So in April I had a baby -- a sweet, gorgeous, pink little baby. He is my fourth baby, fourth boy in fact -- and what a scrumptious, squishy baby he is. I love him. We named him Ezra.
Out in the world and on my chest, I soon began to see if he would nurse. And he did. Victoriously. I was happy, and he was happy. My midwife and I watched as his tongue passed his lower gum line and came out of his mouth, and we both hoorayed, "He's not tongue-tied!" I have not previously had a baby who was tongue-tied, but my sister has, and it was a lot of trouble to get diagnosed and treated.
Fast forward to day three: it's 10:00 at night. I am perched at my computer, Ezra screaming on my lap as I watch how-to-latch videos through tearful eyes. Each extra-pink nipple bears a horizontal stripe of raw, rubbed openness coupled with tiny scabs, and with every suck, I tighten and cringe and cry. I hate this. I label him. He is a bad nurser.
At this point in my life I have logged 11 years breastfeeding 3 different children. I have been a peer-breastfeeding counselor for 10 years. I have a pretty well-rounded knowledge of all-things-breastfeeding, both experiential and educational. I have helped countless women in similar situations figure out how to better nurse to ease or eliminate pain. And here I sit, alone at my computer, because he just can't do it right. Because he is a bad nurser.
Being new to the area, I don't have a clue who would be a good person to call for help. I left an army of good friends and trusted resources -- IBCLCs, LLL Leaders, midwives, doulas, and nurses -- years in the making. Okay, troubleshoot: I try dragging the nipple down his face and over his nose. I try teacup hold of the nipple. I try the "flipple." I try laid-back breastfeeding/biological nursing. I keep my finger taut to the nipple to try and push/shove it further back into his mouth. I try asymmetrical latch, symmetrical latch, sideways latch, and all-around-the-clock-face latch ("would you, could you in a tree?"). I even have my husband buy me a nipple shield and we try that (incidentally, that seemed to hurt even more, as Ezra couldn't latch to the shield so he would just chew my silicone-covered, damaged nipple). Nothing works, for weeks.
I was still in great pain, but the physical damage to my nipples was not getting worse, and that made me
hopeful. I found some Hydrogel Pads I had gotten as samples once, and they helped with the healing. I figured out by latching him in football hold, nursing sessions became bearable. We would also nurse lying down at night, turning on a small light to latch, stopping to make him try again when it was really, really painful (because it was never not painful). I kept looking for answers for my bad nurser.
Aside from the pain I was dealing with, Ezra gained weight exponentially; at one stretch between weigh-ins, he gained 38 ounces in 21 days. He did spit up a lot, like a lot A LOT -- overzealous amounts of milk, often flying out of his mouth in arching streams of stinky frothiness. Keeping the nipple in his mouth was difficult, as it would constantly slide out unless I held my breast in place. Once in a while when the nipple neared his lips, this disgusted look would appear on his face, as if I had presented him with something rotten and spoiled, and he would slowly chew his way up the nipple to latch. And as he nursed, he clicked like a horse trotting on pavement.
Armed with a digital camera, I took pictures of this baby every day for sport -- ahh, the joys of the Digital Age! When he was 3 weeks old I was scrolling through the latest batch, and suddenly, there it was: Ezra was crying, eyes shut, mouth open, with a tongue that curled and cupped up. Wait, I have seen that tongue before! That's a posterior tongue-tie (PTT)! Soon after birth I knew Ezra had a thick labial frenum (upper lip-tie, ULT), but I didn't feel this was the root of our pain; one of my other babies had one and it wasn't an issue, so I dismissed it without investigating the anatomy of his mouth any further. Once I saw this picture and that light went on, I began searching online, I posted the picture on Facebook to an IBCLC friend, and my thoughts about this baby shifted: Maybe he's not a bad nurser!?
I found Cathy Watson Genna's website incredibly helpful (http://www.cwgenna.com). We had met a few years before when she was a keynote at our local breastfeeding conference, and I decided to share this picture with her. She used the term "stingray tongue" to describe his posterior tongue-tie (PTT). From her site I found a link to practitioners around the country who diagnose and treat tongue-ties. I called to make an appointment at a clinic about 90 minutes away and was scheduled about 3 weeks out.
Although I have been working with breastfeeding moms for ten years, I had not heard the term "posterior tongue-tie" until about three years ago; even then, I had not helped a mom with a PTT -- it had all been hearing and reading others' experiences. When we spoke of tongue-ties, we meant anterior tongue-ties, the obvious tethered (often heart-shaped) tongue, easy to spot, that could be clipped in a simple office procedure. While lip-ties I was familiar with, there still wasn't a lot of focus on it other than just getting babies to flange their lips out to latch.
By the time we met with the doctor (pediatrician and IBCLC), I was certain Ezra had an ULT, PTT, and high-arch palate; all three of my suspicions were confirmed. This doctor agreed to fix (release or revise) the PTT but is not a believer in touching upper lip-ties. By using scissors, a diamond-shaped cut under the tongue would give it more mobility and hopefully make breastfeeding better for us. We had Ezra at home with a midwife, and as such, I chose to decline the Vitamin K shot. This doctor wanted him to have that shot first as PTTs tend to bleed more than anterior TTs. Ezra also had a cold with an impressive cough, so it was decided we would make an appointment to have the procedure done at a later date. I left satisfied with the diagnosis and proposed treatment.
While waiting Ezra's cold out, I was hooked into an amazing network of parents and professionals who have experience, knowledge, resources, and often a unique understanding of all-things-tied-in-the-mouth: Tongue Tie Babies Support Group on Facebook. There I have learned not many professionals know how to identify ties (especially PTTs); not many professionals believe in correcting ties, especially in infants; not many professionals believe ties can interfere with feeding, speech, digestion, etc. I have seen that many different kinds of professionals treat ties, from pediatricians to dentists to ENTs and GPs -- there isn't one kind of doctor who specializes in this area, it seems to be more about education and awareness than specific training that would come with a particular area of study. While some doctors fix ties with scissors, others prefer to use lasers. Some breastfeeding moms notice immediate relief and change, and others report it took weeks for things to feel better.
Having more information and more time to think, I began to second-guess taking Ezra back to the doctor we saw. It had been brought to my attention by many people that Vitamin K, at this point, is most likely unnecessary because of his age. And I learned I might have dismissed the role of Ezra's ULT a little too quickly; at the time I didn't think to ask about the Vitamin K and the ULT as I was a bit overwhelmed by my crying baby and the (unexpected, male, older) resident shadowing the doctor as she examined not only my baby, but also my breasts.
I found a second choice, three and a half hours away, where the treatment is done with a laser; not only could we get the PTT taken care of, we could also have the ULT revised as this doctor (a dentist) does both. I am not sure what to expect, but I am hopeful this is the right step for us...our appointment is next week.
This is long! Be warned!
I think when a person in is a position to serve a woman while she is in labor, that person should have required training every few years, like a recertification, on what it feels like to have a baby. I am not certain how this certification could be obtained, virtual reality plus some sort of pregnancy suit? Actually having a baby? I haven’t figured out the logistics, but I have recently had a recertification of my own, and that is called, my fourth child.
This fourth pregnancy was a surprise. Technically, I got pregnant at a time when no one would be able to get pregnant – only I guess more like I got pregnant at a time I felt I was highly, highly unlikely to get pregnant. My last menstrual period was June 10th. I did not get pregnant until July 13th at the earliest (a time when I was waiting for my period to start), to July 20-ish at the latest; looking at the date he was born now (April 6th), July 13th seems closer to the target date…we were on vacation.
I had lots of irritable contractions combined with irritable baby movements (probably more of the latter versus the former) that would happen around 10 pm to 1 am. The week before labor began I pretty much experienced these every night and I hated them. During these times, I would have waves of panic and anxiety about the reality of actually having to go through the birth process again, and I was always grateful when they were over and I could finally climb into bed.
Friday the 5th of April was pretty normal except I had two very serious bouts of grumpiness that made me feel deeply in touch with someone who was (hopefully!) going to start labor soon -- it was like total,
irrational, not-triggered-by-much anger that switched on so fast, I knew it was something else with some other root than just me being moody.
We had pizza for dinner, and like I had for the last week, I restrained myself from eating too much (“If labor starts tonight I don’t want to be too full,” was my rationale). I had two pieces and then cut myself
off. I took a little nap in bed, which I hoped would actually be “going to bed,” but I woke up at about midnight when I couldn’t ignore the antics of Wild Baby any longer. I watched TV a little and sat on the ball to try and bounce my guy into a calmer state. At 1 am I decided to watch the last episode of Mad Men on Netflix so I would be ready for the new season, with the intention of going to bed after that.
At 2 am, just when I was settling into sleep, I realized I was contracting, and these contractions felt different. They came 5-6 minutes apart, were totally manageable, and lasted about 40 seconds. I tried to sleep, but I was also mindful of needing to recognize true labor so I could get my sister and my mom on the road from two and a half hours away if this really were it.
Everyone was asleep, and as long as I was okay, I felt no need to wake them. I was feeling hungry, so I ate half a lemon Chobani (again, not wanting to eat a lot) in the morning quiet. I did call my sister at 3 am to let her know it was go-time. I labored longer, in the quiet of my living room, tending to small errands and tasks between contractions. At 4 am I woke Brad up to tell him I was in labor. He came out to the living room and asked, “What can I do?” and I immediately answered, “Take the recycling out, it’s driving me crazy and I have contemplated doing it myself for the last 2 hours.” I was hoping he would just lie back down on the couch and snooze a little, but he was up and ready to go.
I thought I would wait to call my midwife until 5 am, but at 4:30 my contractions began to get stronger and longer and closer together, just as they should, and I finally had some show. I phoned Linda to let her know I was in labor. She asked me a few questions, and then said she would be over soon. She lives about 40 minutes from us.
At 6 am, Linda arrived, and things were beginning to feel real. We had our tub set up in the dining room and I was feeling a pull to climb in, but I didn’t want to stall labor if I wasn’t that far along. I asked Linda to check me and she said I was 3 centimeters (“Not quite active labor!” I thought with a little disappointment), about 90% effaced, baby maybe at -2 station? I can’t remember that part. I mentioned I wanted to get in the tub, but I should probably try the shower instead (so gravity could keep helping my labor), and Linda agreed.
I got in the shower, and I really don’t know how long I was in there. The water felt great on my belly and during contractions I would swing from side to side so the water could fan over me. In between contractions I alternated putting my foot up on the side of the shower to lunge, in case my baby was posterior like his two brothers before him. Soon I found I had to vocalize during the contractions. I was in the bathroom alone and I had a lot of time to think. The thought that kept coming back to me was, “All is as it should be,” which was part of a prayer Brad had said earlier in the week when I was feeling really overcome with fear. I rubbed my belly and talked to the baby and told him to hurry, it all felt like it was happening in slow motion.
When I got out of the shower it was about 7 am and Linda checked me again. I was 5 centimeters. I went straight for the tub at that point, dropped my towel, and climbed in.
Jacob and Jonas were awake and had been for a while. Soon Isaac woke up and came straggling out of his bedroom in his standard sleeping attire – undies and a t-shirt. Brad told him we had company and he might want to put clothes on. Before Isaac woke up I remember Brad asking Jonas if he knew why Linda was at our house so early? Jonas admitted he didn’t, and we made a joke about Linda just coming for an early-morning visit. Brad then said, “Your mom is going to have the baby today.”
I looked to the tub for the relief it had brought in the past; with both Isaac and Jonas I got into the Jacuzzi tub at 5ish centimeters and after an hour was at 9ish centimeters, and I was hoping for the same, with the addition of having the baby in the water. After 30 or 40 minutes it seemed the tub wasn’t going to work as I had planned. I had intense pain in my lower abdomen to the point of not being able to sit in a relaxing position, so the whole time I was in the water I had to be on my hands and knees, and I didn’t want to stay that way much longer. Also, Brad started making pancakes in the kitchen.
At about 7:45 my mom, sister Shiela, and her two boys arrived. I headed to my bedroom, finished with the tub. Linda had set things up around the pool in preparation of a water birth, so some rearranging was in order, moving things to my room, getting equipment ready if needed. Once in my room it was just Linda, my mom, Shiela, and I. Brad had the boys going with pancakes and if they were making any noise, I sure didn’t hear it.
I asked someone to bring the piano bench into my room as I was laboring standing up, and I wanted to continue to lunge in case I had a malpositioned baby (which I don’t think he was, but I was a little gun
I think I had Linda check me again, and I think I was 7 centimeters? I am not really clear on this part. I wasn’t ready to sit down, so I continued to labor standing up. Shiela was a super doula – she would squeeze my hips during my contractions, and it brought so much relief! One thing I know about that double-hip squeeze is, it is hard to do when you have to press your arms together at the height of a woman’s hips – you get tired fast, and the laboring woman usually doesn’t want you to stop. If the
mom can get on her hands and knees on the floor, you can squeeze her hips with your own inner knees by straddling over her back, but I didn’t even want to try or offer that as I didn’t feel good in that position.
Over and over, a contraction would come, and I would tell Shiela, “Hips, hips, hips,” and she would start
In reality I have no idea what kind of time span this all happened in, I say over and over, but maybe it was only about 5 contractions? Or maybe it was 10?
I did finally sit on the bed for a bit. I remember taking my watch off and handing it to Shiela with the feeling that this was taking too long. I know for a fact I wasn’t looking at my watch or paying attention to how long it was taking in a linear fashion, but it was more some sort of symbolic resignation that I
would try to just flow with the timetable my body and baby presented even though I am as impatient as they come; in the last picture of me with my watch on, I see the time is 8:55 am.
I decided to visit the toilet. I spent a couple of contractions there, and Shiela was with me. She said my noises changed and she knew I was getting closer. As I sat laboring on the toilet, I opened the shower door next to me and contemplated getting back in -- I was looking for anything to comfort me at this point. Then I decided to see if I could feel anything inside of me, so with one finger about one knuckle in I was shocked to find something! “Is that a head?” I asked. But then I realized it was a bulging bag of water, with a head behind it. After all the years of hearing practitioners say, “I feel a bulging bag of water” (which I did remember Linda saying when she checked me last), I finally knew what that felt like and what it meant. I think I almost gingerly hopped off the toilet at that point, feeling remotivated.
I had one contraction standing up, with Shiela at my hips. Then I had another, and my water exploded all over the floor. There was a little meconium but Linda said it looked old and there was no reason for concern. I finally climbed into bed.
At this point I knew it would soon be time to push. I suddenly had the need for Brad to come and be with me, so I called to him and patted the side of the bed next to me, I just wanted him to sit with me and be near. Shiela was on the other side of me, and Linda was at the foot of the bed. My mom was by the door, ready with the camera, and the boys were in the living room playing Legos (again, I never heard anything from the boys, and there were 5 of them. Actually, I think after they ate pancakes they walked to the park with the dog to play for a bit. But I do know when the baby was born, they were playing Legos in the living room).
I did begin pushing at some point, and Linda said I still had a rim of cervix and she was going to try and move it, and I was totally fine with that because if anything was holding this baby up, I wanted it gone. So for a couple of contractions she worked on that and I guess it went away. I was pushing with such intensity but it felt fruitless. I truly felt nothing moving or changing and I imagined pushing forever
and not making any progress. It was at this point that I remember thinking, “I should have gone to the hospital so I could have the drugs!” (Interestingly enough, when I had my babies in the hospital, I never thought to ask for drugs, because I know if I had had the thought, I would have asked; maybe at home when it is not an option, my brain safely went there, just as a way to cope and vent.) Brad and Shiela were helping me pull my legs back during the pushing. Instead of rolling my chin to my chest, which I have helped women remember who-knows-how-many-times, I arched my head back against my pillows. I also had my body twisted in some way, crooked a little. Linda gently reminded me to get better aligned (with words and heart I could understand at that point), while giving me positive encouragement for this task I had to undertake.
Linda! What else could you want from a midwife? Really, not one thing. As a doula, I get really uncomfortable when people say, “Stacie, I couldn’t have done it without you.” Because, come on, you could have, and you would have. I don’t want anyone’s birth experience to have me entangled as an
essential ingredient; it should be all about the mom and her family, not me. But I have to concede that
when the right person is helping you with the right words and attitude and presence and spirit, it helps make the experience even more amazing, if that is possible. When you have the right midwife, the feeling is similar to being in your own home – the comforts of being in your own bed, using your own bathroom, lunging on your own piano bench – Linda was a natural extension of that. It felt right that she be here, in our home, unobtrusively watching over the birth of our baby.
The support Shiela gave me was also invaluable. Family members don’t always make the best doulas.
Shiela actually has taken a DONA-doula training, and that coupled with what she knows about me (just about everything), made her perfect for the job. She stayed by my side, she gave me verbal encouragement, she wished she could help me more. The truth of the matter is, only the mother can have the baby, but she doesn’t have to be alone while she is having her baby. I will forever treasure that my sister was there to support me during one of the most intense experiences of my life.
Pushing was hard, it was really hard – it seemed harder than it ever had been. I know I was lost in my head, and in there, the storm was raging. Every push came with screams, I hate to say it. I have never screamed with any of my other babies. And also, I cried, which was something new for me. In hindsight I probably could have pushed more effectively keeping those screams to myself, but they just came out. I know the boys didn’t appreciate the noise (although they all later admitted they weren’t scared), I am thankful my neighbors didn’t call the police, and the screaming is not my favorite thing about the birth video – oh well!
After so much pushing (again my sense of time is really off here), finally his head emerged. I felt his head with my hand, but it really didn’t mean anything to me, I just wanted the rest of him out! I pushed for one or two more contractions, maybe three, and then his shoulders popped and he tumbled out on a
wave of fluid and tons of baby poop. Linda helped bring him to my chest, all the while rubbing him and talking to him and watching him carefully. I was so relieved and instantly went from that person experiencing the very hard work of pushing toward a goal, to that mother experiencing her baby
for the first time. I was rubbing him and toweling him off and just taking him in, my body relieved of the burden with the prize in my arms. He was born at 9:42 am.
We all watched as he turned from purple-y to pink. His apgars were 8 and 9. Very soon after birth he wanted to nurse and he seemed to know just what he was doing. The boys peeked in one by one, only appearing mildy interested (we had two 13 year olds, two 11 year olds, and one 7 year old), and then backing out of the room again.
There were lots of things in the birth kit we didn’t use. My perineum didn’t need massaging, which Linda was prepared to do. We didn’t need the bulb syringe to suction the baby’s airways. There are lots of Chux pads that didn’t get used. Everything just happened easily and well, as it so often can when left to its own devices. I am sure the level of comfort and security factored into that for me as well. I am still struck by how ordinary things were and how extraordinary they were. Within a couple hours I was back in my shower. A little while later I threw a load of laundry in. My mom bought donuts and I happily ate three. Our new (nameless) baby was being admired and touched and held by his cousins and brothers and dad and aunt and grandma, while also nursing and visually taking in all he could. In many ways it was like a normal Saturday morning at home, but then, it was also like some rare, high holy day, calm with introspection, peace and joy.
Ezra Christian was 8 pounds, 1 ounce. There was much debate about his name – the other choices were Benjamin, Ruben, and Abraham. He was born on what we in the LDS religion believe to be Christ’s birthday, and also the day the LDS religion was restored; Christian is my brother’s middle name, and we
felt it appropriate for Ezra as well.
Moving through that birth, I didn’t feel alone. I remembered so many births and situations and strong mamas moving gracefully through this work. I could name each and every one that came to mind, but hey, this one’s my story. Just know if I have been with you for the birth of your baby, you were with me during mine in spirit and endurance and admiration. This has brought me so much more appreciation and compassion for birth and women while experiencing it – that’s why I feel there should be something birth workers can do every few years to get back in touch with what it can really be like to physically grow and have a baby. It changes you, and sometimes we forget that.
The first thing that I'd want to do...
I have a theory about why birthing people can bond so strongly to those on their care team, and could you guess, I think it's all about the oxytocin? Whether it's the connection to an excellent provider, or the attachment to a provider who treated my client terribly -- I blame oxytocin.
The woman doing the promoting said their product was a synthetic of oxytocin, which in the birth world we know as pitocin or syntocin, so naturally I wondered if that is actually what they are using? If so, maybe they are just getting hold of the bags they use in the hospital all the time? Heck, I might be willing to swipe a bag, saturate my clothes, and see if I strike it rich in money or love!
Okay, technically I have to say (in disclaimer mode) I have already struck it rich in love. Ahem. But money, on the other hand -- the verdict is still out on that one.
I am an avid blood-donor -- when the Bloodmobile shows up, I am out there, ready to give away a pint of my blood for a $5 coupon to the movies. If this company is interested, I would be willing to offer my own oxytocin for sale -- why not!? As a nursing mother I should have plenty to spare. Perhaps I will contact them and see if they are interested. After all, I am a cheap date!
Additional fascinating facts about oxytocin:
-The Two Faces of Oxytocin
-Hug the Monkey
-Breastfeeding Trust Hormone Clue
It's always a good feeling when you get to save the day. Today my oldest was putting together a model of a Mini Cooper and he lost a main piece. He was upset already because his baby brother was trying to get in on the action of putting the car together, and naturally my oldest thought my youngest was to blame for the missing part.
With three little boys, a husband, running out at wild hours to help women have babies, teaching childbirth classes once or twice weekly, leading a breastfeeding support group, and then doing all the normal stuff one needs to do at home, I sometimes feel like a spoke on the wheel of the bicycle of my family’s life. I see myself, spinning around and around and around, the playing card taped to the rim making an annoying ‘clack, clack, clack,’ sound like the Big Wheel on The Price is Right.
♥ four young boys and a boy dog (offspring)