Some might be offended that I am using the word 'survived.'  Sorry, but that's how I feel! I didn't think I would make it without having to use formula. I didn't think our routines would survive, because it wasn't sustainable. Turns out, only some people are able to have a tongue and lip tie release and then be perfectly fine. Most people need additional training and help. We were in the latter group. Here are some key things I learned:

• Babies have been with their tongue and lip ties since 12 weeks gestation. They have been practicing swallowing amniotic fluid in the womb repeatedly and have a developed motor plan. This will take time to re-learn and undo.
• The surgical portion of remediating tongue and lip ties is the first step- an important one.
• The next step is making sure they don't re-attach, which is achieved by performing stretches and movement.
• After that, you need to work on re-training, which can be taught by a knowledgable lactation consultant or knowledgable SLP. I say this because I spoke to lactation consultants and I am an SLP and was not told about this or learned about it in school. Luckily, I took courses online that taught me how to perform these exercises.
• NOT DONE! Then, you need body work. This can be performed by a chiropractor or someone trained in cranio-sacral massage and movement. Why? Well, you need to understand that tethered oral tissue pulls on muscle groups and makes certain facial and neck muscles tighten. BUT all muscle fascia are connected from the tongue down to the toes, so body work involves loosening tight muscles and allowing the body to get back into alignment. 

It is soo so so so important to make sure all of these steps are completed, even if you think things are fine after a release, I would make sure you checked all these boxes. The consequences of not doing so are far-reaching and surprising. Even things like crowding of teeth and a child's future of dentition are affected. Children can become picky eaters, have articulation and speech issues, can develop sleep apnea resulting in poor sleep quality, which can affect how they learn and attend during the day. It snowballs slowly over time.

The earlier these things are fixed, the better the outcome for the child will be. The tissues in the palate are not yet formed, so it is easiest to mold the palate now before those bones fuse together. 

This is my feeding station. I don't go here to feed exclusively every single time, but it is often. It's a hot mess. I'll explain a few of the things I have here and why. 

Mentally and emotionally I was drained. Picture this: Baby is screaming and flailing their little body, sliding off the breast. You know they are hungry and are ready to serve, you shove the breast into their mouth, making sure you do the thing where you line the nipple to the nose, you pull them in quick. CHIN FIRST (I hear in my head). The latch isn't good- and it hurts! So, you try again. You unlatch, then re-latch. Same problem. Now he's on and he's eating... for about 15 seconds. The baby is screaming again and you are screaming too. "IT'S HERE! IT'S IN YOUR MOUTH! WHY AREN'T YOU EATING?!" Also you're tired and hungry. Did I drink enough water today? This was my reality for awhile. It's heartbreaking to watch, but it's so much harder when it's you. Your baby is struggling to eat and it's your job and your job alone to provide them with that food, and you feel like you're doing a bad job. In tears I would say, "I get why people give up and bottle feed, this is so hard!" ..."But he is gaining weight!" people would say. I was relieved at that, but you just know in your gut when something isn't right. I needed help. Fast. 

SURVIVING is as easy as 1, 2, 3:

1. Having a support system: This has been invaluable to surviving. Otherwise, I might have given up a long time ago. Facebook support groups, Kellymom.com, friends or family who have breastfed, and seeking out lactation and doula support. This was by far, the biggest factor in surviving breastfeeding and not giving up. You need people who understand, who have been there and come out the other side. If I didn't have this system, I wouldn't have known about the nipple shield or the special pillow that made all the difference. Talking to people also made me feel validated- I wasn't crazy, I'm not doing a bad job, I'm actually doing a great job! You need cheerleaders!                                                                                                                                                                                                                                      I think this is hard sometimes when the people closest to you don't believe in you. That was thankfully not the case. Although, I got a small taste of it when my mom said, "When you're tired of this and ready to wean" ...and I almost lost it. Wean? What the hell are you talking about? I've been doing all this hard work and figured out all this stuff and you think i'm going to give up now? No way!
2. Education: Without being armed with knowledge, without knowing that there's something that can be done, without knowing what is normal and what is not, it would be almost impossible to keep this up! Knowledge is power and every time I learned something, I felt a renewed sense of, "I could do this!" 
3. Tools: You NEED the right tools. My most prized tool has been nipple relief items. I don't think I could continue without the nipple shield and the breastfeeding pillow. The cooling gel pads were also really helpful initially.

                                                                                                                                                                    The nipple shield can be a controversial item. Basically, it shouldn't be used unless you have to because if you need a nipple shield, there's more to the issue and you should be seeing a specialist to help remediate the issue instead of using the shield as a crutch. It does NOT decrease supply. This has been disproven and might have been true when they were made of a different material. The silicone is thin enough that the milk has no difficulty getting though.

I agree with the controversy and I will say I always try breast first, then if I need to add the shield I do. If I can remove the shield partway through feeding, I do. That being said, I think it is absolutely necessary and would not have made it this far without it. 

​I wanted to write about my journey through breastfeeding thus far . It's something I always knew I wanted to do, but I wasn't determined or passionate about it until I watched 'The Milky Way' You HAVE to watch this. Your boss needs to watch this, your husband, your mother- just watch it! I didn't really understand the importance of breastfeeding until I watched this video.




​Here's some things you should know about breastfeeding:

• Breastfeeding reduces infant risks of: Respiratory tract disease, ear infection, Eczema, Asthma, Childhood Obesity, Leukemia, SIDS [[Breastfed babies are actually less likely to get ill overall]]
• Reduces Risk of ovarian cancer, breast cancer, depression, stroke, heart disease and type II diabetes [[There's no pill that can do all that at once!]]
• Burns about 500 calories per day [[helping to drop that baby weight faster!]]
• Exposes babies to different flavors [[based on what you are eating]]

THE MOST EPIC THING!: 

• Breastmilk changes day to day, even feed to feed! The saliva in baby's mouth touches the nipple and tells your body what to make for baby based on their needs at that moment.      [[Seriously?! Your body just makes exactly what baby needs? That's magic]]
• Your body gives baby antibodies that you have so they are protected from diseases 
• Baby does a 'Breast Crawl' immediately after birth to the breast [[they move themselves and latch on a minute old?! Incredible!]]

After learning these facts, I just had to do it. I insisted not a drop of formula would grace my son's lips. What I didn't know was how hard it would be to maintain this dream. 

With my baby, I waited for the breast crawl and was not disappointed! It really did happen! He latched immediately and there was no pain. My doula casually said in passing "I think he has a lip tie". I brushed it off because he latched no problem, no pain. My baby was perfect and a rockstar breastfeeder. No intervention necessary, I read books people! 

Well... if you are able to infer by the title of this post, it wasn't exactly all sunshine and roses. 

That was the first and last pain free latch I would experience for weeks. Now I had heard a few things about breastfeeding, like how it hurts initially really badly but then it gets better. Your nipples have to 'toughen up' essentially. This turns out to not be true! There shouldn't be pain when you breastfeed! 

I asked the nurses and went to the hospital's breastfeeding class. I asked for the lactation consultant to come to my room to observe my feeding, but apparently she was only there for a couple hours and had a lot of people to see, so I had to go to the class (this was a baby friendly hospital too...). A little put off, I went because I was in pain and I was wondering if there was any way to make this easier. I learned about the football hold. She observed the latch and said he had a great latch, despite the pain I was in. I trusted her. After all, she had been doing this for 30 years. 

After discharge, it wasn't getting easier. In fact, I was now crying in pain with every feed because we were feeding so often I didn't have time to recover in the interim between feeds. I was tired, so very very tired, and in excruciating pain. I was lathering coconut oil and nipple cream on to try to get relief. 

This was exhausting and upsetting. I felt so defeated. One week in I had my doula come by. She weighed him before and after and he took in so much milk! She adjusted the latch and it did help. She gave me some tips on how to ease the raw feeling after a feed. Did you know a hairdryer on your nipples can help?! Also rubbing breastmilk on them can help too! I felt so much better that she saw me! I felt a renewed sense of ease. Everything would be fine now. 

Despite a slight improvement, most of the feedings were still painful, but we pushed through. Something just felt wrong. It shouldn't be this hard I kept thinking. I started researching. What my doula had said at his birth stuck in my head and I went off on a tangent researching lip and tongue ties. As an SLP, I feel like I should know about this! Why were we not taught about it in grad school?! 

So now here I am bleary eyed and sore and researching at all hours what could be wrong with my baby- or with me. I had enough information to suspect that this tie was the issue. I sent my doula a video and photos of his mouth. She quickly said he had a moderate lip tie and posterior tongue tie. FINALLY AN ANSWER!! 

ONE MONTH: 
I immediately sought out a highly recommended surgeon to check him out. We had an appointment the next day, despite the craziness of the corona virus! Sure enough, he did have a tongue and lip tie. 

​This was right before the laser tongue and lip tie revision. Baby gets goggles to protect their eyes as well as anyone present in the room. The actual procedure was about 30 seconds in total. There was crying, of course, but we breastfed right after. The next two days baby was uncomfortable and would cry more frequently. Homeopathic medicine Camilia (used during teething traditionally) has been helpful. 

A few days later, I felt there was no progress. I think it actually felt worse. Baby was trying to latch, then arching back and screaming as if nothing was in there. So I tried pumping and got almost nothing after a half hour. Holy crap where was my supply?! Something was wrong. I reached out to a IBCLC lactation consultant. These are the top experts certified to know about how to help you breastfeed...But it was a teletherapy session because of the Corona virus. I got some great tips. Like for example, she knew his cries were gassy cries (how did she hear that I don't know) she told me not to have Fenugreek because it makes babies really gassy, and I should avoid dairy and chocolate and caffeine. Ah! gas! That's going to solve everything!! Finally! 

​So now I'm not eating dairy, or chocolate, not using fenugreek supplements..... and I'm still in pain! He is screaming and thrashing his body and I just want to cry and give up. 

Give up. 

The person who was not going to allow a drop of formula to touch my son's lips was thinking of giving up?! I felt so horrible. Now I know why people give up. I was so quick to judge before. I would think, "Don't they know how great this is for the baby? Have they not seen the documentary? Are people just selfish?" Now I understood. The pain, the screaming...it wears people down! You're so tired and vulnerable and it's SO EASY to say "I GIVE UP!" 

I started finding courses online about breastfeeding and tongue ties. No one can come over physically because of the Corona Virus, so I felt it was up to me to figure out how to make this work. This was my last effort. 

I found a great website that IBCLCs watch to learn and continue their education. I spent about 20 hours learning in between feedings. I watched lectures from IBCLCs, Dentists, Surgeons, Speech Pathologists (yes! some are great with this niche population), Chiropractors, Occupational Therapists, and Pediatricians. 

I was determined to become an expert in this!

​After many many hours of learning,I finally knew what I had to do... and there was SO MUCH to do!