Three Days Postpartum: Monday

Today was the day we confirmed my suspicion that David is tongue tied like his brothers John, Joseph, and Thomas. I read that tongue tie has a genetic component, and occurs more frequently in boys, so this was something we were ready to check for. I had already contacted my IBCLC before I delivered, and when I did, I scheduled her to come to my home on Day 3 (when milk typically comes in).

It was on Sunday afternoon that David began wailing inconsolably and rejecting the breast, and causing a damage to Mama during his nursing attempts. After a few hours, I reached out to my parishioner friend T--- who lives nearby and asked her for some formula . . . something I hadn't given even one bottle of to my five previous babies. She left her children with her husband, leapt in the car, and raced to my house, whereupon I burst into tears when she walked into my kitchen.

She was so kind to make me sit down, offer me water, and just sit and talk to me while we fed David a bottle of formula: a spiritual milestone for this mama and retired La Leche League leader.

I credit some excellent breastfeeding professionals and paraprofessionals who trained me and taught me not to get hung up on ideals but to remember

The First Rule: FEED THE BABY. 

We don't let a newborn go hungry because we are unbending about ideals. With Thomas, I was blessed to have donor breast milk, but for David I didn't.

On Monday, my IBCLC did a comprehensive exam, and the long nursing session and measurement on a transfer scale (sensitive down to one gram/milliliter) revealed that David transferred exactly zero milliliters of milk, even though my supply had come in.

I know the drill by now. Rent the hospital-grade pump and transfer scale. Begin pumping 8-10 times per day immediately to build a supply that the baby won't be able to build. Feed via a bottle. Schedule a tongue tie revision. Begin oral exercises to strengthen baby's mouth so he can learn to nurse.

It helps a possibly overwhelmed mama to think of this like feeding triplets, which she would know and accept as a Herculean effort, not something that "should" come easy.

• Pumping 8-10x/day = one baby
• Making nursing attempts 8-10x per day so baby can learn = second baby
• Feeding with a botttle 8-10x per day so baby is actually fed = third baby

Repeat this cycle every two to three hours around the clock. Please pray for my perseverance!


(Retroactively published to Monday.)

Two Big, Fat Pounds

Thomas has gained two pounds in the three weeks since his birth. He weighed in at 10 lbs 2 oz today!

I didn't have to put down Thomas for this nap because
a dear friend of mine took my kids for a play date on Sunday.

Thomas' big nursing success is that he is latching on himself a couple of times per day. Last night, I happened to get him on the transfer scale before and after, so I know he was able to nurse one whole ounce by himself before he tuckered out. This is a good success for which I am grateful, but I also know we have a long road ahead as his typical bottle feed is three ounces and he consumes about 30 ounces per day.

Our next tactic is going to be trying a Haberman feeder, about which I'm very excited!

Milk drunk

10 lbs 2 oz at 3 weeks old--concerned expression

I am working so hard trying to learn how to run the home, feeling overwhelmed by the nursing issues, and trying to process all this postpartum 'stuff.' I have an essay in my head that I very much want to write but no time to write it and so far no ability to frame it right, either.

In the meanwhile, adventures (like Mary's fracture) continue around me, irrelevant of the fact that I declare I have enough on my plate with normal postpartum transition and a baby who can't nurse. This morning, I was working in the kitchen, baby in arms, while the children played in the back yard. I stepped out to check on them, as I do every few minutes, only to find Margaret (4-1/2) nonchalantly very high in a tree.

If you click on the picture to zoom in, you will note that the children somehow lodged an ottoman/stool up in the tree, as well as a pretend, pink shotgun to defend themselves from varmints.

Margaret (4) in a tree

Margaret did not know she was stuck until I inquired and she discovered she could not get down. Frankly, I don't even know how she got up there: I know the two older kids can shimmy straight up a rope, pulling their dead weight, but not Margaret! Thankfully, Daddy was home to get her down safely from the tree because I really, really do not need any more trips to Urgent Care or the hospital for a long time.

Then a mere hour later, my heart rate had calmed down from the tree incident, and I try to step away to pump milk for my wee baby . . . only to return and hear report that the children had spotted the 6-foot rat snake that apparently lives in our back yard. I can't ever step away without adventures happening!

Frenectomy Report

Thomas' frenectomy procedure on Friday went well. I would have been a basket case of tears had I not been through this with two boys before.

Waiting for the doctor to join us

So far, Thomas is not the 'miracle baby' Joseph was--having his frenectomy and transitioning from exclusively bottle-fed to exclusively breastfed within 12 hours. I think little Thomas will be more typical in needing a lot of help and teaching: time will tell! I remain incredibly grateful for my husband's support and encouragement to take these days to help Thomas learn to nurse, even though it means I'm not running the home or making meals, supervising children or homeschooling them.

Tongue Tie Revision Is Tomorrow

Plastic to the rescue! I try my best to pump when Thomas is napping but a few times per day, I can't coordinate the timing, which leaves Thomas screaming for fifteen long minutes. I just dug out a freebie newborn pacifier that came with our new car seat and gave it to Thomas . . . my first baby to keep a paci in his mouth! Thank God for a calm baby for those minutes. 

Maybe it won't be too much longer that I'm juggling quite this much . . . an appointment opened up such that Thomas' tongue tie revision is scheduled for tomorrow (Friday) morning instead of three weeks from now! Please pray for a good procedure, easy recovery, and the baby's ability to learn how to nurse.

Bonus reading that deeply touched my heart in particular during this journey of mine right now: "When Lactation Doesn't Work" by Alison Stuebe, M.D.

Pics of Joseph proudly holding his baby brother and Thomas not enjoying it:

Maundy Thursday 2014

Lent is penitential and Holy Week even more so . . . and nothing says 'penitential' like dental work, right? Our family experienced two episodes of Dental Drama this week.

On Tuesday evening, Joseph (1) was walking along carrying in his hands a cork drink coaster--not exactly a lethal weapon--which he then stuffed in his mouth, as toddlers are wont to do. When he stumbled, as they are also wont to do, the corner of the coaster hit his first lower left molar just perfectly right to almost knock it out!

I've seen plenty of mouth injuries and we all know they bleed profusely, but this was the most blood I'd seen. Of course, when it happened, my husband was out of town and dinner was burbling on the stove. The molar was knocked to about a 30- to 35-degree angle, the top pointing in toward the tongue, the bottom making the gum bulge out.

I spoke to our after-hours dentist, who said the emergency could wait till morning when I should go to a specialist dentist, and we were there by 9:30 a.m. (thanks so much to S---- for babysitting my girls!). What the specialist told me is that brand new baby teeth have such short roots that--while an adult tooth couldn't be at that angle without the roots having snapped--it is possible that Joseph's molar got knocked out of place without breaking the roots and it will re-settle and heal, the roots continuing to grow as normal. Rather than submit Joseph to an x ray that day (which I've got to imagine would require sedation!), the doctor recommended we give the baby two weeks to heal, then come back for a check-up. 

The only other concern is infection setting in, and we are armed with prescription antibiotics if it does. However, I am comforted at the thought that Joseph's wounded gum is being bathed one to two dozen times daily in natural antibodies custom-made (within about a half an hour) to respond to any germs to which he-and-Mama have been exposed . . . I am so grateful for nursing!

Already, forty-eight hours later, his molar is looking much straighter!

Our second Dental Drama this week was that John had a laser revision of his labial frenum.

My longtime friends will remember that John had a posterior tongue tie and lip tie for which he had a laser revision in New York at 15 months old. Many problems with nursing and eating solids were caused by the tongue tie, hence the correction. Unfortunately, the labial frenum grew back big as ever because, at that time, doctors apparently didn't know that stretching and rubbing exercises are required post-operatively.

John in the chair, happily watching a cartoon ahead of time

So, here we are at seven years old and we decided to take advantage of John's "seven-year gap" (both his top front teeth missing) to have the frenum removed . . . essentially a cosmetic procedure. This should allow his teeth to come in closer (without the big gap) or, if they still descend with a gap, orthodontia should easily correct the spacing instead of the rubber band-like frenum repeatedly stretching the teeth apart despite braces/a wire.

Joseph "praying" for his brother . . .
Mama trying to entertain the baby with her rosary!

The procedure went so well (and thanks to K---- for babysitting my girls!). John was very calm going into it, based on what little information I gave him. The dentist was quite skilled with his word choices about "sleepy medicine" and use of anesthesia, such that John had no idea he even received two shots of lidocaine.

There is vastly more information online about the world of tongue and lip ties now than seven years ago: this four-minute video of another seven-year-old undergoing this laser revision is very similar to what John underwent (except John's surgical wound is noticeably bigger).

A milkshake: doctor's orders!

After the procedure, the dentist said this is the one time he prescribes a cold milkshake to a child, and I said this was the one time during Lent I was going to give our boy such a dessert! The soreness is fairly mild and should last only 24-48 hours. This time around, we know about the stretching and rubbing exercises (three times daily for three weeks), which John is to do in order to prevent the fibrous frenum from reattaching.

And now we proceed full steam ahead--with our sore mouths--toward Good Friday and the Easter triduum!