Sunday, December 29, 2013

A Little Situation

Before Bugs made me a mama, I would see newborns snuggled up with their mom or dad and I'd run up and politely ask to take a peek.  I'd get that "what a sweet baby!" giggle and I'd say something that I thought was appropriate-- something like, "oh my goodness! She (or he) is sooooo tiny!!"

I told you that to tell you this:  Before I began touring the country and performing with my husband, I worked for nearly 6 years at a children's gym.  So, when Bugs was born, I anxiously anticipated her 4 month mark so that I could begin taking her to classes there.  And it was fun!  She loved it and I loved it.  

Until we were getting our shoes on to leave.

It started with that comment that I once deemed totally appropriate and harmless.  The exchange went as follows:
Mom 1:  Oh, she is soooo old is she?
Me: 4 months yesterday.
Mom 1:, my friends 1 month old is bigger than her.
Me: *blank stare of confusion*
Mom 2: How much did she weigh when she was born? Was she a preemie?
Me: She was only 5 days early.  She weighed 7 pounds, 2 oz.
Mom 2: Oh, so she was average sized then.
Me: Yeah, I guess....she's my first.
Mom 1 to Mom 2: She's definitely not on the charts.  
Mom 2: *shakes head*
Me: But...but....she's hitting all her milestones.
Mom 3: What does her pediatrician say? Is he worried?
Me: He hasn't said anything.  Her weight is lower than a lot of babies her age, but that can be normal in breastfed babies.  Sometimes they have slower weight gain, sometimes quicker.  I think every baby is different.  And I heard there is a chart for exclusively breastfed babies that's a bit different.
Mom 3: Oh, is she ONLY breastfed.???

Say what?!?!  Yeah Bugs, my feelings exactly.

So, I packed up the Bug and headed home and directly to my computer where I proceeded to Google the bejeezus out of every growth chart,  every breast feeding website and Facebook page and every blog where a mother had a "tiny" baby. 

But, trust me when I tell you that if a baby is small, the mama knows this.  I knew it.  Bugs' pediatrician knew it.  It was never a cause for concern since she was healthy, hitting all her developmental milestones (sometimes earlier that average) and was an all around happy baby.  But, the onslaught of the Mommies 1, 2 & 3 made me doubt what I already knew to be true--she was getting everything she needed from "only" breastfeeding.

But I did learn an important lesson--much like dealing with pregnant women, the only truly appropriate thing to say is how wonderful they are!  Every pregnant woman needs to hear that they're beautiful and every new mom should get to hear how adorable her baby is and what a blessing she holds in her matter how light or heavy.

What is your favorite comment that you have received about your baby?

Friday, December 27, 2013

The Importance of Good Nutrition

We all know that breast milk is the best nourishment for babies (and don't forget toddlers!), but did you know not all breast milk is created equal? Everyone knows how important good nutrition is while pregnant, but what about while nursing? Eating right and putting the most nutritious things in your body will produce the best milk for your baby, full of all the antibodies and nutrients needed.

I follow a traditional style of eating, based on the teachings of Weston A Price. While I don't follow the recommendations to a tee, I do like to use it as a guideline for making sure I'm truly providing the best for my baby and myself. While WAPF recommends following every aspect of the protocol for pregnant and nursing mothers, I realize it isn't practical for everyone. Here are the WAPF recommendations, with notes on what I eat to make sure my nursling gets the best.

Cod Liver Oil to supply 20,000 IU vitamin A and 2000 IU vitamin D per day - I do take CLO, but please keep the warning at the bottom of this post in mind when supplementing with it. My favorite is from Green Pastures, which you can find here.

1 quart (or 32 ounces) whole milk daily, preferably raw and from pasture-fed cows (learn more about raw milk on our website, A Campaign for Real Milk, - I'm lactose intolerant, but I'm able to drink raw milk and all raw milk products from our dairy herd association with no problems. I'm not always able to drink a quart a day, due to production from our cow share. In the spring and summer, we get at least 6 quarts each week so it isn't a problem. In the late fall and winter months, we only get 1 1/2 or 2 quarts a week, so I do the best I can.

4 tablespoons butter daily, preferably from pasture-fed cows - This is an easy one for me! I LOVE butter. Seriously, don't tell my husband about the affair we have going. We use Organic Valley's pasture butter. It is the most delicious flavor and is packed with good levels of vitamins, CLA, and balances omega-3 and omega-6 fatty acids. I put butter in and on everything I possibly can.

2 or more eggs daily, preferably from pastured chickens - This is another easy one for me. I loved eggs during my pregnancy. More than I ever have before. I'm fortunate to get wonderful eggs from happy, pastured hens that my parents lovingly raise. Eggs from the grocery store just don't have the proper nutrition that pastured eggs do, so it is important to try to find a good source for high quality eggs. When my parents are out of eggs (they only have 6 hens), we buy them from a local health food store that sources them from a local farmer.

Additional egg yolks daily, added to smoothies, salad dressings, scrambled eggs, etc. - This one is hit or miss, but I always try to add in the nutrition of extra eggs whenever possible.

3-4 ounces fresh liver, once or twice per week (If you have been told to avoid liver for fear of getting "too much Vitamin A," be sure to read Vitamin A Saga) - I finally found a good source for liver, but I still couldn't bring myself to do it. I'm hoping to cross this bridge soon because I know the health benefits are worth it. Hey, I consider it a crime if my chicken stock doesn't have feet floating in it now, so I'm sure I can figure out the liver situation ;)

Fresh seafood, 2-4 times per week, particularly wild salmon, shellfish and fish eggs - Living in the Midwest, I don't have great access to fresh seafood. I'm also still a bit concerned about contamination in seafood, but I do enjoy sustainably sourced seafood (say that five times fast!) when I can find it and when it fits in our budget.

Fresh beef or lamb daily, always consumed with the fat - We have great access to the most delicious, locally raised, heritage breed meats! Boy was I glad when I found Grass is Greener Farms. They raise heritage breed cows, pigs, turkeys, chickens, sheep, ducks, and lambs. The bacon and sausage have the most fabulous, buttery flavor, and they melt in your mouth. The chicken and beef are so tender and packed full of healthy nutrients. We eat meat almost every day and always source it from our local farmer. Meat from the grocery store can be loaded with hormones and antibiotics which you don't want to pass on to your baby.

Oily fish or lard daily, for vitamin D - I use lard or bacon grease to cook everything. When made from properly raised pigs that are able to root and roam freely, these fats are superior to anything you can buy at the store and provide good levels of Vitamin D. I cook everything from eggs to vegetables in lard or bacon grease. If you've never cooked eggs in bacon grease, you are missing out!

2 tablespoons coconut oil daily, used in cooking or smoothies, etc. - I really love finding new ways to get more coconut oil into myself and my family. This stuff is like gold! Lately, I've been enjoying homemade hot cocoa with some coconut oil melted in. I use my immersion blender to make it frothy and creamy. I also love it in fudge, coconut flour muffins, and even straight off the spoon. My favorite coconut oil is from Tropical Traditions and can be purchased here. I order this stuff by the gallon.

Lacto-fermented condiments and beverages - I just started making my own fermented veggies this year. It was a little confusing at first, but a friend helped me out and now I've got the hang of it. The benefits of lacto-fermentation include everything from helping make food more digestible to providing you with plenty of healthy and beneficial bacteria. It's also known to increase vitamin levels.

Bone broths used in soups, stews and sauces - I can't say enough good things about bone broth!  It's always a staple in my house, but especially around the time of year when germs are rampant and everyone is getting sick. It's so simple and cost effective to make your own bone broth, and you'll never get the same goodness from a can or carton of broth. I started using this recipe and have since adapted it by trying different things. I always add chicken feet to my stock to give it extra collagen and gelatin. Yum!

Soaked whole grains - Soaking grains is really important for proper digestion and maximum nutrition. Soaking grains prior to consuming them helps break down and pre-digest the grains, making it easier for your body to absorb the nutrients.

Fresh vegetables and fruits - I think this one is pretty obvious and needs no explanation!

Of course we all indulge and splurge sometimes (my sweet tooth can get quite convincing, sometimes) but eating healthy overall is best for you and baby. Many people follow the 80/20 rule, eating healthy 80% of the time and not worrying about the other 20%. Do you eat healthy while nursing? Do you try to stick to good habits most of the time?

Read more details on fats here.

This post contains an affiliate link. If you purchase coconut oil from Tropical Traditions using my link, I may get a gift certificate for referring you. Your price will remain the same and you will get the same great quality product that I use everyday.

Thursday, December 26, 2013

Nursing Necklace Roundup

Last year at this time, I thought a lot about what my holiday would be like with an almost 10 month old baby.  To me, 10 months old seemed so far out.  I couldn't have even predicted how much different Christmas would be with an on the move baby.  Nor would I have realized the struggles involved in nursing a curious, distracted little one during the holidays.  I hear mothers say all the time that their nursling pulls off and squirms while nursing and they need to know how to fix it.  I have found a super simple solution...nursing necklaces.  You may not think that a necklace would interest your baby but really it can distract my little one from almost anything.  Here is my round up of my favorite breastfeeding accessories.

This was my very first nursing necklace that I got when Jad was 5 months old.  He was just starting to get really distracted and I needed something to tame him.  These are simple pendant necklaces that come in a wide variety of shapes, colors and sizes.  They are silicone and safe to chew on.  With the minimal design, they are easy to keep clean as well.  They are having a sale which takes their necklaces down as low as $9.99.

These were my first wooden beads I tried.  This is a nursing necklace that is made of different size wood beads and different textures to occupy the baby.  They go really well with most of my wardrobe and are virtually undetected as anything other than a normal accessory.  Alphabet Soup Busy Beads retail for $19.99.

This is definitely my favorite silicone necklace.  Instead of just one pendant, this is a strand of silicone beads.  You can get them in all sorts of style and colors and they can be worn everyday.  I love to strap this one in my purse loop on my Boba and throw it back to occupy Jad while going about my day.

This was my latest addition to my nursing necklace obsession.  Boubeads will actually custom make your beads.  This was my recent custom I had made for my birthday.

You give them colors and combinations and they create a super cute and fashionable option that is safe and super fun for baby.  Custom strands are about $43.00, ready to purchase run about $24.00. Jad gives them a thumbs up.

How to you keep your nursling on task?

Friday, December 20, 2013

The Breastfeeding Experience I Don't Talk About

I have come to realize I talk a lot about most of my breastfeeding experiences. But there is one thing my family doesn't know, one thing my closest friends don't know. In fact that only people who know are my husband and the few women I know won't judge me.
I nurse my 3 year old.

I'm not ashamed or embarrassed about this fact. The reason I don't talk about it might be more surprising.
I weaned him at 20 months.
Why on earth would I start nursing a preschooler who was already weaned? We weaned when I developed a huge aversion to breastfeeding when I was pregnant. As much as I wasn't ready for our nursing relationship to end, it felt like nails on a chalkboard. I was open to the idea of resuming and tandem nursing. L had always found love and comfort at my breast so I was prepared that he would ask to nurse again once he saw his sister doing it. Sure enough one day after his sister was born my son looked at me with his big blue eyes and put his mouth to my breast. I told him it was ok, his body relaxed but he didn't suck. He had forgotten how to nurse.

Helping his sister nurse

Then one day when he asked to nurse I said yes. This time he imitated his sister in sucking. It was for maybe 10 seconds and when he was done he pulled my shirt up and said " thanks for sharing with me mommy" It has happened a few times since then, and each time has been loving and tender. It has been a great tool for those days when he is having tantrums and is harder to handle.
Some people may not understand this decision and that's ok. When I see my boys body relax because he is getting the comfort he needs. When he is asking for my attention in a positive way. I know I'm doing what's best for him. I don't know how long it will last. But for now I'm enjoying more snuggles with a boy who is growing faster than I would like. And every time I hear " thanks for sharing with me mommy" and I watch him run to play, I smile.

Thursday, December 19, 2013

Freedom from the Shield

I had no idea that flat nipples were a real thing.

I grew up thinking that nipples were nipples and it didn't matter how they looked or what they were like because I would still be able to breastfeed.

The glorious day came for my sweet girl to be born and I was mentally preparing myself. My thoughts were something like this, "We will do skin to skin and then she will latch. It will be easy!" Well in all honesty, she latched. But OH MY WORD it HURT!!! I think I knew that it would hurt but I had no idea it would hurt that bad.

About 10 minutes after she was born.
So we made it through our first night together. I called a nurse in every time I tried to latch her because it just did not feel right.

The next morning the most wonderful person I had ever met came into our room. Our Lactation Consultant. (Hi Sharie!!) She took one look at me and said, "Oh Honey, You're going to need a shield." *cue confused look from me* I had no idea what that was but if it let me breastfeed my sweet baby I was game!
Momma needed to have some fun sometimes!

We took the shield home and that was how my baby ate. She made it back to birth weight by one week and she was thriving!

But I was not. I felt so trapped. I felt like I couldn't nurse her anywhere but my house because putting on the shield exposed me too much. I knew how important breastfeeding was to my daughter so I continued to push through and planned outings around the shield.

I called my LC multiple times asking how to wean her from it but every time we tried it was a huge mess. I would give up and say that I would try again next week, remembering the advice my LC gave me. She said that L would decide when she was done with the shield. I kept waiting. Praying that she would figure this thing out.

Suddenly at 5 months she got it. She looked up at me with her goofy smile, grabbed the shield and threw it across the room. And as I was standing to go get it she latched like a pro. I cried. And cried. I felt like I could FINALLY leave the house!

Mommas with shields. Do. Not. Worry. Every kid grows out of it and learns how to latch!

Merry Christmas! Love, Lily!

Wednesday, December 18, 2013

WW: Just Because

These are my favorite kind of nursings! Ours our usually followed by a great cuddle.

Tuesday, December 17, 2013

The 5 Things You *Really* Need to Breastfeed

There are so many products out there that people say you *need* in order to raise a baby or even just to breastfeed. The truth is though that you don't really need much to be able to breastfeed successfully. Yes there are some amazing products out there that really helpful for breastfeeding relationship but at the end of the day..this is all you need:

1. A Baby--Barring any medical complications the baby is the first thing you need to breastfeed and once you have one of those you're good to go. Some babies may have a hard time with breastfeeding at first but usually there is a root cause that can be fixed. Babies don't hate breastfeeding, they love it! 

2. Breastmilk aka YOU--More likely than not your body is going to produce just the amount of breastmilk that you need for your baby. The most important thing to remember is bring your baby to your breast as much as possible and let them nurse nurse nurse. It is NORMAL for them to nurse every 1-2 hours. Breastmilk works on a supply and demand basis. The more is demanded (through breastfeeding and even pumping) the more supply you will have. So nurse that sweet babe on demand! 

3. Support--You'll need support through this entire process some of it relies on other people, your partner, friends and family. But a lot of it relies on you too. Making sure that you know a lot about breastfeeding before actually needed to breastfeed and asking for help when you need! If it's late night and you're in a pinch send a message to our FB page, tweet on twitter with the hashtag #Breastfeeding or #BFCafe or check out

4. Adequate Diet--It takes a lot of effort on your body's part to make breast milk so it's important to make sure you're eating correctly, so that your body is energized. Make sure you're getting lots of fruits, vegetables and protein in your diet. One way you can help with this in the early months when you're exhausted is by preparing freezer meals before you have the baby and having quick and healthy snacks on hand. Think pre-washed salads, apples, carrots, etc. 

5. Water, Water, Water--Whenever I sat down to nurse Mason or Kyla I tried to make sure that I had a bottle of water on hand. Water is key to milk production and not staying hydrated can actually cause you have low supply. So drink up ladies!

Do you agree or disagree? Is this really all you need to breastfeed successfully?
 If not, what else do you think should have made the list? 

Image Map

Monday, December 16, 2013

Fixing a Tongue Tie

In case you missed it, I started our tongue tie story here by sharing the issues we faced during the first 11 weeks and the symptoms of a tongue tie. 

After I realized this could be out issue I called our pediatrician to find out what to do. We had an appointment a few days later and the pediatrician said it did “look like a tongue tie” but that she “wasn’t an expert.” She did commend me for sticking with breastfeeding for 11 long weeks of pain.  
Here’s where the story gets ugly…I was told that she has never once referred anyone to an ENT for a revision of a tongue tie.  In fact, she didn’t even know where to send me.  She said that because I was obviously committed to breastfeeding and that I would not be okay with switching to bottles she would refer me.  She also said that the ENT probably wouldn’t do anything though. She was pretty sure no one in our town would do a laser revision on a 4 Posterior Tongue Tie.

I was encouraged and frustrated at the same time! Thanks for telling me what’s wrong with my child but there is no solution? I was also told that because of his weight gain (or lack there of) I needed to start offering him a bottle of pumped milk after every feeding – so that meant I needed to start pumping after every feeding! Thankfully I still had my hospital grade rental pump!

As I was driving home from the doctor I made the decision to call Dr. Lawrence Kotlow’s office in Albany, NY. All of my research on posterior tongue tie revisions had led me to him and I knew that he would be able to help. Within minutes I was on the phone with a wonderful office assistant who told me that yes they would be happy to assess my child and preform the oral surgery if Dr. Kotlow believed that was best.  That night we booked our plane tickets (we are about a 15 hour drive away) and the 6 day wait began!

When we arrived at Dr. Kotlow’s office (which is incredibly kid friendly!) his staff was waiting for us. I’m going to be perfectly honest, I was a wreck! I was about to give my child to a man and have to sit and wait while my 12 week old had his tongue sliced with a laser. The office staff made me feel so much better! After a brief wait we were brought into an exam room and asked to watch a video regarding tongue and lip ties.  As I sat and watched this video I KNEW Dr. Kotlow would confirm we did, in fact, have a posterior tongue tie and lip tie. Once the video was over Dr. Kotlow came in and did a brief examination of Lucas’s mouth. It only took a few seconds for him to let us know that Lucas had both a posterior tongue tie and a lip tie.
The next part was so hard for me as a first time mother. I kissed my little baby and gave him to the doctor to be taken for the revision procedure. I honestly can’t tell you how long it all took – I sat in a room crying thinking of the pain Lucas must be in. I kept reminding myself of the articles I read about Dr. Kotlow and how babies were returned to their parents happy and without tears.

Unfortunately that was not the case with my son. When he was eventually brought back to me he was STILL screaming. I knew I needed to get him to the breast immediately but was nervous for so many reasons: Would it hurt him? Would it hurt me?  What if this didn’t fix anything?

Right after the procedure.  See how swollen he was!

I took my crying baby and put him to the breast and I could instantly tell a difference! It didn’t feel great, but it certainly felt 100% different and so much better! I started crying again, different tears this time – tears of relief and joy! Dr. Kotlow came in to check on us and as a sat there crying and thanking him for fixing my son that wonderful man started wiping away my tears (my hands were a little full at that moment!). He did mention that Lucas was probably going to need a fair amount of Cranio-Sacral Therapy/OT and that, because of his age, breastfeeding may actually get worse before it got better.

Lucas did pretty well after we left the office. He slept most of the afternoon and pretty much the whole night. I could tell he had a fair amount of discomfort pain and he had a lot of swelling but the Tylenol we gave him really seemed to help. I was over the moon excited when I woke up in that Albany, NY hotel room the next morning! Little did I know that our saga wasn’t over quite yet!

Lucas’s procedure was done on a Thursday afternoon. By Monday morning things were worse than before. My child was screaming at the breast. We were still using the nipple shield. My supply was tanking because he was refusing to eat. Lucas was dropping weight faster. We went to our local hospital’s Breastfeeding Support Group. The LC  told us Lucas had a “weak suck” and was going to have to learn that all over again – at 12 weeks old. To say I was a total mess would be a huge understatement. I just wanted to feed my child!

My amazing LC was at my house the next evening. We worked on Lucas’s latch (which she said still looked good), we did some sucking exercises using our fingers, and she promised me using the nipple shield wasn’t the end of the world. Most importantly, she encouraged me. I will be forever grateful for her kind words and encouragement that evening.  She may not realize it, but what she said kept me going.

We had our first therapy appointment that morning as well. And while I know the CST was huge in the change I saw in L, I'll save those stories for another day.

The next morning (so the Wednesday after our Thursday revision) Lucas got up extra early. I decided to try and nurse him in bed. I put on the nipple shield and he wouldn’t latch. I tried several times and then finally, out of frustration, took that silly piece of silicon off and tried to latch my son again. IT WORKED! My son was nursing, without a shield and I wasn’t in excruciating pain! I began to cry! I sat there, in my bed, at 4:30 in the morning with my husband still sleep and cried tears of joy! As the day went on, each time I fed my son it got easier and easier. By the next morning I can honestly say that things were 100% better!

A few weeks later I was weighing Lucas for his 4 month chalkboard photo and started crying (again! I’m still blaming the hormones!!). In one month’s time my son gained 2.5lbs!  I was beyond excited. I also got hit by the Mommy Guilt Mac Truck when I realized my son had been so hungry in those first few months. I still live with that guilt and some days it gets the best of me. But then I remember everything I did, and am still doing, for my son and I give myself a pat on the back for trusting my instincts all those months ago.

Lucas is now 10 months old still seeing getting CST once a month, just to make sure the exercises we’re doing are still needed and working! I also still freakout at the slightest hint of pain when he latches or the first sign of a plugged milk duct but I am proud to say that my son has been exclusively breastfed for 10 months with no signs of stopping! We are so blessed to have had people in our lives that were able to help us correct what could have been the reason our breastfeeding journey ended well before either of us were ready.

Sunday, December 15, 2013

Diagnosing A Posterior Tongue Tie

My son was born 16 days early after my induction due to pre-eclampsia. While our breastfeeding relationship seemed to be off to a good start, two weeks later and I was in a world of pain! I honestly believed that if spy agencies used breastfeeding as a method of torture there would be no secrets left to tell! I kept calling Lactation Consultants until I found one that was able to see me right away – something needed to be done because there was no way bleeding, cracked nipples were normal! Our latch looked good so the LC took a closer look inside L's mouth. She immediately diagnosed him as having a bubble, or high, palate. L would not let her get a good look under his tongue but I had been told in the hospital he did not have a tongue tie so we didn’t think that was the issue.

Because he was a late pre-term he lacked buccal fat in his cheeks – so, along with the bubble palate, we thought we had found the issue. I began using a nipple shield and was told that in a few weeks, when the fat started growing in his cheeks, nursing would get better. From that point on our lives were dependent on that silly little piece of silicon. I couldn’t go anywhere without it – in fact, I got nervous if I didn’t have one immediately within arms reach.

Lucas was also eating pretty constantly – if he went more than 20 or 30 minutes without eating he’d start screaming. Each nursing session was also at least an hour. He was constantly falling asleep at the breast and I would have to pat his little bum to get him to keep eating. My life revolved around breastfeeding.  I didn’t mind it, but I had friends with babies only a few weeks older than L and that was NOT the breastfeeding relationship they had with their children. I tried to remind myself every baby was different, but something just didn’t seem right.  

Out of frustration, I finally called the pediatrician and they scheduled an appointment. They asked about my supply, thinking that may be the issue, but I was pumping 4-6 oz AFTER feeding him in the morning so that was ruled out; my son didn’t spit up so they ruled out reflux, the breast did calm him so they said it wasn’t true colic. After 20 minutes I was told I had a fussy baby and I was feeding him too much (He had gained 1.2lbs in about 2 and a half weeks – but remember he was eating constantly and attached to my breast about 16 hours per day). I was told to only feed him for 15-20 minutes per side and then wait at least 2 hours before feeding him again. The pediatrician said that the first few days would be rough but that my baby would “adjust.”

I hated that advice but I felt pressured into doing what the pediatrician told me to do. Those next few days were torture. I’m pretty sure there is video of my husband and I with the baby in the kitchen with the microwave fan on, the water running, us “shhh-shing” and squatting with our 8 week old. Those videos will certainly be used against us at some point in the future! After two days I knew this wasn’t really working and started to feed him more frequently again but not constantly. We began giving him bottles at night and he’d chug 5 or 6 oz if we let him. He made such funny noises when he’d take the bottle (another red flag we totally missed by the way!).

At the 9 week mark Lucas started losing weight. I had also began to have the most horrible pain in my breasts, which I eventually realized was blocked or plugged milk ducts. Literally every two or three days I’d be in the hot shower, massaging my breast and pumping like crazy. I even began taking Lecithin (which does help with plugged ducts in case you were wondering!).

Finally, after posting all of this on a Mommy Group board that I belong to one of the women suggested a posterior tongue tie. My mom, who is amazing and was doing her own research, came up with that same theory. Once we came up with this theory I started doing a ton of a research on the subject. Here is what I learned:

First, posterior tongue ties can be extremely difficult to diagnose. Because breastfeeding became less popular than bottle feeding many years ago a lot of pediatricians are not skilled at discovering anything other than the obvious “snake” tongue or “1 and 2″ tongue ties. **Oh, I should mention there are 4 “levels” of tongue ties.  The first two are very obvious and easy to see, the 3rd and 4th are considered posterior and make diagnosis difficult. 
If you look closely you can see the dip in L's tongue where it was connected
Second, tongue ties and lip ties are considered hereditary. My brother had a tongue tie that was clipped as a baby as well as a lip tie that was not corrected and my father’s brother still has a pretty significant lip tie.

Third, tongue ties, lip ties and bubble pallets are typically related – meaning if you have one, there is a good chance you have another.

And fourth, in order to breastfeed correctly, babies need full movement of their tongue – they need to create a seal around the nipple, preventing slippage, and proper drainage of the breast. A tongue tie prevents this – hence the pain, low weight gain and even plugged ducts you’ll see below.

So what are these tongue tie symptoms? I’ll highlight the ones we had in an effort to save you from reading too much!
  • Sore, damaged, cracked nipples that do not go away after the first few weeks of breastfeeding
  • Mis-shappen nipples after feeding (flat or pinched typically)
  • Frequent feeding
  • LONG nursing sessions – an hour or more at times!
  • Slow or no weight gain or excessive weight gain (quick explanation – because baby is eating all the time and constantly getting the high calorie foremilk they can gain weight excessively but if feedings are “limited” like was suggested to us they will not gain weight or begin to lose because they aren’t getting enough food)
  • Reflux
  • Hiccups
  • Fussy at breast
  • Tense and unable to relax when feeding – think clenched fists, tension in head/neck, etc.
  • Colic
  • Baby only takes short naps and never sleeps peacefully
  • Cannot maintain a seal on breast/bottle – a lot of leakage
  • Infrequent swallowing
  • Constant need to suck – at breast, on a bottle, paci, fingers, etc.
  • Mastitis or recurrent blocked milk ducts
  • Supply issues
  • Nursing blister on baby’s upper lip
  • Green stools
  • Unable to maintain a latch at breast
  • Noisy feedings – baby makes clicking or popping noises at breast and bottle, loud swallows, etc.
  • Excessive gas
  • Gagging
  • Weak or lazy suck
  • Baby falls asleep when feeding constantly
  • Snoring when sleeping
  • Scoop in the tongue
  • Unorganized suck/swallow pattern – doesn’t suck/swallow but rather you get suck, suck, suck, swallow, breathe.
  • Excessive drool (not related to teething)

Obviously we had a lot of things going on so I wanted to get into the pediatrician right away! I was pretty sure I had figured out our issue but I needed confirmation and a solution.

Was it a posterior tongue tie?  Finish reading our story here.

Thursday, December 12, 2013

I See You Formula, I See You

It happens to all of us to some extent I'm sure, that internal dialogue telling you that it might be a good idea to have some formula on hand, you know just in case. Perhaps that dialogue even extends to friends and family. A well-intended comment from a parent or grand-parent here or a coy suggestion layered with snark from a "friend" there, circling around. I know it did for me.

 You see, I knew early in my pregnancy that I was to be a single Mom. That I was "ok" with. What I was not "ok" with, however, was the insinuation that I couldn't be the type of parent I wanted to be or provide the best because of that title. I wear it with honor. So as the well-intended or snarky comments enveloped me the more determined I became. I had decided that I would breastfeed, come hell or high-water. After all, breast is best and my Harper was to have nothing but.

I hadn't once considered actually purchasing formula. I just knew that if I had that "stuff" in my house I'd give-in at 3 AM when I was struggling. For me personally, formula represented defeat in a can. Not just breastfeeding defeat, but parenting defeat. Then one day that "defeat" showed up in the mail. And then another can and another, until I had a stack in my closet staring back at me each time I put away more baby items. How did they find me? It was like some big inside joke between the formula companies and all the nay sayers (as it turns out this happens to most pregnant woman, but that's a different post altogether). For whatever reason I just kept it all.

When my daughter arrived the breastfeeding challenges began. It was the happiest moment of my life, but I immediately felt that voice encircling me again saying, "You can't do this, you'll never be able to do this. You won't succeed". I can remember it being around 4 AM in my hospital room trying to help Harper latch. She struggled with my flat nipples. I felt like my body was failing me. The nurse came in, took one look at my breasts and said, "Oh you've got flat nipples. We'll try a shield, but you may have to go to formula." Then she offered me a breast shield, but it just wasn't working. My mom rolled over from her hospital chair-turned-bed and suggested I just try giving her a little formula. I know, you're thinking how unsupportive that is. Honestly, those were the best words she could have ever said to me. They fueled me. I was angry that this wasn't going the way I'd imagined. I looked down at my little girl and said, "Don't worry. Mama knows you're just learning, so am I. We can do this. We will do this."

From then on it was breastfeeding jaundice, weaning from the shield, cracked and bleeding nipples, thrush, chronic plugged ducts, and mastitis that taunted me at every turn (which I plan to discuss in more detail in future posts). Those days. Were. Hard. With each hurdle I'd pass that closet and glare at those cans. Again those cans represented so much more than just a dry powder. They were my nemesis during that time and I just had to keep on keepin' on.  I'd say, "I see you formula, I see you. And it's not going to work." Then I'd apply my nipple butter like I was Katniss in The Hunger Games doctoring my wounds with salve. I like to think I was in a bit of a survival of the fittest game myself, only I call it The Hungry Games and we won.

We've since donated the cans to a local charity as we are almost 9 months strong in to this whole breastfeeding thing and I feel a great deal of support and confidence now. So "F" you formula, we won, and you still live in a can.

How do you feel about having formula in the house during the early days? Is it necessary?

Wednesday, December 11, 2013

WW: Pumpkin Spice Lacation Cookies

What better excuse to eat 3-4 cookies than they help with milk supply?

Go check out the recipe for Pumpkin Spice Lactation Cookies and report back! Would you eat them?

Tuesday, December 10, 2013

A Bad Latch

I did so much to prepare for the birth of my daughter.  Twenty four hours of Bradley classes (spread over eight Saturday nights), pain management practices, book after book.  During my time educating myself I read up on breastfeeding and even practiced with a doll at my classes. 

After basically the most awesome natural birth ever I brought my baby to my chest and she latched on with ease.  I grew this baby for nine months, I birthed her and of course I could feed her.  We spent the next twenty four hours wrapped in each others embrace in my hospital bed.  New York City hospitals are pro-breastfeeding and keep formula out of sight, but no one ever asked if I wanted to see a lactation consultant or got close enough to see her latch.  And I was too prideful to ask them.

Toward the end of my baby's first week of life I was in so much pain I declared breastfeeding harder than giving birth naturally.  And I meant that.  My nipples were cracked and bleeding and I was crying along with my baby.  Finally, late that Saturday night I called my Bradley teacher in tears.  I remember so clearly that she told me, "It's okay not to love every second of this."  She helped me find a lactation consultant who came over the next morning and not two seconds into her visit she diagnosed Adelaide as having a bad latch and showed me how to get her to latch correctly.

She also suggested I soak and rinse my nipples in warm salt water which helped tremendously in healing.  

That afternoon I put on my shoes and my coat, put my baby in the sling and walked proudly outside to meet my husband and in-laws who were picking up lunch.  My nipples still hurt like hell, but I knew from then on out that I could do it.

It's been just over nine months since my daughter was born.  I don't think there's any feeling in the world like knowing you made this tiny little human and your body alone is sustaining all of her needs. 

Now if only teaching her not to bite me with her shiny new teeth was as easy as teaching her to latch correctly.

Monday, December 9, 2013

4 Myths Busted

My adventure in breastfeeding started about three years ago when I started working as a night RN in the newborn nursery. There were no night shift lactation consultants at my hospital and most of the time, since company was gone for the day and things had settled down, night shift was the perfect time for first-time breastfeeding moms to ask for coaching. It was also the time that breastfeeding moms wanted to give up and get sleep. I took on the challenge, even though I had never breastfed, and instantly fell in love with lactation. During my journey of trying to conceive and pregnancy loss then finally my pregnancy with C, I was envious of all of the breastfeeding mothers. All I wanted to do was nurse my own baby and I prayed that all of the advice I gave new moms over the years was worth taking!

Working in the hospital with new moms during their first few days, I hear so many reasons why moms don't think they can nurse right away, exclusively, or at all. Here are some of the most common myths - busted.

I can't squeeze anything out so my baby isn't getting anything.

If only we could be so lucky! Most women aren't blessed with the ability to squirt milk across the room right after the cord is cut (and yes, I actually say that at the bedside because I'm awesome like that). It takes time and effort to establish supply.

Think of it as breast milk economics. Create the demand for a supply and generally it will come.

It can take 4-10 days to beef up milk supply to the point of feeling full or that milk has come in. Even after this period, it is normal to have highs and lows of production throughout the day, so don't be discouraged if you see colostrum dripping out during the first feeding and not the second or more commonly, morning and nighttime feedings.

Check out my next post for yummy recipes and ways to modify your diet to help increase supply!

My baby is in a low weight percentile so I need to supplement with formula to help him gain.

In the words of my son's pediatrician, someone has to be down there! Anywhere from the 1-99 percentiles is considered normal. If a baby is below the 1st percentile or starts dropping weight rapidly, that can be cause for concern, but some babies just gain slower than others and that's OK.

Exhibit A - My son's growth chart

He was consistently under the lowest little line but thanks to a great pediatrician, supportive family, and a hint of genetic stubbornness, we are now 9.5 months into our breastfeeding relationship without supplementing and he is now in the 31st percentile for weight and 69th for height. We are lucky to have a great pediatrician who told us that C would just follow his own curve and around 6 months he was expecting him to shoot up - that's exactly what happened.

Usually, as long as baby is having adequate wet diapers and not showing any signs of dehydration or other distress, even with slow weight gain, exclusive breast milk feeding is the way to go.

I have sensitive nipples. 

Oh yeah? Me, too!

Can it hurt a little in the beginning? Yes. Should it hurt the whole time? No.

If the latch is good, (which is a topic on the shelf for another day) it should not hurt for the entire duration of your breastfeeding relationship. A good way to initially check a latch is to assess if your baby is tugging or biting. It should feel like a strong tug so if it feels like a bite, break suction, start over and get the nipple deeper in the mouth until you feel a tug. This helps alleviate a lot of tenderness in the early days.

A question I get asked often by mothers experiencing tenderness is if it goes away. I'd love to tell you it does but the jury is still out. Does it go away or do we just toughen up and get used to it? 

Regardless, that wincing, piercing, OMG-why-am-I-doing-this feeling should subside in the first week or so. In the meantime, air out your nipples, wear gel pads, use lanolin cream, coconut or olive oil and ensure that your baby has a good latch.

My baby is hungry an hour after I nurse. There's no way he's getting enough.

The simple answer: You and your baby are designed to grow at the same rate. As long as you exclusively breastfeed, baby's tummy and your supply will grow together. In the first few days, when you just have colostrum -aka liquid gold- baby will probably want to eat small, frequent feedings and as milk gradually gets more calorie dense, there may be longer stretches between feedings.

Baby's tummy probably isn't going to be bigger than a marble on the day of birth and it will gradually increase in size.

As baby sucks more, mom will produce more, then baby's tummy will grow. If a bottle is introduced in these early days, baby will suck it down really fast and it is super easy so the tummy will expand faster than mom's supply can catch up.

What myths, wives' tales, or opinions did you have to combat in the early days of your breastfeeding relationship? Were you able to bust or overcome them?

Keep calm and nurse on, mamas. Til next time...

Sunday, December 8, 2013

When Maternity Leave Ends...How To Have Continued Success with Breastfeeding

Since this isn’t Europe, with extended maternity leave times of up to 12 months, most mamas return to work at least part-time between six and twelve weeks after the birth of their babies.  For those who are breastfeeding, this can be a daunting experience, but with proper preparation, it is absolutely manageable.  You can have continued success with breastfeeding and pumping, allowing your baby to continue to have breast milk for as long as the two of you both want it to happen.  That’s not to say that there still will not be tears; when returning to work myself, I definitely cried.  As time passes, though, it becomes easier, I promise.

Above all else, I recommend getting a good breastfeeding relationship started prior to attempting to use the pump, unless there is a medical necessity for pumping sooner.  To illustrate this, my first child was born early at 37w5d.  She was jaundiced, and a sleepy nurser.  She would latch, nurse for thirty seconds or so, and fall asleep.  The key to removing her jaundice, though, was to nurse.  So, to help her with getting milk, I started pumping for her at 5 days old, and gave her 1 ounce of pumped breast milk at the end of every nursing session.  Pumping that early on, though, eventually lead into an oversupply situation for me, which will be discussed in a future article.

Let’s start with the most basic of questions, one I hear frequently, that being some variation of how much milk needs to be frozen ahead of the “the big day.”  A lactation consultant that I worked with after the birth of my second child gave me this wise piece of advice, “Not much.”  Ideally, the milk that you are making is exactly what your baby needs at the specific age and stage of development.  That’s not to say that milk pumped when he was 3 months old won’t be useful to him at 6 months, but it is definitely different in nutritional value and fat content. 

When pumping, ideally, you’d like to just keep up with your baby.  For that first week back, you’ll need a “starter stash,” but again, it may only need to be a day or two of frozen breast milk.  Presuming that you return to work on a Monday, you could use frozen milk on Monday to provide for your baby, but on Tuesday, you could use a combination of milk that was freshly pumped on Monday, and through the week, use less and less frozen milk.  Sometimes, by the end of the week, you will have excess milk, and that would restock your freezer supply.  In other words, there is no reason to stress out if you have a small freezer stash prior to your anticipated return to work date. 

Now with that established, let’s rewind a bit to discuss pumping, and what you’ll need to be as efficient and comfortable as possible.   When you decide you are ready to try pumping (ideally plan to do this about 4-6 weeks before you return to work), get out your pump and its instruction manual.  Read through the instruction manual, and set things up to make sure you are comfortable with the parts and the function of the pump.  If you were not sized at the hospital with a lactation consultant, definitely check out this link ( first from Medela to figure out which size breast shield fits you best.  Not all women will be comfortable using the included (with Medela pumps) 24mm breast shield.  Having the wrong size breast shield can sabotage your success at pumping before you ever get a chance to get started!

While you certainly can simply hold the breast shields against your breasts during the pumping process, many mamas find that it is more comfortable to invest in some type of hands-free device.  While not all women can multi-task during pumping, for those that can, taking time from the workday to pump does not decrease productivity.  I have used two different options for hands-free pumping.  The first is a bra that goes over your nursing bra (with the clips undone), and has an opening in the fabric to slip the breast shield into that holds it in place.  One such brand name of this type of product is Simple Wishes (  The bra is highly adjustable with both Velcro sizing and a front zipper, allowing for a customizable fit. 

A second option is a device that goes fully within your nursing bra, and collects breast milk in a slightly different manner.  In some ways, it almost looks like the funnel part of the breast shield was turned “inside out,” and set inside a cup.  As there is not a traditional breast shield, there is also not a traditional collection pouch or bag!  With the Freemie (, the milk collects inside the cup, inside your bra, and the only exposed portion of the device are the two thin hoses that come out from underneath your shirt to attach to the pump tubing.  When finished pumping, you simply remove the collection cups from your bra, and pour the milk from the collection cup into a pouch or bag for storage.   

When you begin pumping, prior to returning to work, I personally recommend pumping once daily, or even every other day, depending on the length of your maternity leave.  Typically, you will feel the fullest, and have the most milk, after the first morning nursing session.  This can vary if your baby wakes several times during the night, of course.  Waiting 30 minutes to one hour after that first nursing session (long enough to change a diaper, cuddle a bit, and set up the pump) will also increase the amount that you may be able to pump.  It’s important not to focus necessarily on the ounces that you pump initially.  That can be a significant hang-up to pumping mamas, and a stressor that may ultimately negatively affect milk production.  Pumping should last usually about two minutes after you stop seeing milk flowing freely into the breast shields (after the end of the let-down), but some women will have a second let-down in any given pumping session.  These pumping sessions may not initially result in an entire extra feeding of expressed milk, but will be the beginnings of what you use for your “starter stash” described above. 

Returning to work can be a daunting process for a new mother; there is so much emotion involved in the actual separation from your baby in addition to the desire to continue to provide breast milk.  However, with the right pump, properly fitting breast shields or other collection device, and some way to pump hands-free, pumping at work is entirely doable and can be done without much interruption to your regular workday.  In the next part of this series on returning to work, more information will be given on collection, storage, and usage of expressed breast milk.