And then there were three … part four

I got my antibiotics, and also started to hand express some milk to try and feed Sid with.  It was becoming so painful to feed him that I had tears in my eyes. We struggled over the weekend trying to get through a very difficult situation.

On Monday morning, the health visitor arrived.  She weighed Sid and told me he had lost over 17% of his birth weight and immediately referred us to hospital. I was worried sick.  He was also quite jaundiced.

At the hospital, I chatted with the doctor, who was keen to help me continue breastfeeding whilst also making sure my son was gaining weight.  He suggested that if things had not improved sufficiently in the next four to five days we might have to consider formula top ups but he was keen to help me avoid that.  Because of the jaundice, he wanted to take some blood and make sure my son’s liver was functioning properly.  On such a young baby, they take blood from the back of the hand, preferably whilst the baby is feeding, and so this is what we did. There was a young lady in the room on work experience and she was on hand to cap the bottle of blood when the doctor got it.  He got in position and I tried to feed my son.  It was telling that this doctor, experienced as he was, winced when he saw me trying to feed.  He said nothing until we had the blood (which was no mean feat), but then admitted he had underestimated the damage done, and thought that it was unlikely my son and I would be able to breastfeed out of this situation.  He referred me to the Infant Feeding Coordinator (as my HV had the day before).  We were sent home (to everyone’s surprise, since my son was far enough down the action plan to be kept in hospital) with instructions to stop breastfeeding altogether to give my nipples time to repair the damage and to express as much milk as possible to give to my son.

We saw the Infant Feeding Coordinator the next day. She was lovely. She listened to my concern that the tongue tie had grown back and examined my son.  In her opinion, it had not grown back; it had not been correctly dealt with in the first place. She diagnosed a posterior tongue tie, which many of the doctors who deal with tongue tie have not received training on apparently.  In fact, she said, many refuse to believe it exists. My poor son had been born with both anterior and posterior tongue tie – it was no wonder we were having difficulty getting feeding right!  She told me that she believed he would never be able to successfully breastfeed, unless we first dealt with the tongue tie.  Our options, it turned out, were limited.  There were no doctors in our health authority who could or would deal with posterior tongue tie.  We could ask for a referral to a consultant in Derby who would release it, but this would be under a general anaesthetic. The other option we were given was to pay a local independent midwife who would release it without use of anaesthetic, and would provide ongoing breastfeeding support afterwards. I left hospital with a recommendation to get a prescription of donperidone from my GP to help boost my milk supply, and with the loan of a hospital grade breast pump, which I have named Meryl the Milking Machine, worth £1000 and instructions to express at least 8 times every 24 hours.

This brought on a whole new set of issues. We finally knew what the problem was and that there was nothing more my son or I could have done to have avoided this situation, but there was plenty we could do to improve it.  I was to avoid breastfeeding until my nipples were completely healed, and we were to feed him as much expressed breast milk as I could gather, and then top up with formula.  I was ok with all of that, except it broke my heart to give him formula those first few times.  My husband was due back at work three days later, and it became very clear, very quickly that this would make my situation impossible – there was no way I could express every 3 hours, as well as feed him, and look after our 2 year daughter.  I was exhausted from having to get up several times in the night to express and having to function during the day.  My husband’s employer granted him a week of compassionate leave, which helped us out enormously.  We then had to discuss what to do about the tongue tie, and eventually, it was decided we would approach the independent midwife. We knew that we didn’t want to risk a general anaesthetic, even the small amount needed for this procedure.  We knew too that we would need help to re-establish breastfeeding. Four days later, the procedure was performed. By this time, miraculously, I was healed enough to consider being able to feed my son, but I did so with fear – it had been so unbelievably painful the last time I had tried that my husband had immediately driven to the nearest supermarket and bought some formula since we had run out of expressed milk.  I was so scared of feeding my son, but we tried.  And we kept trying over the next four or five days, each time feeling that it wasn’t working, he still couldn’t latch on, it was never going to work. I hadn’t realised at the time that he needed to get used to this new tongue and learn how to use it.  And of course, he needed to learn how breastfeed, since he had never managed it efficiently in the whole of his four weeks of life.

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