Shane's Nursing Story

Having breastfed before (and being a LLL Leader) I just assumed things would go smoothly for me this time. I wanted to hold and nurse Shane immediately after birth, but because there was meconium in the fluid they had to take him off to the side and suction him. I did get him a few minutes later, though, and as soon as I got to hold him I brought him right to the breast. He didn't even attempt to suck, but I kept trying every few minutes. Sometimes he wouldn't open his mouth at all but he'd lay his cheek next to my breast and fall asleep, and sometimes he'd open, I'd put the breast in his mouth...and he'd fall asleep! It was like he didn't have a sucking instinct! I'm not sure of the time frame of everything, but he hardly nursed at all that whole first day. Occasionally I'd get him latched on, but it took forever. He'd scream and scream, and I knew he was hungry, but he just couldn't get it. And when I did get him to nurse it just didn't feel right. It looked like he was latched on right, but he wasn't sucking properly. The nurses thought I was nuts (they had a really weird attitude towards me because they knew I'm a LLLL), but by the second day when Shane still wasn't nursing well I called an IBCLC to come to the hospital. They don't have one on staff anymore and the nurses just couldn't help us. I felt like a real idiot, and even the LC acted like I was over-reacting. First she checked Shane physically (for a tight frenulum, cleft palate, etc.) and said he was fine. He didn't want to open his mouth more than a tiny bit, though. She taught me how to squeeze my breast to make it easier to put in his mouth (it's called a "nipple sandwich" - cute, huh?), and that seemed to work pretty well. Shane still had a hard time and would cry a little before I could get him latched on, but I thought it was getting better.

He slept with me and nursed pretty well all that night, and nursed almost constantly the third day (we went home that morning). I really thought we were on the right track. Then my milk started coming in. It didn't come in all at once like it did with Jakie; it came in gradually over about the next 24 hrs. I got engorged and Shane couldn't latch on at all! He would scream and scream and scream, and it would take me 1/2 hr. - 45 minutes to latch him on, and by that time we were both exhausted and I would be so upset that the slightest word from Greg would make me break out in tears. I don't know how we did it, but we just took one day at a time. Some days were better than others, but for the most part nursing was very difficult. Shane got a little better at latching on, but not much. And when he did get latched on, whenever the milk would let down it would break his suction and he made a loud clicking sound (from the lack of suction) with every suck. Once the milk slowed down he would usually be able to get the suction back, but the letdowns upset him so much that he couldn't do much comfort nursing. He'd try to, but when the milk let down it would wake him up and upset him so he'd let go. Consequently he nursed almost constantly, probably because he wasn't getting enough hindmilk at each nursing session. I could tell Shane wasn't sticking his tongue out far enough, and I tried everything to get him to do it. I tried oral exercises to bring his tongue out, but every time I'd put my finger even a tiny bit inside of his mouth he'd gag, sometimes to the point of throwing up! For some reason he has a hyper-sensitive gag reflex. I tried "mirroring", where I'd stick my tongue out, trying to get him to mimic me - no luck. I tried every nursing position I could think of, including him laying on his stomach on top of me or sitting up, to bring his tongue forward, all to no avail.

When Shane was 3 1/2 weeks old I got my first case of mastitis, probably because he wasn't emptying the breast well enough. Some parts would get emptied well, but because of his poor latch-on he would miss some parts of the breast, and I guess some of the ducts got plugged. Anyway, I'd been through it before (twice w/Jakie), so I knew what it was & I called the midwife right away for a prescription. I'm not big on antibiotics normally, but I know from prior experience not to mess around w/mastitis! I still ended up w/a 104 degree fever, but it went away relatively quickly because I started treatment right away (abx., hot compresses, rest, nursing, etc.)

When Shane was 6 weeks old I was playing w/him while changing his diaper and I got a good look at his tongue. Because the LC said he was fine it didn't even dawn on me to check, but he obviously had a tight frenulum!! I felt so stupid for not noticing before! It wasn't mild, either. It was very short and attached almost to the tip of his tongue. I knew he had a problem with not bringing his tongue far enough forward while nursing, but then I realized it was because he *couldn't*! I spent the next week searching for a dr. to do a frenotomy on Shane, which was a much bigger ordeal than I expected. I talked to or saw ENTs, oral surgeons, pediatric surgeons, pediatricians, and dentists. Most of them either had no experience with the procedure or claimed to have experience but insisted on using general anesthesia. One even insisted he had to *remove* the frenulum, not just clip it! Fortunately I knew what the procedure should involve, so I kept looking. I finally found a very experienced ENT (almost 2 hrs. away from my house!) who would do it. He had 2 nurses hold Shane down (I couldn't stand watching this - every bone in my body screamed out for me to snatch him up in my arms!), then he held the tongue and just made a quick snip in the frenulum with a pair of surgical scissors. I was worried about him not using any anesthesia (he says babies seem to have more complications from the anesthesia than from not using any at all), but I honestly don't think it hurt. There was a tiny bit of blood, but although Shane was hysterical from being held down, it never changed to that "pain cry", you know? He never acted the least bit sore afterwards, either. Unfortunately his nursing didn't improve much either. If he'd have had the frenotomy at a few days instead of 7 weeks, it probably would have completely solved our problems, but Shane was already used to nursing the wrong way. It's been 8 weeks now and although he's improved some he still has problems. He latches on much better now and sometimes even opens his mouth wide, but most of the time I have to let him "suck the breast in" (which is getting more painful now that he has teeth - he just got his second tooth 2 days ago). He has a very hard time staying latched on, though, unless I support my breast well throughout the whole nursing. He still does the "clicking" (breaking the suction) when the milk lets down most of the time too, although some times he does better than others. The frustrating part is that now I know he *can* do it, but he just doesn't. I have a lot of hard feelings towards the LC I saw in the hospital - she should have noticed Shane's tight frenulum!! If she had, I wouldn't be going through all this today.

For the longest time I wasn't able to nurse Shane laying down, so although I slept w/him I had to get up every time he woke and nurse him sitting up in the living room. It made for some very long nights! Now I'm able to nurse him laying down, so thankfully I don't have to get up at night, but he still needs more help than he should. I usually sleep with a very dim light on so I can help Shane latch on right. Because it's such an effort for him (sometimes he gets so worked up he breaks out into a sweat!) he tends to nurse a lot less at night than he would if it was easier. Sometimes he'll stir a little and put his lips to the breast, but then he'll fall asleep because he's just too tired to make the effort. :-( I have to pump after he goes to sleep at night, to make sure my breasts are emptied well enough so I don't end up with mastitis. I got it again anyways a couple weeks ago, and I've felt it coming on a few more times, but have been able to head it off before it got bad.

Things have gotten much better since the early days (thank goodness!), but it's been very hard to let go of my expectations of the "perfect" nursing relationship. Because I have to support the breast for Shane to latch on, it pretty much rules out discreet public nursing. Oh, and when we do try to nurse in public the stimulation seems to really throw him off. Even when he's obviously hungry he acts like he's forgotten what to do and has a very hard time nursing! He even did this at home the other day when my Mom was over. We were talking and I think he just heard her unfamiliar voice and he couldn't latch on! She went outside to play w/Jakie for a while & he latched right on. Weird, huh?

Even with everything we've gone through I still wouldn't trade our nursing relationship for anything in the whole world. Seeing my sweet little baby get that blissful drunk look on his face when he's nursing makes it all worthwhile! :-)

This story was originally written on June 21, 1997, when Shane was 3 months old.

UPDATE - August 27, 1997: Shane's nursing has improved very slowly ever since the frenotomy, but he's made some pretty big strides in the past month or so. I'm now able to nurse part of the time without supporting my breast, making it easier to nurse in public. It's still not as easy as it should be, but he's getting stronger and more able to hold the breast in his mouth by himself. We can also nurse at night with the light off most of the time, which makes it much easier for me to get some sleep! :-) I do still have to use the breast pump every night after Shane goes to sleep, to make sure all parts of the breast get emptied, since he still doesn't latch on quite right. I've had 3 cases of mastitis now and 1 plugged duct - I'm hoping to avoid any more! I'm pretty sure, in addition to having had a short lingual frenulum (under his tongue), he also has a short labial frenulum (connecting his upper lip to his gums), making it hard for him to flange his lips out and nurse properly. Anyway, I've quit looking for "solutions", and have accepted what we have. Shane is gaining well and growing beautifully being exclusively breastfed, and when he stops nursing to give me a big grin it makes it all worthwhile! :-)

UPDATE - October 27, 1997: Shane still doesn't latch quite right, and I've had 2 more cases of mastitis, bringing the grand total up to 5. We've also still been battling thrush on and off, but I may have finally gotten rid of it with an aggressive course of gentian violet (keeping my fingers crossed!). I'm still pumping at night after Shane goes to sleep, but I'm going to try to "wean" myself off of it. Even with all the problems we've had, nursing Shane is the most incredibly rewarding, beautiful experience, and I wouldn't miss it for anything in the world.

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