Survival? Well, I don’t know. But it does sound catchy, and we did make it through with not a single drop of formula.
When the hospital’s pediatrician checked Tova he told Yitzchak, “Just so that you don’t sue me, she has tongue tie. It shouldn’t cause a problem for nursing and in 90% of cases it doesn’t.”
When Yitzchak brought Tova back to me (note: in Hadassah Ein Karem they don’t separate you for a minute; in Soroka it took two and a half hours before she was brought back to me, during which time Yitzchak was with her for all except five minutes) he told me what the doctor had said. Angry as I was at how the birth had gone, the birthing-factory treatment (they have 20 delivery rooms and no competing hospitals) and how I was being treated like an idiot (thanks, Soroka), I rolled my eyes, thought, “Oh, great; a nursing mother’s nightmare,” and asked why they hadn’t clipped it. Yitzchak told me it shouldn’t be a problem, and I hoped that he was right, while reminding myself that he was the sane one at the moment (and I was the exhausted, hormonal one).
After a few days, we brought Tova to the pediatrician because we were concerned about her jaundice. The jaundice, thank G-d, turned out to be fine, but the pediatrician asked to weigh her (fine by me, since I hadn’t taken her to the well-baby clinic to check her weight yet) and discovered that her weight was not fine; I think she had gained 50g. We were to come back in three days.
Three days later she had gained only another 30g.
Three days after that, we came back again. This time, she was already over a week and a half old and hadn’t yet regained her birth weight – and at the rate she was going, we weren’t sure when she would.
At two weeks, she still hadn’t. I don’t remember when it was, but there was a week in there that Tova gained only 70g – slightly less than half of what she should have gained.
I remember that during this time my mother called and asked how we were doing. I said we were fine and thank G-d everything was going pretty good. And as I said it, I thought of how ironic it was. Shlomo had bronchiolitis (or bronchitis, not sure which) and was on antibiotics. Tova wasn’t gaining weight and the pediatrician, Dr. R., had sent us for a pee test and told me to pump, see how much I got, and then feed her the bottle to see how much she took, and had given us a referral for the ER just in case she did XYZ (don’t remember what). I was sore, overwhelmed, and dealing with excruciating pain every time I nursed. Yitzchak and I were barely sleeping, despite being blessed with a baby who, if left to her own devices, will give us a decent night’s sleep. And with all this, I told my mother I was fine.
Then we did a nursing test. I brought Tova in, she was weighed, Dr. R. put me in a private room to nurse, and then 40 minutes into the nursing session Tova was weighed again. To our credit, she had gained 85g. Not all would stay, obviously, but it meant that she had eaten quite a bit. Don’t tell the pediatrician, but a good portion of it was squirted into her mouth, since she wasn’t nursing well. Not that it mattered, of course: the point was to see how much she was getting, and it didn’t really matter which of us was doing the work, as long as it did the job. To my dismay, the previous day’s “cheating” backfired: I had sent her to be weighed just after a meal, so that the scale would show more. It wasn’t enough, obviously, and when she was weighed, hungry, the next day it looked like she had “lost” weight. I didn’t tell Dr. R. why she had “lost” weight; it was enough that to see that she obviously could get enough and officially rule out milk supply as the issue (it wasn’t the issue and I knew that, but we had to prove it).
Several times along the way we were suggested formula – starting in the hospital. Because even a single bottle of the stuff can do permanent damage to a baby’s gut, Yitzchak and I have started calling formula “medicine”. It is lifesaving when medically necessary and potentially damaging in any other case. What parent gives their kid medicine when it’s not medically necessary? And what parent will expose their kid to something even potentially damaging, if there is another option? Thankfully, our pediatrician was as reluctant as we were to add formula and gave us other options.
The “other options” weren’t fun, though. The next step was to see if she would gain weight if enough food was forced down. So, Dr. R. told us to nurse every two hours, maximum every three at night, and come back in two days. If she hadn’t gained at least 50g – well, let’s not think about that.
We did it. And thank G-d, she gained 70g in those two days. In other words, problem found, and it was a simple, easy-to-fix problem. Tova wasn’t eating enough, and therefore wasn’t gaining enough. Thank G-d, a million times over, that that was the problem.
However, since she was such a weak nurser, and didn’t want to be nursing so often, each feeding took about an hour. Every five minutes, we were waking her up. At one point, I was pumping in the evening, refrigerating the bottle, and Yitzchak was feeding her one of the late-night feedings so that I could sleep a bit. (After all, I was only three weeks postpartum.) Other times, Yitzchak gave the bottle I’d pumped earlier, while I pumped a new one.
You know that there’s something wrong when it’s easier to pump than it is to nurse.
Thankfully, I had a hospital-grade pump from Yad Sarah and could easily get 80-90 ml in about 20 minutes (from one side). Let’s hope that when I go back to work and have to pump, I still have an easy time pumping the amount that she needs.
For a week, I nursed every two hours during the day and every three at night. Ten feedings a day.
We asked the pediatrician – maybe it’s the tongue tie? We were told to go to the ENT; the place where he does it, and he himself, will not clip a tongue before the baby is 8-10 months old.
Then it was every two hours during the day and every four at night – for another week. Nine feedings a day, she said.
Then we got permission to let her sleep – no more than five hours – at night, but we still had to do every two hours during the day. Eight feedings a day; don’t do any less.
Then I realized that the usual postpartum breastfeeding pains had gone away, but Tova was STILL hurting me every time she had nursed. I managed to keep her from making my nipples bleed, but the dark lines on the tops hadn’t gone away, and my nipples would often continue to hurt for an hour after each feeding – which in those days, meant that the side I had nursed on hurt pretty much until the next feeding.
It suddenly occurred to me that maybe her gassiness, my sore nipples, her difficulty gaining weight, and the long nursings, all had a common cause: TONGUE TIE. I went online, asked if I was on the right track, and asked for referrals. I was given two names: Dr. C., a surgeon in Be’er Sheva, and Dr. K., a surgeon in Ashkelon. Be’er Sheva is closer, so Be’er Sheva it was. I asked for a referral and Yitzchak took her in. Dr. C., and all of Soroka, will only clip the tongue when the baby is at least a year; we should wait and see if it interferes with her speech development. Yeah, and what about the nursing?
[Then Tova got a cough and we borrowed a nebulizer from Yad Sarah, bought a mask and saline solution, and “masked” her three times a day for five days. Dr. R. wanted to see her again just to make sure that she was able to breathe okay. And we got another list of things to watch for and another just-in-case ER referral. Thank G-d, these referrals were never necessary.]
Then Dr. R. told us to go the Tipat Chalav (well-baby clinic, where nurses check development and give vaccinations) and that she was officially dismissing us. Thank G-d.
I made an appointment with the surgeon in Ashkelon. He, I had heard, would clip the tongue in the clinic, on the spot. He was on vacation for a few weeks, so I took an appointment the first day he was back.
We went back to the pediatrician to get another referral. Dr. R. doesn’t like surgeons; she prefers ENTs. So she went to ask the ENT herself, partially to make sure that it was really impossible and partially because maybe if she asked the answer would be different. It wasn’t, and she gave us the referral.
In addition, for the past month or so, Tova’s poop had been forest green. Dr. R. said it could be because she had a cough, but sent us for a stool culture. Thank G-d, it came back negative and the doctor said we didn’t really need to do it after the color changed back, even if it wasn’t perfect. But we did it anyways.
So, we went to Ashkelon. And I took Tova on a bus, by myself, to Ashkelon. We left at 1:30pm and came back at 7:45pm. She was two and a half months old, and still taking an hour to nurse. Both buses were late, so I arrived 40 minutes late. Thankfully, Dr. K. still took us, and even forgave us after I explained what had happened. He asked some questions, including one that surprised me – if milk spilled out the side of her mouth while she ate (it did). Then he checked her tongue, expressing surprise at how far the frenulum was tied, “It’s tied practically to the end.” (Dr. C. had said it was “borderline”.)
Then he took out a sterile kit with scissors, a long q-tip, and asked me to hold her chin. Using the q-tip to hold the tongue up, he showed me what he was about to cut, took the scissors, reassured me that the crying was okay and I shouldn’t worry, and clipped. It took about two minutes. There was a bit of blood, but after another two minutes it had all but stopped bleeding. Tova, the sensitive baby that she is, cried hysterically for long after the bleeding stopped. Dr. K. said that she would calm down when I started nursing – and she did. I took her to a corner of the waiting room and nursed.
She latched easily. She sucked fast. It took 40 minutes, but not 40 minutes like the previous 40 minute nursings had. Previously, when I stopped after 40 minutes, I felt like she hadn’t finished but didn’t have the energy to argue. This time, I was pretty sure she’d eaten enough. And – what had been sore still hurt. But as any nursing mother knows, previous sore spots and new sore spots feel different. There were no new sore spots. And she didn’t leak milk.
I went to the wheelchair bathroom (that’s what you do with a stroller; this one happened to have a change table, too) and changed her diaper, which had leaked. It had been full before the doctor clipped her tongue, but for obvious reasons, I nursed before changing her. Since Yitzchak had forgotten to pack me wipes, and I had decided not to ask because obviously he hadn’t forgotten, I had to clean Tova in the sink.
We went home; Tova pooped on the first bus; I nursed her on the second bus, stopped just before I had to get off, and finished nursing her fifteen minutes later when we arrived home.
When we got home, a few things happened:
1. YItzchak changed her diaper – and her poop, which had been green when I changed her diaper in Ashkelon, had suddenly turned mustard yellow again.
2. She went back to nursing for an hour. Luckily, this was temporary. Now she nurses for twenty or thirty minutes; more than that happens, but not often. She can eat every two and a half or three hours. I am starting to trust Tova to tell me when she’s hungry. But I still want to weigh her again, just to make sure I’m not making a mistake by trusting her. She still spills milk sometimes, but after she finishes nursing, not while she’s still attached.
3. Nursing didn’t hurt anymore. After two and a half months of torture – it didn’t hurt anymore! I’m still in shock, a few weeks later.
I have a life again. When I was nursing an hour out of every two, this is how my day looked:
Pee and drink OR eat OR shower
Poop and eat a bit
Shower and get dressed
Put in a load of laundry
Get the point?
In three words: It Was Awful.
But we did it. Without a single drop of formula to ruin our baby’s gut. If I hadn’t read up on the subject of formula, nursing difficulties, and tongue tie, I wouldn’t have made it.
If Yitzchak hadn’t been so helpful and supportive, I wouldn’t have made it.
And next time they tell me in the hospital that my baby has tongue tie, or I see that my baby has tongue tie, I will wait a week to see if the weight gain is normal. And if it’s not, or the baby isn’t latching well, I will make an appointment with Dr. K. in Ashkelon and take the baby to get its tongue clipped at three weeks instead of at two and a half months.
I tell this story for a few reasons:
1. It is therapeutic for me to write it. Very therapeutic. This post has taken me about two hours to write, and I feel so, so, so much better now.
2. If this post helps anyone else, I will have done a lot.
3. I believe that it is important. Important to write about nursing difficulties, important to know that they can be overcome, and important to be educated.
I do not tell this story because I want everyone to know that I, Chana of Little Duckies, gave birth to a tongue-tied baby and am a radical anti-formula mother who insisted that her baby will have no medicine that is not medically necessary.
I would rather be able to choose who I tell my story to and who I do not tell my story to; this choice vanishes the moment I write the story on the internet.
But it is important, it can be done, and if any of you are in Maccabi in the south of Israel, use the “contact me” page and I will try to help you out. After all, it was another mother online who helped me.