Wednesday, 20 November 2013

This is my life now

I should probably update all 4 of my readers on how things are going with me and baby Rosie. :)

As it turns out, I have low milk supply. This is not a surprise, considering her tongue tie prevented her from sucking effectively from the very beginning. I have never had any engorgement issues, I barely leak, and I rarely feel that tingly, let-down reflex that happens before or at the beginning of a feed. All of this happened regularly with my previous children, so I know it isn't my fault! (poor baby gets all the blame)

Getting the tongue tie fixed was an important step in rectifying the situation, but it wasn't a magic panacea that I had secretly hoped it would be. She was gaining weight, but far too slowly; in a four day stretch, she had gained 9 grams, when babies should be gaining 20 grams per day, at minimum.

This wasn't good, and was a clear indicator that my supply is low. The next step was procuring an electric pump, pumping milk at least 8 times a day, and feeding her the expressed milk afterwards. After a weekend of the new regime, Rosie gained 60 grams! What a huge difference. We're still not at her birth weight, and she's not gaining the minimum of 20g/day, but we're close to both.

Unfortunately this is kind of a long-term arrangement. She needs a good 4-6 weeks of this treatment before we can start considering ourselves out of the woods, weight-gain wise, and for my supply to be enough for her to take 100% straight from the tap, as it were.

The good news is that all this pumping is doing good things for my supply. I am able to pump a bit more milk each day, but I can't always get the milk into her tummy! She prefers milk from me, which is good of course, but she also needs extra calories that she can't always drink on her own. She sometimes will take a bottle of expressed milk, but it's not reliable. I have a tube for an SNS system, and I've heard that you can make your own out of a regular bottle, so I'm going to look into doing that. When I'm not tired and overwhelmed, maybe? Ha haha!

I've read a book about making more milk, and the suggested mathematical equation to work out how much supplements a baby needs gives me a figure of 10oz a day for my baby.

I honestly don't know how I'm going to manage that! I am almost able to pump that amount, but if she won't drink it, then what? More questions to ask my health professionals, I guess.

As for galactogogues, I am eating oats like crazy. Porridge, granola, flapjacks, etc. I add brewer's yeast to my porridge, and I was taking fenugreek over the weekend, but it made the baby constipated. Woops. I'm going to try again with the fenugreek, but with the addition of blessed thistle. Taking them both together helps with effectiveness, apparently. Fingers crossed.

I have 14 oz of expressed breastmilk in the freezer, as well. This is my "back-up" supply, in case something happens like yesterday when I was heating a container of milk for the baby and it tipped over in the jug of water and the lid wasn't on tight enough... nightmare! Water got into the milk, making it watery and unpalatable for baby. She absolutely refused to drink it so 2 oz went down the drain. Sigh.

This is a huge learning curve for me. I sometimes feel like my head is going to spin, with all the rules of safely handling breastmilk, juggling containers in the fridge and freezer, remembering to pump and desperately trying to get that milk into her tummy, and counting out ounces of breastmilk as though I am handling fluid gold. I am grateful I've never had to struggle with breastfeeding before now, and that I've been surrounded by so much positive support during these past few weeks.

So yeah. Feed, pump, supplement. Wash, rinse, sterilise. Feed, pump, supplement....

It's working, though! She's gaining weight and growing.

Also, she's smiling. *heart melts* She's worth it, for sure.

Friday, 8 November 2013

Baby update! Posterior Tongue Tie Edition.

It looks like my sweet little baby has a posterior tongue tie. A tongue tie is when the frenulum (the skin that attaches the bottom of your tongue to the floor of your mouth) is too tight and inhibits tongue movement. It's strange, because there were a few warning signs but because I'm not in pain when I feed her, I never really considered it.

But, here we are, at 4+ weeks, and she still hasn't achieved her birthweight. She gained a bit last week (hurray!), but didn't put any weight on at all this week. In a growing baby, this is not good at all!

I've done all that I can to get milk into her belly, aside from using a funnel (no, I wouldn't do that!), and we're treading water. Thankfully, even though the signs of a posterior tongue tie are subtle, we've been able to catch it. Warning signs include:

  • A flat tongue. When she cries, her tongue doesn't/can't reach the roof of her mouth, and it stays pretty much completely horizontal. It can't curl up on the edges like a hot-dog bun, either. In essence, her tongue can't flex and grip the breast tissue effectively, so there just isn't as much milk flowing.
  • Bevelled nipple shape. After a feed, the end of my nipple is shaped like a new tube of lipstick. My older children even noticed this one, but I had no idea it was a sign of problems!
  • Bubbly spit/drool. When I read this elsewhere on the internet, I was dumbfounded. We had all noticed that she had bubbles in the corner of her mouth sometimes, but I just wrote it off as a baby drool thing. Nope - another possible warning sign.
  • Losing weight/poor weight gain. This one is kind of obvious, because she just isn't getting enough milk to grow properly. I've been pumping and assisting her feeds by using breast compression techniques each time, but baby is usually better at getting the milk out than any other method. The poor dear just can't manage it with her tongue as it is.
There are other signs/symptoms, but they relate more to the fact that baby isn't taking in enough milk - frequent feeds, not enough dirty or wet nappies, and so on. 

The funny thing is, that once I started with compressions during feeds, her poo-and-pee count went up. From the outside, she really seems fine. But now that I know there is a problem with her tongue, I've realised that her latch isn't the best at all. I can feel her tongue sort of losing its grip during a feed, and she often makes clicking noises during a feed, when she loses suction. She is trying terribly hard to get enough milk, but her tongue just isn't cooperating! 

Just today I noticed that when I feed her at a certain angle, she manages to take in the milk much more easily. It seems like our reclining couch is the best place, with my feet up and my torso slightly leaning back. She is more on top of me rather than in front of me, and I guess her tongue doesn't slip and slide so much in that position.

Hopefully this challenge will pass quickly, however; we have an appointment tomorrow to get it officially assessed and hopefully snip the tight bit of skin to release the tongue. I am very excited about the prospect! I really look forward to watching those scales increase in numbers while her legs get chub rolls and my milk starts flowing faster. It isn't a magic cure; she will have to re-learn how to breastfeed essentially, since she's never used her muscles in that way before. But we'll get there!

I'm so relieved to have a cause for her struggles. The idea of a mystery ailment bothered me greatly, and made me worried for the future. Now, so long as everything goes well tomorrow, we can expect positive changes and turn things around for her.

As much as I love having a little baby and don't want her to grow up too fast, I really do want to grow bigger!