Maybe it's the domperidone...

This is the first chance I've had to write since the bottle incident. Apologies for leaving it so up in the air, but I needed to sort myself out a little.

Yes, I got my husband to give him a bottle, and that beautiful little baby of ours actually took it.

I was worried about my milk production. Again.

Ever since we had his tongue tie snipped, I have been slowly reducing my domperidone levels. All advice for stopping domperidone is to do it very gradually, and so I have been going down by one 10mg tablet each week. I was on 120mg, so it'll take a while.

The day before the bottle was my first day at 80mg. That night, despite feeding all night long, he woke with an almost empty nappy. Those morning nappies are usually my favourite; the ones that make me feel like yes, I DO have milk! But not that day. We then changed his nappy and went out for the day. I fed him as usual, which is every two or so hours (though usually only for a few minutes before he wants to continue looking and interacting with the wondrous world around him. Ah, the distracted feeder!). I subconsciously found myself feeling his nappy throughout the day, and eventually we came home around 4 and changed him. I presumed that my husband had done another change in the day, but he said he hadn't. It was dry. Perhaps there was a tiny pee in there, but it was pretty much dry.

So I took him to the bedroom, did our skin to skin lie-down feed and prepared myself for a marathon feed session, but he just cried and pulled at my nipple the entire time, like he used to before. I didn't feel any of the usual letdown feelings I have been getting (though I know that isn't necessarily a sign of anything), I didn't hear any swallowing. I couldn't hand express anything. Not a teeny drop.
Those sleepy feeds that I love
So I got my husband to give him a bottle. The last time we tried was in hospital and there was no way he was going to have that bottle anywhere near him, so I didn't actually expect it to work.

He stared at me with his big sad eyes the entire time, the poor thing.

He only took around 15ml from the bottle, and then was totally happy again. My crazy boy.

That was Sunday. On Monday, I took him to the local clinic to have him weighed, and he has only put on 0.35kg in two months. We had his 6 month doctor's appointment on wednesday where they weighed him again at 7.35kg, and I asked about it. He said that yes, the weight could definitely be higher, but my superstar is so healthy, is absolutely not a skinny-mini, is reaching milestones like a champ (already standing on furniture and sitting!) and is happy, so don't stress about it. He said if I like and am worried, I can give some formula again, but when I talked to him about what we had been through, he said not to worry about it. 
Standing like a champ already! His brother is impressed :) 
He suggested to keep feeding him as much breastmilk as I can, whenever he is bored or tired or grizzly or anything (which we do), and that the solids we give at the moment should not just be the plain vegetables or fruits, but try to focus on high calorie solids for a while. So at the moment there is quite the focus on banana and avocado, and some milchbrei (No idea what this is in English... spelt and millet cereals with the milk included in the cereal). He is snacking on steamed zucchini strips, red capsicum and cucumber, and I am giving him some pureed veggies with potato... but I am on that whole 'is my baby gaining enough' bandwagon. Back to get him weighed again soon.

So I am back up to 90mg. When I feel ready again, I'll try to go down to 80mg again and see if that really is to blame.

Meanwhile, I'm making heaps of milk again. His nappy this morning was chock-a-block full.  

And once again I don't really know how I feel about it all. Maybe it actually is me after all, and not just the tongue tie. Sigh. But one thing I do know is that I have some beautiful boys in my midst.

My happy healthy 6 month old boy

So this happened...

So this happened... and not by choice.

Not out of the woods, it seems.

(Edit: This was after his posterior tongue tie was snipped, but things got sorted.)

Ten days later

It has been eleven days now since I have used any supplement. In four days, my little boy will be six months old.

Right now, I am out of the house at a cafe with my little boy sleeping on my chest, with nothing in my bag but nappies, wipes, change mat, blanket, spare clothes, cardigan, toddler snacks, toy car, bandaids, domperidone, wallet, phone, laptop and keys. Cool, huh? No thermos of water. No two SNS bottles filled with 90ml of water each. No formula canisters with three scoops each. No defrosted bag of donor breast milk wrapped in an icepack stored in a tupperware container.

I had wondered how long it would take me to leave the house without my back-up. Eleven days, apparently. And I'm only ten minutes from home, if worse comes to worst.

Today is my eleventh day of being an Exclusive Breastfeeder, but it is ten days since the release of mylittle boy's tongue tie. Strangely enough, the 24 hours leading up to the procedure, he also didn't need supplement. This has me thinking that there is a chance that it isn't the actual procedure that is to thank, though don't get me wrong, I do realise that would be quite the coincidence. But I would definitely have been thrown out of any scientific study regarding it all...

It could also have been his food intake. Two days before his procedure, he started having one proper meal of solid foods each day, and was absolutely demanding it. He has begun eating around 120grams of food at each sitting, rather than just have a little taste.

It could also be the fact that I started absolutely chowing down these VERY yummy lactation biscuits from Franjo's Kitchen (Goodness, I could eat ten a day! And they are super healthy too, so no need for me to feel bad whatsoever!), and while I've tried lactation biscuits before, perhaps it is all the magical ingredients in these particular ones that tipped me over the edge into super-lactation.

It could also be the fact that he is teething dramatically right now. He popped a tooth the day before the procedure, which may have made him want to suckle less, who knows. And right now he is in the midst of the second tooth erupting, so maybe once that is done, he will go back to demanding more milk... I don't know.

It could also be a combination of these things. Perhaps the day before the procedure, he was teething so badly that he didn't want to feed from the breast much, and then after the procedure I stepped my confidence up to a new level, so that when he was fussy in the evening, I just let him be fussy, and didn't presume he needed more milk. I let my husband put him in the carrier and walk him to sleep for those first couple of nights, which he did surprisingly easily, and that continued to build my confidence (though goodness, I was certainly shitting myself about it at the time! Will mothers ever really know if they are making the right decisions?!). Now I feed him to sleep again, but I need to swap sides between four and six times for him to sleep. He doesn't tug at my nipple and whimper anymore, though, which makes me feel pretty happy about it all.

No SNS on the plane this time! So much easier!
But... as one of my best friends said to me yesterday when we discussed all this, does it really matter? Who cares what the reason is! I suppose I care only because the process of lactation – the physiology of it, all of the unknowns that still exist – absolutely fascinates me, and I wish that my story could benefit the wider community in a very concrete way. But that's how breastfeeding goes, it seems! There are no absolutes.

And so now I have entered the world of 'Does he have enough?', that world that it seems almost all breastfeeding mothers have entered at some point. And although that in itself is at times confusing (like, what actually constitutes a 'wet nappy'? And what if his nappy is dry after hours and hours, but he is happy, doesn't appear dehydrated, he has been feeding very frequently, and we have been out in a dehydrating environment like a plane (!) for hours and hours (and hours and hours)?), I get a secret little thrill to know that I now have the questions that a normal breastfeeding mother has. How cool is that?

In short, I am happy.


A posterior tongue tie and lip tie

After five and a half months of believing without a doubt that I have low milk supply -- no, make that almost three years, seeing as I had the same problems with my first beautiful boy -- a specialised paediatric dentist finally confirmed that he has a very significant posterior tongue tie and lip tie.

5.5 months and finally with a free tongue.
Stage 1 of the swaddling, and not impressed.
Applying the anaesthetic cream. Still not impressed.
After years of believing that my body is flawed, after years of hating my breasts and their total futility, of struggling to come to terms with the fact that I am unable to reconcile with that absolute primal need of sustaining my baby on my milk alone, of trusting those experts that confirmed the problem was mine, it wasn't.

After spending the first 34 weeks of my second pregnancy in a constant state of anxiety at the thought of having to battle through those first three months again somehow, God only knows how, of noticing how my breasts never changed in pregnancy or postnatally, of heavy-heartedly tossing out beautiful hand-made breast pads that I'd had made when first pregnant, of having counselling sessions over lactation issues to allow me to at least bring this next baby to my breast at least once... it wasn't me.

After searching and searching and searching for a miracle cure, spending thousands of francs on foods, drinks, supplements, drugs and contraptions that gave hope of an increased milk supply, hunting high and low for anybody on this earth that could truly understand what this feels like, I had it wrong.

My last blog post was met with a flurry of comments that suggested that my boy indeed does have a tongue tie, and disbelief that none of the medical professionals I had sought advice from thus far had confirmed it, even when I specifically questioned them about it. A few friends here in Australia gave me the name of a paediatric dentist who was very experienced with tongue and lip ties, but when I called regarding a consult, they wouldn't be able to fit us in before we flew back to Switzerland. That was disappointing, but not surprising, and I once again had to reconcile with the fact that I wasn't going to get anyreal answers or any real help. They were very understanding of our situation, though, and we were put on a waiting list.

On Wednesday, somebody cancelled. In we went. My boy was an absolute gem of a smiler, but I was feeling so conflicted. I wasn't even sure what I would want to do if they found a tongue tie, all I knew was that I wanted answers. I mean, he has just recently started solids once a day, so maybe it wasn't even necessary. The 24 hours beforehand, strangely enough, he had not had any supplementation whatsoever, though he also cut a tooth, so was perhaps not wanting as much... But I was thinking thinking thinking. Maybe I was just being selfish now, wanting to breastfeed him when it perhaps wasn't so vital for him anymore, and did I really want him to have a surgical procedure and to endure pain in order for us to do that? I just needed to know, then I could mull it over and make my decisions later.

The dentist confirmed it, and for the first time I could clearly see it. A posterior tongue tie – a very thin membrane under his tongue that was keeping it held low to the floor of the mouth. He then checked the top lip and found that it was unable to fully flange upwards. It apparently should be able to either touch or almost touch the nose when you turn it upwards, but again his was tied down my a tendon. It was able to flange a little, but not significantly.

He discussed options: If this was a five week old baby, he said, he wouldn't hesitate; It would make an enormous difference to feeding. But now, my little one has learnt how to feed in his own way, and it would perhaps not change anything. And he wouldn't want to fix the lip tie or fully cut the tongue tie before we were about to leave, as there was a chance of a post-op bleed when we were travelling, and he'd be unable to provide any check-ups, which both he and I were uncomfortable with. But I had my answers. He discussed the fact that this procedure is purely a 'first world procedure', as he called it, as 'we' know that if nothing is done, that baby would continue to thrive and grow up happy and healthy. He said that at this point, right at that consult, he could use a laser to remove the small membrane holding the tongue down – a painless, one minute long procedure – but whether that would make a significant difference or not is unknown. He said he would really only do it in cases where the mother was incredibly passionate about breastfeeding...

I didn't really have to convince him. I told him that yes, that indeed is me. I am passionate about it. And sure, let's try it.

First feed post-procedure.

The worst part, really, was not the procedure itself. In fact, it was fascinating the way that the laser worked so smoothly and quickly, and it was incredibly to watch that membrane just vanish and his tongue raise higher and higher right there in front of my eyes. He just didn't enjoy being swaddled so tightly and having his head being held still, but it was obvious that the anaesthetic cream they applied had worked. He had no pain during it, and appeared entirely unaffected by it afterwards – in fact, the moment that I picked him up, he stopped crying and smiled at the dentist.

This was three days ago.

Since then, his feeding doesn't feel that different on the whole, but there have been two feeds that absolutely were different. His latch was much deeper and he seemed so much more effective and focused, and I felt as if that was what a proper feed was like.

I haven't used the SNS for three days. I am now on day four of being an Exclusive Breastfeeder.

I still don't know how I feel.

I am not angry, which surprises me. I am sad. I'm not sad for my littlest boy, as the SNS has allowed us to have a breastfeeding relationship, and for him to get a lot of my milk anyhow. But I am very sad that there is a very high chance that this is what caused all the problems with my first, and that all that trauma was unnecessary.

Once again, I find myself grieving that lost time with my first boy.

This is me, looking like I'm doing ok. I'm not too sure.
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