it would be enough to enable Diego to nurse effectively.

Meanwhile, my nipples were still so traumatized that I had to wait for them to heal before I tried nursing Diego again. My nipples were more painful than anything I had ever experienced in my life. They were more painful than mastitis. They were more painful than the C-section incision. I went topless for weeks inside my house while I waited for them to recover.

During this time, I was fraught with worry over whether Diego would forget how to nurse or if he would decide he preferred bottle-feeding. All the leading parenting magazines make you feel like nipple confusion is your greatest enemy if you want to breastfeed. It is much easier to draw milk from a bottle than from a breast. Wait at least two weeks to a month before even introducing a bottle, or your baby could become confused and forget how to nurse. These words rang over and over in my brain and I couldn’t help but feel like a complete breastfeeding failure already. I was convinced that Diego would have nothing to do with my breasts after experiencing the addictive pleasures of plastic nipples.

I decided I wouldn’t let it be easy for him. I bought six different types of bottles and rotated them each feeding to keep him guessing. I even considered letting a (very generous and kind) friend nurse him while my nipples recovered just to keep him practicing. But in the end I just waited it out. Sharon kept encouraging me and telling me that Diego would be fine and not to worry about how much time was passing. “Babies want to nurse,” she told me. “As long as you are committed and give them plenty of opportunities to try, they will nurse eventually if they are able. Don’t be anxious. Just wait and see. Babies really do want to nurse.”

Meanwhile, my nipple drama was far from finished. Even though I had stopped nursing, I was pumping every 2-3 hours around the clock to keep my supply up and my nipples were not recovering. In fact, it seemed they were getting worse.

I called Sharon and asked her why it felt like my nipples were being set on fire every time I pumped. Was pumping supposed to feel this way?

Sharon thought for a moment and then asked me what size breast shields I was using with my Medela Pump-in-Style. I replied that I didn’t know that the shields came in different sizes. What exactly was she talking about?

“Breast shields come in a variety of sizes,” Sharon informed me. “If I recall correctly, I think your nipples may be extra large. Maybe extra extra large.”

Despite the embarrassing fact of finding out that my nipples were grotesquely, inhumanly large, I was again relieved to hear that there was a potential solution for my problem. “I have some samples of the different shield sizes. Why don’t you come by the office and we will try them out on you?” she offered.

It turns out that your nipples should not be dragging in and out of the shields when the breast pump suction is on. My nipples were so big that they were being sucked all the way through the tunnel and out the other side of the shield. This was abnormal, apparently. And caused a ridiculous amount of friction on my already mangled, but not-so-little friends.

Once Sharon got me fitted with the right size shields, my nipples began to heal almost immediately. At the end of two weeks, my nipples were better and I was eager to try nursing Diego. I was so hopeful that the procedure would have solved the problem and that everything would be just fine.

I took Diego to Sharon’s office for the first feeding. In case there were any difficulties, I wanted guidance on how to go forward. I put Diego to my breast, holding my breath with excitement. Instantly I knew something was not right. Sharon was correct, Diego was able, even delighted to nurse, but he was still unable to pull my nipple deep enough into his throat.

His tongue was just not long enough and his palate was too high. My nipple was still compressed flat when it came out of his mouth and it hurt like nobody’s business. I was so disappointed I began to cry. I couldn’t believe this was happening. How could this be? My baby was incapable of nursing?

Sharon was so helpful and reassuring. She told me that she had other clients with babies who were tongue-tied. “Diego may not be able to nurse now,” she said. “But babies’ mouths change a lot during the first few months of life. He may be able to nurse in a month or two. Just keep trying him from time to time and see if he latches on correctly. You will know when it is right. And remember, babies want to nurse. It is their natural, biological desire. Don’t give up hope just because he can’t right now. Diego will nurse when he is able.”

I pumped milk, exclusively, for six full months. I was a regular dairy cow. Not only did I pump enough milk for him to drink every day and night, I pumped so much extra that I planned to quit making milk at nine months (if he was still unable to nurse at that time) and have enough milk saved in my deep freezer to last the rest of his first year.

I spent so much time pumping that there wasn’t a single friend or relative of mine who didn’t experience the supreme enjoyment of watching me spurt milk into six-ounce containers during this six-month period. If you were going to spend time at my home, you were signing up for a half-naked viewing of me hooked up with wires and tubing for at least one or two 30-minute intervals like a Lactating Frankenstein.

To say pumping was challenging for me would be a vast understatement. There is nothing like waking up at 5:30 a.m. with a hungry baby who needs to be fed and meanwhile, your rock solid breasts are begging to be relieved of enough milk to fill a Big Gulp. Not to mention your three-year-old, jealous of the baby being cuddled and fed, demands that you to cuddle him too, while also making breakfast and helping him do Spin Art.

I really don’t know how I managed to get through those six months. In fact, so much of it is a blur, I may have blocked it out. What I do know is that while nursing can be challenging, pumping and then feeding a baby your own breast milk is immensely more difficult. You may as well have twins, with as much time you spend on feeding, pumping and cleaning the 8000 bottle and pump parts.

Additionally, my body didn’t have the same emotional or physiological response to the automated pump that it did to a nursing child and it caused my milk to back up. Every time I pumped, which was at least 6-7 times a day, I would have to heat my breasts with a rice sock in order to keep the milk flowing. To this day, I cannot even talk about pumping without feeling like I’m smelling burnt rice somewhere in the distance.

I took every supplement that I could find that was touted to help mothers to naturally fight breast infections. Garlic, lecithin and homeopathic phytolacca were part of my daily routine. But nonetheless, I still managed to get almost daily clogs and repeated infections.

During those six months, I would periodically try to nurse Diego, but he was still unable to use his tongue properly. Each time we tried unsuccessfully, I felt deeply disappointed and sad. I would watch my friends who had nursing babies and feel envious and heartbroken because I was unable to have that relationship with Diego.
When I went to the mall and bottle-fed him in the play area, I couldn’t help but think that all the other moms were judging me in their minds. I waited for somebody to come by and give me the “Breast is best” lecture. I wanted to wear a T-shirt that said, “I really do want to nurse. My baby is just tongue-tied.”

I also took Diego for periodic craniosacral therapy throughout the six months he was unable to nurse. My homeopath told me that craniosacral therapy (gentle touch that assists the body to release tension that can cause illness, pain and dysfunction) could help to improve the function of Diego’s tongue and restore his ability to suck and latch more deeply. In fact, it did seem that craniosacral therapy was effective on Diego. I’ve since learned there are other therapies available for babies to help train them back to the breast, as well. Physical therapists and speech pathologists are two additional options that have apparently been highly effective with tongue-tied infants.

Just after Diego turned six months old, one night around midnight, I decided to try him. He was sleepy, and I figured maybe he would just latch on and it would work. Unbelievably, at six months of age, after not nursing for all but those first four days of life, he nursed! He really, truly nursed. There was no pain and my nipple came out of his mouth without any compression whatsoever. It was so amazing that as tears of joy sprung to my eyes, I also felt the need slap myself to be sure I wasn’t dreaming. After that, it took me just over a month to get him back fully nursing. It felt like a miracle, how easy it suddenly became. At first, he still liked to bottle-feed and didn’t get as much milk from nursing, but eventually he got stronger and was able to nurse exclusively without any more bottles whatsoever.

What did I learn from this experience? Aside from the fact that I am as stubborn as a mule, slightly demented and willing to expose my closest friends and family to unspeakable horrors and frightening images of me half-naked that will probably traumatize them for the rest of their lives… I realized that my lactation consultant was right. Babies want to nurse. Even at six months of age. If you really want to make it happen, the opportunity is there. Now, a year and a half later, Diego is two and still nursing. Believe it or not, I sometimes even forget all the drama we went through to get him nursing, because nursing is such a normal part of our life these days.

At the same time, I am certainly not advocating that anyone else in a healthy or stable frame of mind should have to endure the insanity that was my life for those six months. I would completely understand if 99% of moms out there (the 1% being other crazies like me) decided to give up in the first week and switch to formula. That’s what formula is for, isn’t it?

However, I did find myself truly amazed at the capacity my baby had to adapt to the situation. Apparently the biological need to nurse is more powerful than I ever imagined. Nipple confusion is certainly real, but if you have a good enough lactation consultant, you can probably make it though many nursing dilemmas that at first glance seem insurmountable.

My best advice to all the moms out there who are dealing with nursing difficulties of any variety is the following. Get the best lactation consultant you can find. Don’t settle for the sorority sister consultants who read the Girlfriend’s Guide to Lactation. Get a real lactation consultant who is certified by the International Board of Lactation Consultant Examiners. Do not be cheap. Do not settle for less. Do not pass Go and collect $200. Just keep searching until you find a consultant who has the right certification and many, many years of experience.

Experience is key. My consultant has been in the business for 22 years and I do believe she is most probably not just a lactation consultant but a lactation psychic, considering how easily she is able to assess any breastfeeding dilemma tossed her way.

The nursing relationship I have had with both of my boys is one of the most meaningful, powerful and loving experiences of my life. I will be forever grateful for the generous help we received to overcome the many obstacles we experienced. And I hope that you, too, will find the help you need if you happen to experience any bumps (or boulders) in the road during your (hopefully long and happy) nursing career.

Share

Posted under Family, GDM Baby.