Breastfeeding problems? Check inside your baby's mouth!

Today we are so excited to bring you another wonderfully informative post from our local friend and lactation expert Emily Heldt who runs Tree of Life Breastfeeding Counseling in Salem Oregon. Sometimes what some people might consider a "normal" hiccup in breastfeeding might actually be more of an issue. Lip tie and tongue tie are a common problem and today Emily will be explaining common signs and steps to treat it. 

Breastfeeding hurts. My newborn keeps biting me - it feels like she has teeth!
My nipples are cracked and bleeding
We have chronic thrush
My baby has a short tongue
I’ve had chronic clogged ducts and mastitis
My baby has reflux, colic, fussiness and gas
My baby isn’t gaining enough weight
My baby sleeps through most of the feedings
My baby can’t latch or can only latch with a nipple shield
There is a clicking sound during feedings
Baby chokes a lot during feedings
I’ve always had difficulty with supply
My milk supply “dried up” when my baby was 3-4 months old
Once her teeth came in, I had to wean because it was so painful
Everybody says things are fine, but something just doesn’t feel right

Do any of these sound familiar? Have you ever examined inside of your baby’s mouth?
All of these things can be linked to a lip tie (LT) and tongue tie (TT), which usually come together. Most of us have frenulums in our mouths, which are pieces of tissue that help anchor our tongue or lip. Having a frenulum isn’t a problem unless it is tight enough to restrict normal function.

LT/TT can be very frustrating and very complicated. What can make it worse is that many providers, including IBCLCs, ENTs and pediatricians may have never heard of LT/TT or may only look for the more classic heart-shaped TT when there are several different types (including posterior tongue ties that can be incredibly difficult to spot) that can cause restriction and lead to problems with breastfeeding. What I often see in my practice are moms who have seen multiple providers, tried various things and breastfeeding still isn’t going quite right. I recently saw a mother who had seen 6 lactation consultants before me as well as their pediatrician who all said there was no LT/TT when in fact her baby had a significant one.

Historically, ties were snipped often right after the birth by midwives or in the nursery without the parents even knowing that it had been done. As we got away from breastfeeding being the norm, knowledge on ties kind of fell by the wayside.

LT/TT can impact each mom and baby differently. Some babies may not be able to latch at all while others seem to do okay for a while. Babies are incredibly smart and can sometimes compensate for their inability to feed well by developing different habits, but often these compensations lead to other problems (lip blisters, easily exhausted at breast, painful for mother, biting, etc.) or they may only be able to compensate for so long until it becomes obvious that they aren’t breastfeeding as well as they should be.

Outside of breastfeeding, there are many things that LT/TT can also impact – speech, reflux, palate development, need for orthodontia work due to crowding or diastema (space between teeth) plus lots more.

So what if your baby has a LT/TT? It is important to know that there is no one magic treatment; however, a procedure where the frenulum is either clipped by scissors or lasered is an important part of normalizing function. My favorite resource to connect families to is the Tongue Tie Babies Support Group on Facebook. This is an amazing group that maintains an up-to-date listing of LT/TT knowledgeable providers who clip or laser frenulums all over the world. They also have files on pre and post treatment recommendations that include supportive homeopathy and bodywork. If you haven’t already, find a local IBCLC who is knowledgeable about the different types of ties who can evaluate in person what the ties look like and how they function, assist with latch, discuss resources in your area and help with suck training.

For more information, check out: 
http://kiddsteeth.com
http://www.brianpalmerdds.com
https://www.facebook.com/groups/tonguetiebabies/

Thank you Emily for this great post and link to resources that may help a few mama's that are struggling with breastfeeding with little improvement. As Emily suggested if things don't feel right seek local help. 

Emily Heldt, IBCLC is a former doula and homebirth midwife who now works as a lactation consultant near Salem, Oregon. She teaches childbirth preparation and breastfeeding classes for families as well as classes for medical providers on how to better support breastfeeding mothers and babies in their practice. She is passionate about early identification of LT/TT and has recently started teaching classes to help other providers recognize them. For more information, check out Emily's site for Tree of Life Breastfeeding Counseling at SalemNaturalChildbirth.com or on her Facebook page https://www.facebook.com/pages/Tree-of-Life-Breastfeeding-Counseling

Breastfeeding essentials 1,2,3,

As a first time pregnant mom I remember roaming the isles of a baby store with a scan gun at hand trying to think of anything that I might need for the baby. Especially with feeding. I knew I wanted to breastfeed and I really wanted to be successful but what in that isle would do that... ? That question was a little overwhelming.

Well mamas I have good news for you. There are three essentials that you will not have to purchase in the store. In fact you will already have them. Today we are privileged  to have a special guest post from IBCLC Emily Heldt she runs Tree of Life Childbirth Education and Breastfeeding Counseling here is Salem OR. She has broken down  the top three most important things that could help lead you and your baby to a successful breastfeeding relationship. Keep reading if you want to find out. 

Tree of Life
Childbirth Education and
Breastfeeding Counseling

Emily Heldt, IBCLCServing Salem, OR and surrounding areas(503)580-3535emily@salemnaturalchildbirth.com

When our drive is to normalize breastfeeding and educate in order to increase breastfeeding success what are the essentials?

1.BIRTH – Having a normal physiologic birth, which minimizes trauma to both mother and baby is truly important to getting breastfeeding off to a good start. But mothers who don't have an ideal experience and need to utilize necessary interventions that may cause side effects to breastfeeding can begin to set that foundation as soon as baby is able to be in their arms again. Doing skin to skin as much as you are able is a perfect first essential. I often say that it is my #1 tip for successful breastfeeding. It keeps baby close for easy access, they get exposed to mom's bacteria, which is important in colonizing their gut, your breasts heat up or cool down to help keep their temperature stable and it decreases incidence of severe jaundice and excessive weight loss, which can both lead to supplementation recommendations. Don't delay it and don't let anyone stand in the way of that precious time.

 2. YOUR BABY – Your baby is born with reflexes that are perfectly designed to help him or her find their own way to the breast without any help beginning immediately after they are born. This is survival instinct at its finest. 

In many other countries, women typically lie back either totally flat or semi reclined and nurse baby while baby is straight up and down or at an angle. These positions allow for babies to use these reflexes to find their own way to the breast,  they can root around, smell (the areola contains Montgomery glands that secrete a substance that smells like amniotic fluid and helps to draw them toward the breast all the while practicing opening their mouths widely and dropping their tongues in preparation to latching on well (http://biologicalnurturing.com/). Babies can do all of these things in the first few hours after birth if they are left alone and given the time and space to explore. 



3. YOUR BREASTS – In the beginning after baby is born, you have colostrum in your breasts. I like to call colostrum “yellow milk” or “first milk.” There is a common misconception that colostrum is inferior, or moms need to supplement “until my milk comes in” or that there isn't enough milk for the first several days. Colostrum is a highly specialized milk (http://www.llli.org/faq/colostrum.html) and there is plenty of it as long as baby gets frequent access to it – no “back up” formula needed! It is specially designed for the first several days to provide baby with loads of fat and protein, lots of immunities and also serves the purpose of coating their digestive tract, the benefits of which last a lifetime. Unnecessary supplementation during this time can erode that coating and interfere with baby's ability to assimilate some of the essentials in the colostrum. Colostrum is thick and comes out slowly so baby learns how to suck, swallow and breathe, which are tough to learn how to do! Baby's tummy is also very small in the beginning and they only need a small amount each feeding – in the first day, their tummy is about the size of a shooter marble, by the 3rd day it grows to be about the size of a ping pong ball and by about day 10 it is the size of an egg. 



And one last tip to moms: 


How your breasts feel will vary in the first several weeks, but that feeling alone isn't necessarily a good indicator of what is going on with your supply. Some moms feel some slight engorgement once the white milk comes in and then never feel any other sensations in their breasts for the rest of the time that they are breastfeeding. The biggest concern that new moms have is “am I making enough milk?” As long as baby is gaining and having plenty of wet and poopy diapers, your supply should be ample. If there is pain, baby isn't gaining well, has worrisome jaundice or is not having plenty of wet and poopy diapers, make sure to get in to see a lactation consultant ASAP. It is not as common for a mom's milk supply to be low as it is that the baby's latch is off slightly so baby is not getting full access to all of the available milk. 


Thank you again to Emily for writing this super informative post. Please feel free to check out the awesome online resources she has linked in  her post and also if you are in the Salem area as well as surrounding cities and need some birthing or breastfeeding guidance don't hesitate to call Emily herself.