Remember when I promised you guys a kitchen update, but also mentioned I’d had some sudden milk supply issues? Well, kitchen update is on hold because I threw out the need to finish up the cabinets to focus on feeding Peter and figuring out why he wasn’t gaining as much weight as he needed to. And it was a stressful week, but one I learned a lot from. Then we went on a family vacation to the Oregon coast, and so now I’m back…with an update on the breastfeeding sitch, a couple posts in the hopper, and hopefully cabinet hardware arriving this week so I can finish up this kitchen project and show you pictures.
Okay, let’s back up. Since birth Peter’s spit up a good amount and was fussy and colicky, but he was growing beautifully, so I wasn’t too concerned about the reflux and figured that I would attempt to eliminate the triggers of his colic and reflux before medicating him. I went off every food that could possibly have irritated him, without much improvement. A few days before his 2 month appointment, my mom was over and I was at my breaking point: Peter had been screaming for days on end, it seemed. So I called our pediatrician and asked what our options were. They prescribed baby Zantac, and he was, I thought, a happier baby. He still spit up a ton, but he wasn’t arching as much while eating. His colic was improving with age and the use of a daily probiotic drop, so the fussiness was less – but I knew reflux was still at play. Somewhere around 3 1/2 months, I felt like he was spitting up more and more. Everyone always says that it looks like more than it is, but I felt like he was spitting up significant portions of each feeding. He was also a fussy eater again – he ate quickly and then screamed, and then spit-up. Classic reflux baby, but we were treating it. Anyway, I expected his weight gain to have slowed, but since he was packing it on in his first two months of life, it didn’t cross my mind he’d be dropping growth channels.
So, at his 4 month appointment three weeks ago, I was expecting him to be around 13.5 pounds when his previous chunking would have indicated he’d be about 14 pounds – and he clocked in at 12lb 3 oz. I was horrified. I immediately blamed myself and my milk supply – it was my fault because I’d been working out and eating clean. Our pediatrician was out of town, so we were seeing our practice’s very thorough PA. Before I continue, let me say I totally understand where our PA was coming from in this story – she’s a medical professional and she wants to see babies growing. I tend to be pretty calm about medical stuff – I rarely take my kids to the doctor when they’re sick because I know that a virus is a virus. I don’t call for every fever, we use a lot of natural home remedies for comfort and let fevers and viruses run their course. But, I usually choose appointments with this PA when we’re trying to diagnose something outside of a well check – Nell’s GI issues, for example, because I know she won’t say, “Let’s wait and see what happens in a week.” When I get to the point with an illness or dilemma where I decide we need a doctor’s visit, I want to know we’re going to examine every option. But for well-checks, I tend to prefer to see our pediatrician since she’s a little more on my level in terms of remaining calm. But anyway, we saw the PA, and she was very concerned about Peter’s very slow weight gain (he did gain, just slowly). And I was a hot mess. Now, having seen our PA with all three of my kids, I think I can say at this point that she’s not the most pro-breastfeeding – the practice itself is, but this particular individual wants hard numbers, which breastfeeding doesn’t readily supply. At every single appointment during the year I nurse my babies, her first question is “How many ounces are you pumping?” – even when my one month old is growing beautifully and gaining growth channels. When I tell her I’m not pumping, she asks me to start pumping once a day so she has a number to go off of. I always say, “I pump when I need a bottle”. Her recommendation was to exclusively pump for every feeding so that I knew exactly how much milk he was getting and to supplement him with formula to fatten him up.
Now, I firmly believe that asking a mom to exclusively pump to see if she’s providing enough milk to her child is a sure fire way to get the mom to stop breastfeeding. I know that one of the ways moms – especially first time moms – are told to help bring their milk in is by pumping. I was told the exact same thing with Thomas, and I spent the first month of his life obsessing over how many drops of milk drip-drop-drip-drop-drip-dropped into those damn Medela vials. Because breast pumps suck. And pumping is stressful. And I know for a fact that if I had to exclusively pump, I’d struggle to provide my children with breastmilk for the first year of their life. I’d try, but I’m pretty sure it wouldn’t go well. When I was working when Thomas was a baby, I had to pump three times during the day and twice after he went to bed in order to make enough milk for his bottles at daycare the next day – if I’d had to pump for all his feedings, I would have been pumping all day. I have many friends who have determined their milk supply by how much they pump, and quit before their babies are a month old because they aren’t producing enough milk. I also know there are circumstances where moms don’t produce enough milk, but generally speaking, I think that the United States is a little broken in how they approach breastfeeding and babies and weight gain.
Obviously there was a weight gain issue for Peter – his reflux was part of it, he was spitting up a good portion of feedings, and luckily, he performed his spit-up routine in the office so the PA could see just how much he does spit-up. We switched his reflux medication from Zantac to Prevacid which made a difference in his spitting up and demeanor. But, we did pre- and post- feeding weights at that appointment, and he was only taking about an ounce during each feeding. Which brought milk supply issues to the forefront. So I panicked. I posted here and you guys were awesome. I posted on instagram and you guys were awesome. And then, when my friend who’s working towards her IBCLC certification got back from her family vacation, I called her and she came running over to my house. Where she told me everything I needed to hear: That this is not my fault. That eating a healthy diet and exercising do not affect milk supply – that my body would starve itself before it stopped producing milk and to not stop taking care of myself as a result of this. Then she told me that I have successfully breastfed two babies, plus Peter for 4 months, and I can get my milk supply back up. It will take work, but I can do it. She watched Peter eat, she witnessed his fussiness and agreed he wasn’t taking a full feeding, checked his latch (which looked fine) and told me to go to a breastfeeding group lead by a lactation consultant she really respects for pre- and post- feeding weights, and more ideas, because she wanted me armed with numbers information when we went back to Peter’s weight check the next week.
So, the breastfeeding group was great, and the lactation consultant was amazing – encouraging and logical, which not all are. She spent a lot of time with Peter and me – at this point I’d been pumping after every feeding for a week, so my milk supply was much better than it was a week before, but Peter was still not taking a full feeding, and still screaming afterwards. She watched him eat and thought his latch looked fine, but because of his screaming and the fact that he wasn’t taking a full feeding, she checked him for a tongue tie: and he was indeed tongue tied. I was shocked. Peter was my best nurser from birth, and I couldn’t believe it would take 4 months for the signs to show up. She explained lots of possible scenarios to me, but the long story short was: get the tongue tie clipped, get my milk supply back up, and feed the hungry baby. She sent me off with a plan for continuing to improve my milk supply by pumping 2 – 3 times a day – such a relief after pumping after every feeding – and a baby weight gain plan which included supplementing Peter with 2-4 ounces of the pumped milk (or formula if necessary) 2-3 times a day until his tongue tie was clipped so he could nurse more efficiently. The next day, thanks to my milk supply rebounding due to all the pumping, and the bottle supplementation of the pumped milk, Peter was up 8 ounces, up a growth channel, and we had an appointment for his frenectomy the following day.
The frenectomy was simple and done with a laser in a pediatric dentist’s office. It took a couple of days for him to start using his tongue, and we were on our way off to Oregon for vacation, but a few days into vacation I noticed that he was eating much longer and I could actually see his tongue when he was eating. This whole ordeal also took place during a huge developmental period for most babies, and his fussiness has been better over the last few days since that developmental period has past, as well. And that’s where we’re at: Feeding Pete’s still a priority, but he’s continuing to catch up on weight gain – gaining just under an ounce a day (Pediatrician wants to see 1/2 an ounce a day so he’s currently over achieving), and is generally happier. And I’ve got a few gray hairs, now.