It has been awhile since I've written and it is hard to believe that my daughter and I have been breastfeeding now for over 15 months! Wow, has it ever been a journey! But overall, it has been an experience that has been so worthwhile! If you told me in the early days of our journey that I'd still be breastfeeding at this point, I'd probably be a bit surprised (pleasantly).
Over the past several months, I've been thinking a lot about our breastfeeding journey, and analyzing several aspects of it. Tonight in particular, I was thinking a lot about it, which led to the need to write and document some of my thoughts...
For those of you who read this blog, you know of my history breastfeeding after reduction. Since the time I was pregnant (and even before then), I knew I might have difficulties breastfeeding because of my previous breast reduction surgery. In the beginning, I felt that my supply was enough to feed my daughter and was surprised (although maybe I should not have been) and devestated when our midwife said we needed to start supplementing and trying to increase my milk supply. This was after my daughter lost a little more than 10% of her birth weight and was regaining weight a bit slower than the midwife wanted to see (although she did seem to be gaining at least 1/2 oz. per day, which they told me to expect).
In the beginning, there were a number of symptoms besides slow weight gain (for example, excessive gassiness, sleepiness at the breast, green watery stools, etc.). Many of these symptoms could be related to low milk supply. Others we thought were just normal newborn things, a result of too much hind milk, etc. I also had several symptoms from the beginning including a hospitalization at 9 days postpartum with a suspected cause of mastitis, continuously sore nipples (they are often still painful to nurse), nipples that would not fully heal until well after 1 year of breastfeeding, and more.
After the postpartum period was up with my midwife, I started going to see the lactation consultants at the hospital that I was admitted to at 9 days postpartum. At the clinic, they would watch us breastfeed and do before and after weights. There were a few things that I noticed in the beginning that I thought were strange but the lactation consultants passed off as normal, or attributed to my breast reduction. One thing was that whenever my daughter would latch, her top lip would flip in, and I always had to manually flip it out to get a proper latch. She never had one of the beautiful latches that I see in pictures. I also remember being so sad at some of the visits asking the LC, "how could she only have taken that much breastmilk?", explaining afterwards that when I tried to pump instead of a feed, I could get more than she was drawing out. That seemed odd to me, but I figured that the LC knew best and my breast reduction somehow was the explanation. I even remember the midwives and nurses in the beginning looking at aspects of my breastfeeding (for example, how fast my milk came in, being able to hand express [squirt] milk, and how much I could pump following a feed in the early days) and believing I had lots of milk and breastfeeding wouldn't or shouldn't be a problem.
I remember immediately after my daughter was born, noticing the deep V in the middle of her upper lip and actually asking my midwife if that would eventually go away. I had never seen a baby with that before. And, there were actually some other people who mentioned it as well. I didn't think it had anything to do with breastfeeding.
After months and months of research on low milk supply, and feeling like I had made such a mistake by having my breast reduction (I'm bigger now than when I had it done - partially due to breastfeeding), I started to think...maybe it wasn't just my breast reduction that caused the issues that we have had along our breastfeeding journey.
After researching more and more, and talking with friends, I've discovered that many of the symptoms that my daughter and I both had, could be attributed to a lip & tongue tie. One of the first things I came across (I didn't even put the symptoms and the possibility of this together until later), was the fact that her deep V in her lip could be because of a lip tie. My chiropractor actually told me that usually the deeper the V, the more extensive the lip tie. After that, I decided to take a look. Lifting up my daughters lip, I noticed an evident frenulum that looked to extend to the ridge of her gums, and possibly behind slightly to the top of her mouth. Now that her top teeth are growing in, there is a gap, although it is difficult to say if that will close with time.
After talking with a friend, she told me 2 things: lip ties generally occur with tongue ties and that lip and tongue ties run in families. I also recently read online that if a baby has a lip tie, it is unlikely for them NOT to have a tongue tie...in other words, if they have a lip tie, they most likely have a tongue tie as well.
Once I talked to my friend and learned from her, I went home and checked myself. After looking at pictures and myself in the mirror, examining my mouth, it looks like I do have a bit of a lip tie, although it doesn't extend past the gums. My friend told me that one test to check for a tongue tie is to try and touch the top of your mouth with your tongue when your mouth is open as wide as possible. If you can't, you likely have a tongue tie. I tried the test and sure enough, I can't quite touch the top of my mouth. Also, when running my finger along the bottom of my mouth with my tongue up, there is a frenulum ridge. Although minor, it looks like I might have a slight lip and tongue tie. In the beginning of my breastfeeding journey, I talked to my mom about my difficulties and found out that she thought she had a low milk supply too. I figured maybe it ran in the family and wasn't just because of my breast surgery. Looking back, maybe it was a slight tongue and lip tie that caused the difficulties.
So looking back at everything over the past 15+ months, I wonder if the difficulties that we have encountered were not due only to a breast reduction but because my daughter had/has diffculty with milk transfer, related to a possible tongue and lip tie. Even today, I experience issues such as nipple pain during breastfeeding, clicking noises while breastfeeding, etc. This experience has definately made me look more into the issue and will make me more aware in the future. Assuming that we have enough child, these are things that I'll be watching out for once again. And, if the same circumstances arise, knowing that ties often run in families, I will have my son or daughter assessed for ties early on. While I could be wrong (I'm not a medical expert), and people may say I'm just looking for another reason and I don't want to blame myself (that could partially be true), given all the symptoms that have occured since the beginning, this seems to be a real option.
Update: some of you have been wondering where I am at with my domperidone. Since the last time I gave an updated, I have completely stopped taking herbs. Also, last time I posted, I was still taking 120mg of domperidone (40mg 3x/day). I have slowly been weaning over the past 6 months or so (worried if I went any faster than my supply would diminish). I am now taking only 30mg (10mg 3x/day). I am hoping to be down to zero in the near future. Since I've gone done very slowly, I have not noticed any symptoms. And my milk supply seems to have reduced only a little bit, if at all. And, if it has reduced, that might be due to the amount of solids that my daughter is taking in. Although, I call her my little boobie monster since she still breastfeeds quite frequently (I work from home, which makes it convenient).