Holy jeebus, do I love lactation consultants. We took the Hatchling in this morning after one hell of a bad night: she woke up at 3 am and then nursed until 5 and still wasn’t full; Mr. Squab had to rock her until 6:30 and then we got an hour and a half of sleep before we had to get ready to go. We were both dead tired and feeling pretty desperate. I was afraid the Hatchling would be a mess, having to wait to eat until we were with the consultant, but she was a real trouper and stayed quiet sucking on her daddy’s finger. While we were waiting at the admissions desk, Mr. Squab and I looked at each other and started laughing – we realized we were both sitting in our chairs and rocking from side to side. Apparently babies aren’t the only ones who need to be comforted by rocking.
We got into the consulting room and met the nurse lactation specialist – a very nice, easy-going grandmotherly type – and told her about the problems we’d been having. The Hatchling was stripped down to the skin and weighed, and then the nurse took the baby and put her finger in the baby’s mouth to check her sucking impulse. About two seconds later, she had us look into the Hatchling’s mouth at the membrane below her tongue. “You see that?” she asked, “She can’t stick her tongue out past her lower gumline.” (Blank looks from us.) “That means she can’t suck effectively – she can’t stimulate the breast to get the milk out.” Well, holy crap. You have no idea the relief it was to hear that there was an actual physical cause to our nursing troubles. Apparently this condition is the origin of the phrase “tongue-tied” – the membrane (called the frenulum) literally ties the tongue to the mouth and prevents the person from sticking out their tongue the way most of us can. It’s a problem not only for breastfeeding – and it’s a REAL problem for breastfeeding, and makes it difficult to even take a bottle – but also for speech development later on, since you kind of need to be able to stick your tongue out to make certain speech sounds. Some kids are able to stretch it out as they get older, but for most people, the only cure is to cut the membrane and free the tongue’s movement that way. It sounds kind of awful, but apparently there aren’t a lot of nerves in that membrane or even much blood supply, so with a little local anaesthesia it’s a relatively minor procedure and recovery is almost instantaneous. (And no, the irony of having escaped the circumcision decision only to have to do this is not lost on me.)
After having made that little discovery, we tried to nurse so the consultant could see the problems in action. The nurse said I have “fantastic nipples for breastfeeding” (and then said, “I bet you hear that all the time” to which my reply was, “ehm … no, this is a first”), and our latching on got an A+. That was the good part. But then, sure enough, the fussiness and frustration started – not being able to stimulate the breast means she can’t get any food without a lot of work, and that (understandably) makes her a little crazy. With a little assistance we nursed for 10 minutes on each side, and then weighed her again to see how much milk she’d gotten. Result: 1/4 oz. After 20 minutes of nursing, she’d gotten 1/4 oz. of milk. That’s like an eighth of what she should be getting. So those hour-long sessions we’d been doing at home where she still seemed hungry? Yeah, that’s because she was. The combination of her attached frenulum and resulting poor nursing mean my milk supply is basically crappy. We figure she’s probably only been really, truly full maybe two times since we brought her home from the hospital. Of course, there’s no way we could have really known that without having a scale at home to measure, but still: you can imagine how great THAT feels. I mean, way to starve your kid. Then we tried feeding her a bottle of formula to supplement and as usual, that didn’t work so well either. But then the nurse showed us how to squeeze her cheeks a little to create better suction and lo and behold – she could suck the stuff down! She looks a little like Satchmo with a dairy-based sax, but at least she can eat.
So now we have a strategy: 8 regular feedings a day, 10 minutes per boob. After that, supplement with formula until she’s full, and then I have to pump for 15 minutes to stimulate milk production back to where it should be. And then, when we go back to the pediatrician’s on Thursday to check her weight, we’ll see about fixing her poor little tongue. Just having a plan, and knowing that the problems weren’t of our own making, makes us feel about a million times better. And knowing that we can feed her until she’s satisfied is … just huge. It makes such a difference to see how much more contented she is when she’s actually got a full stomach. Even my mom, who initially thought going to a lactation consultant was sort of a nervous-nelly new-parent thing to do, has been converted. So it looks like there’s light at the end of the tunnel, and this time I don’t think it’s an oncoming train.