I have stated regularly in my previous blogs that knowledge is power. I firmly believe this statement to be true, especially when it relates to breastfeeding. The more we know, the better equipped we are to navigate through the bumpy, yet extremely rewarding journey of breastfeeding.
So basically...I am a Powerhouse of Knowledge when it comes to breastfeeding. I’m not trying to brag or ‘toot-my own-horn’ but as I was sitting at my desk trying to think of a topic to blog about, I started to recall all the tumultuous experiencesI had while breastfeeding, and how those experiences have helped shape the type of Lactation Consultant I am today. I made a list of all the issues and challenges I had when breastfeeding my 3 daughters.....and it’s bittersweet to report the list is a long one!!!!! I say bittersweet because, if I knew then, what I know now, I may have saved myself a lot of tears and perhaps many sleepless nights. But at the same time, if I hadn’t had just about every single breastfeeding issue imaginable, I probably wouldn’t be able to relate so well to my patients today.
A bit of historical information for you: I was a full-time post-partum nurse for 3 years before giving birth to my first daughter in 2003. I had worked a LOT with breastfeeding women and by the time I had my daughter, I thought I was pretty well prepared when it came to feeding my baby. Was I ever wrong!!! Same thing happened with baby #2 in 2005, and then again with baby #3 in 2009. I had been certified as an IBCLC in 2007. You’d think by 2009, I would have been able to figure out breastfeeding!! Sure I was more experienced and a bit more relaxed, but when you are on the other side of the hospital bed, your brain can turn to mush and you literally second-guess yourself on everything you thought you knew so well.
So I’m sure you are all dying to hear my list!! So here it goes in no particular order....well maybe from my worst nightmare to bad dream........
1. Tongue ties in 2/3 daughters
2. OAMER (Overactive Milk Ejection Reflex)
3. Yeast infection (of the breasts my friends)
4. Raynaud’s phenomenon
5. Bottle refusal (with my first daughter.....and yes, some Lactation Consultants choose to give their babies a bottle.....but only pumped breast milk)
6. The Booby Bob (I will elaborate on this later)
Tongue Ties, What Happened Then: After I gave birth to my first daughter in 2003, I quickly found out that breastfeeding was not as enjoyable as I thought it was going to be. I had so much pain every time she latched on, yet everyone told me her latch looked perfect. Finally, on day 2 in the hospital, the Pediatrician decided that Kayla had a tongue-tie and would snip it. Yay!! Finally I thought breastfeeding would be on the up-and up. Unfortunately, the frenotomy didn’t really make a difference and I still had a LOT of pain which eventually developed into damaged, blistered, bleeding nipples and one very sad, sore mommy. Within a few days of being home from the hospital, I was using a nipple shield and basically cringed every time I had to feed my hungry little baby. The damage wasn’t getting better and the condition of my breasts was only getting worse. I remember my husband telling me to just quit breastfeeding. I think I must have been a mess at that point because I remember yelling at him through reddened , tear stained eyes saying, “I HAVE NEVER QUIT AT ANYTHING, NOT GOING TO HAPPEN NOW BUDDY! “ I endured this hell for 6 weeks before things started to turn around.
Tongue Tie Saga Part 2 With Baby #3. Maya was a great little feeder and I definitely had the latch perfected yet I was still having nipple pain. Not with every feed, but with most. My nipples were getting damaged again and I was back to using the shield and compound nipple cream (saving grace...more on this when I get to challenge #3) Never once did I think my baby had a tongue tie. My Family Doctor had examined her and so did the Public Health Nurse. Nobody said boo about her tongue. Eventually things got better with her. My nipples healed, I eliminated the shield, and we went on our merry breastfeeding way.
Tongue Ties.....What I Know Now: So, my oldest daughter is 12.5 years old, my middle daughter is almost 10, and my baby is turning 6 next week. It has only been in the last 5 years that my knowledge and experience related to tongue ties has expanded. I owe most of this credit to Dr Cynthia Landy who has taught me so much when it comes to anterior and posterior tongue ties. I know there are numerous functions the tongue needs to perform besides passing the lower gum line. Now that I have had more than enough time to reflect back on what happened with my first daughter, I realized her anterior tongue tie got ‘kinda’ clipped, but there was still a very tight posterior tie that was never released. With my third daughter, she also had an anterior/posterior combo that was never identified. If it hadn’t been for my more than abundant milk supply, I’m pretty sure I would have quit breastfeeding after one week with both babies. If I knew that by sweeping under the tongue with a finger and actually looking under my daughter’s tongues, I would have been able to prevent so much unnecessary trauma and damage, I would have another baby all over again!! Well maybe that’s exaggerating a little. The bottom line is, I know a lot more now than I did then. I know that in the past 5 years I have been able to diagnose and properly manage tons of tongue ties, saving many mother’s from needless tears and pain this breastfeeding issue can cause.
OAMER, What Happened Then: A blessing or a curse? I haven’t fully chosen my side of the fence on this issue. I produced a lot of milk with all my babies. I had my freezer loaded with bags of frozen milk. I would have been the milk bank’s best donor if we had one back when I was breastfeeding. But, I also choked my babies and drowned them with my fast-let down and caused (my middle daughter especially) to vomit after almost every feeding which appeared to be all the milk I had just fed her. I thought it was normal, and kind of cool to be able to pump 200mls of breastmilk after having just breastfed. Nobody told me not to pump like a crazy woman. Nobody told me there were ways to manage this issue. But at the same time, I honestly don’t remember asking for help!! I just thought this is how it’s supposed to be right? Wrong!!!
I also attribute my ‘lack of knowing what to do back then’ to the fact that I was a very young mother. I had my first daughter when I was 24 years old. None of my other friends were having babies at the time so I didn’t really have anyone to talk to about my breastfeeding problems. I am also the kind of person who likes a challenge and will try to figure it out on my own, even if it meanssubjecting myself to pain and torture (as my training partner at the gym can vouch for today)
OAMER.....What I Know Now: Overactive anything is never a good thing. Same goes for having an overactive milk ejection reflex (especially when your baby has a tongue tie). Now I know that there are fabulous ways to manage this issue. You can block feed (sorry Dr Jack Newman, I recommend it all the time and it seems to be quite effective). Block feeding means limiting baby to one breast per feeding for a 2 hour window. Leaning back while feeding, letting your milk spray or drip after it lets-down....and not blocking it up with your hand. Frequent burping, and sometimes just expressing off some of the fore-milk can help prevent baby from getting overly gassy. By using these management techniques, the supply usually starts to ‘calm’ down within a few weeks. So simple, yet so effective.
Yeast infection, What Happened Then: Remember when I mentioned my bleeding, cracked, sore damaged nipples with my first daughter? Well after a few weeks of breastfeeding , all that lovlieness eventually turned into a raging yeast infection......but I had no idea what the heck was going on. I just thought my breasts hurt because they were damaged from my little monster baby. Anything that touched my breasts made me cringe. My clothes, my bra, my breast pads, even the water pressure from the shower was too much to handle. I remember walking in the mall with my mom one day and saying to her “I didn’t know breastfeeding was supposed to hurt so much!” I can’t remember for certain, but I must have been 4-5 weeks post-partum at the time. It was at this point I went to see my Family MD who thought it could be a yeast infection, but wasn’t sure. She told me to buy some Canestan cream and put it on my nipples. She also referred me to be seen by Dr Evelyn Jain (a MD who specializes in breastfeeding medicine) It took me a week or so to get into her clinic, but once I was there, I knew everything was about to turn around. Dr Jain looked at my nipples and handed me a little piece of paper that truly changed my breastfeeding experience from torturous to enjoyable for the first time in almost 6 weeks!! She gave me a prescription for compound nipple cream. This compound is a 1:1 mixture of fucidin (anti-bacterial) and clotrimazole (anti-fungal). I was to put this cream on my nipples after every feeding and not wash it off. Within a few days of using it, my nipples were healing, and felt so much better. I started to feel like my happy breastfeeding journey had finally begun!!!
Yeast Infection..... What I Know Now: I know that breastfeeding isn’t supposed to be painful. Yes, the initial latch-on can sometimes be a bit uncomfortable, but after 15-20 seconds it eases off and all you should feel is pulling and tugging. Burning is bad. Stabbing knives in your breasts is bad, pink pearly nipples (as lovely as that may sound) is also bad!! All the symptoms I just listed are classic of yeast in the breast. The treatment is relatively simple. Usually we will start with the compound nipple cream and see how that works. If symptoms persist after a week or so, a MD will usually prescribe a course of oral diflucan. The diflucan usually kills off most of the yeast for good. In severe cases, one has to eliminate sugar and really watch their diet and even wash all bras in hot water with vinegar. Yeast can be a tricky infection to treat as the lactating breast can be the perfect breeding ground for spores to thrive in such a dark, moist environment. If I had known that the pain I was experiencing was yeast and could have been treated promptly and easily, I would have been a much happier mama much earlier on. But I am thankful to know now what I do in order to help and treat others who are experiencing the same pain.
Well that covers Part One of ‘I Know This Much Is True’. Part Two will come out in a couple of weeks. I hope you have enjoyed reading about some of my own personal breastfeeding experiences. I know that we all have our own stories and journey’s to share. Please feel free to leave your own thoughts or comments at the end of the blog.
Happy Breastfeeding!! Xoxo
Leanne Rzepa RN BN IBCLC