Advice Archives

Tongue Tied Babies

July 13, 2008

We've all had one of the those moments where we stutter, stammer, or are at a loss for words. "I'm tongue tied," we might joke. But for some babies, being tongue tied is actually a serious problem. Tongue tie, or Ankyloglossia, is a condition that restricts the tongue's movement. The frenulum, the piece of skin that attaches the tongue to the floor of the mouth, is shorter than normal. This can make it difficult for the baby to latch on properly. Some tongue tied babies don't gain enough weight, and breastfeeding can be painful for the mom. Long term, tongue tie sometimes causes speech problems.

A new study, just published in Pediatrics, found that a freunulotomy, a minor surgical procedure to cut the frenulum, can improve breastfeeding. Here's the study abstract:

OBJECTIVE. There is evidence that infants with ankyloglossia can experience breastfeeding difficulties including poor attachment to the breast, suboptimal weight gain, and maternal nipple pain, which may lead to early weaning of the infant. No studies have investigated the cause of these breastfeeding difficulties. The objective of this study was to determine the effectiveness of frenulotomy in infants experiencing persistent breastfeeding difficulties despite professional assistance by measuring changes in milk transfer and tongue movement during breastfeeding before and after frenulotomy.

PATIENTS AND METHODS. Twenty-four mother-infant dyads (infant age: 33 ± 28 days) that were experiencing persistent breastfeeding difficulties despite receiving professional advice were recruited. Submental ultrasound scans (Acuson XP10) of the oral cavity were performed both before and ≥7 days after frenulotomy. Milk transfer, pain, and LATCH (latch, audible swallowing, type of nipple, comfort, and hold) scores were recorded before and after frenulotomy. Infant milk intake was measured by using the test-weigh method.

RESULTS. For all of the infants, milk intake, milk-transfer rate, LATCH score, and maternal pain scores improved significantly postfrenulotomy. Two groups of infants were identified on ultrasound. One group compressed the tip of the nipple, and the other compressed the base of the nipple with the tongue. These features either resolved or lessened in all except 1 infant after frenulotomy.

CONCLUSIONS. Infants with ankyloglossia experiencing persistent breastfeeding difficulties showed less compression of the nipple by the tongue postfrenulotomy, which was associated with improved breastfeeding defined as better attachment, increased milk transfer, and less maternal pain. In the assessment of breastfeeding difficulties, ankyloglossia should be considered as a potential cause.

For more informtaion, Kellymom.com has a series of articles on this topic. And here's an excellent article that can help you figure out if your baby is tongue tied. Surgery is not the only option. (Read this too). But bottom line, talk to your pediatrician and a lactation consultant to figure out if your baby is tongue tied, and what is the best treatment option.

Tell Us Your Breastfeeding Problems-- Join Our Carnival

April 14, 2008

If you've had a baby, odds are you had some sort of confusion, at one point or another, about how to feed her. And if you were breastfeeding, part of it probably went like this. "Oh, man, my boobs are _______." (Fill in the blank with your own thoughts here).

So, in honor of all the breastfeeding challenges we've stared down and conquered, the April Breastfeeding carnival is focused on breastfeeding problems. We want to hear from you about how you overcame a challenge, and where you turned for help. If you used the internet, please share the link with us.

I know this is sort of last minute, but the deadline for submission is supposed to be tomorrow, April 15th (tax day). If the other breastfeeding bloggers and I pick your post, you'll be asked to link back to each of the other participants in the carnival on April 22nd.

Leave A Comment and Enter to Win Weleda Baby Lotion and Soap

March 13, 2008

When our kids were newborns, I hated bath time. I was scared. In my eyes, water plus baby equaled danger. I wouldn't bathe them unless another adult was around. As a result, the kids sometimes went more than a week without a bath. But it didn't really matter. They weren't all that dirty. And besides, "baths dry out the skin," I rationalized.

Once we hit the sandbox years all that changed. Apple sauce and yogurt made baths a necessity. So I figured out various tricks to make things feel less precarious. My all time best move-- using a towel under their armpits to lift them out of the bath. It worked wonders.

And these days, there are definitely high points in the bath routine. The boys now ask to take a "brothers' bath." Together, they bathe their ducks and "wash" the tub walls. There are even comedic moments. The Bear (2 years old) once announced, "Mommy, a nugget." (That's his word for a little poop). And sure enough, I found a marble-sized green ball in the water.

Even so, I sometimes avoid bath time for a different reason-- pure exhaustion. With a 2 year old and a 3 year old, baths involve an incredible amount of wrangling-- into the bathroom, clothes off, into the tub, spash splash plash, out of the tub, moisturize, diaper on before there's a pee on the floor, pajamas on. It's like herding recalcitrant cattle.

But maybe I don't need to dread all of this so much. Weleda, the makers of organic personal care and medicinal products recently contacted me to tell me about their items for babies. So far, I've tried the Calendula Lotion and Calendula Cream Bath. Both have a lovely scent that reminds me of a spa. I can't tell you what the kids think of these products-- we're away and I'm not about to try anything new on them while we're not home. I did, however, test the products on my own skin, which is extremely sensitive and prone to exczema. And so far so good. (But before you try any new products on a child with rash prone skin or allergies, check with your pediatrician).

Weleda has offered to give away five sets of the lotion and cream bath. So I'm holding a little contest. Leave a comment with your favorite bath time story. I'll then pick five winners at random. The contest deadline is March 30th.

Call La Leche League for Answers to Your Breastfeeding Questions

June 21, 2007

A couple of weeks ago I went to a La Leche League meeting. I'd never been before. And in some sense, I didn't really pick the right meeting. It was a session about breastfeeding basics. I was there-- depleted, post-weaning boobs and all-- along with some very pregnant moms, and some very very little babies. (I had forgotten how small a newborn is! Makes my 15 month old "baby" look like a giant!)

But I have to say the meeting was interesting. It was essentially a support group. A chance for people to ask questions and share stories. I'm not sure I'll go back, unless I see something that's a little more relevant to what I'm doing. But even so, it was nice to see the help you can find if you really seek it out.

If you don't have the energy to find-- and actually attend-- a meeting like this, but you need help, La Leche League has a 24 hour hotline, 7 days a week. This is perfect for those 5 a.m. questions that are driving you to tears.

Here's the number:
1-877-452-5324
La Leche League also offers help by email.
And if you want to find your own local meeting, click here.

Breast Feeding Advice: Establishing Your Milk Supply

March 10, 2007

Welcome to our monthly breastfeeding carnival. This month, the booby brigade is writing about breastfeeding advice. Good advice. Bad advice and everything in between. At the bottom of this post you'll find links to the other blogs.

So, now for my two cents. First off, I'd like to do a public service announcement for lactation consultants. As far as I'm concerned, these professionals, the ladies with the IBCLC credentials, are goddesses. These days, whenever a mom asks me for help, I tell her to find an LC. If she's in New York City, I refer her to The Manhattan Lactation Group. If she's elsewhere, I suggest she get recommendations from an OB, midwife, pediatrician, hospital or friend. If she can't come up with any recommendations, I'll refer her to the International Lactation Consultant Association website. And most importantly, I'll add that not all LC's are created equal. They are just like any other professional. There are good plumbers and bad plumbers. Good lawyers and bad lawyers. Good LCs and bad LCs.

Second, I'd like to make a pitch for being a bit obsessive-compulsive shortly after your baby is born. This, I think, is what got me off to a good start with both of our kids. I was udderly (couldn't resist the pun) fastidious about feeding them every 2 to 3 hours, around the clock, for 24 hours, for a couple of weeks. In practice, that meant that I started a feeding every 2 to 3 hours after I started the last feeding. For example, if I feed the baby at 9:00 am, I fed again at 11:00 am (for 2 hours) or 12:00 (for 3 hours). Of course the schedule wasn't always so neat; if the baby wanted to eat sooner, then I fed him "on demand."

As I type this, it sounds insane. So crazy in fact, that I'm not sure I even actually did it. Did I really not sleep for more than a couple of hours at a stretch, for weeks on end?

My husband assures me this is so. He remembers going to our son's two week check-up. I reportedly handed the pediatrician the meticulous log I had been keeping. The log in which I wrote down the time of day, the length of the feeding, which breast, the number of pees and the number of poops. "Here, this is for your files," I said to the doctor. "Oh, that's fine, I don't really need it. Your baby's weight is just fine," he replied.

That was the end of my record keeping. In any case, after a few weeks, both kids started to go longer stretches, eating every 3 to 4 hours. By 12 weeks, they practically slept through the night. Later on, of course, they fell off the wagon and went back to eating in the middle of the night. But that's another story.

My point is that I think it was my nearly maniacal attention to the feeding schedule that helped me establish my milk supply and get the kids on the right track. If they didn't wake up on their own, I woke them to eat. If they were still sleepy, I stripped them to their diapers, tickled their cheeks and lips, even dug my fingernail into the heel of their feet. When the hospital nurse wouldn't release one of the kids from the nursery (because he had been spitting up black stuff), I practically banged down to the door to get in and feed him. I also put a big note on his bassinet saying "No bottles or pacifiers. Only breast milk."

Honestly, I don't know if it was this schedule, or sheer luck, that made breastfeeding work. And it was so exhausting, that I'm always afraid to tell pregnant friends what I did, lest they get scared off. Additionally, what worked for me, may not work for everyone. I'm not an LC. Just another mom, who muddled through this breastfeeding thing as best she could.

So that's my bit of motherly advice. Now, if you want to hear what some other mamas have to say, check out these blogs:

We've got the regulars from the Booby Brigade: The Lactivist, Breastfeeding123, the Motherwear Breastfeeding Blog, and Breastfeeding Mums. We've also got a bunch of guest bloggers: Black Breastfeeding Blog, Mocha Milk, Cairo Mama, The Twinkies, Random Wonderings, and the Baby Gravy Train.

Read More »

Contests For Breast Feeding Moms

January 18, 2007

Hey mommas...Here are a couple of things you may want to check out.

Motherwear clothing is running a contest to find the best breast feeding tips. You can send yours to the Motherwear blog for a chance to win a $25 gift certificate. The deadline is Friday the 19th.

Also...there's a photography contest in advance of World BreastFeeding Week (August 1- 7). The deadline to submit your photos is March 15th. Click here for details on how to enter the contest.

And just a little advance warning...I'm going to be running a contest of my own coming soon. The winners will get some really cool baby products. Watch here for more details.

Yom Kippur, Fasting and Breastfeeding

October 01, 2006

I am not good at fasting. I can barely go three hours without eating or drinking something. If I don't eat, I get cranky and tired. So Yom Kippur, or the Jewish Day of Atonement, is always a challenge. One year, in fact, I actually got sick from not eating.

Last year I was pregnant and I didn't feel well so I didn't fast. Jewish law actually says you do not need to fast if you are ill. So what is the answer for breastfeeding moms? Are you required by Jewish law to fast?

I should state that I'm Reform; in other words, I'm flexible about my religious life. If I was Orthodox, or Conservative, I would probably know the answer to this question about fasting and breastfeeding right up front. Or I would have asked a Rabbi, family member or friend. In my case, I've turned to the internet. Bottom line, it seems that Jewish law says that both pregnant and breastfeeding women should fast unless their health, or the baby's health, would be at risk.

Here is a good site with an explanation as well as guidelines on how to fast while breastfeeding. Nishmat: The Jerusalem Center for Advanced Jewish Study for Women.
Another source of information is Kellymom. www.Kellymom.com.

As always, make an informed decision. And if you do refrain from eating, have an easy fast.

Question From A New Mom-- Any Advice for Her?

September 21, 2006

If there's one things we moms know, it's pain. Our backs hurt when we're pregnant. Childbirth is... well you fill in the blank with whatever adjective you'd like. And then, sometimes, breastfeeding can have its ups and downs.

One mom wrote to me asking if people had some advice for a problem she's having now. She's going to check with her midwife to see what's going on. But in the meantime, she wanted to know what all of you out there had to say. Here's what she wrote:

"I've got an eleven week old and we've been breastfeeding without too many problems, only over the last week or so, I've got this painful white spot on one nipple. When it first appears, I've got some sore, swollen breast tissue in the area of the spot. The soreness goes away after several good nursings, but the blister doesn't go away and continues to be sensitive, if not painful. I'm soaking it and using compresses before nursing, trying to nurse and pump frequently. It's appeared twice, once last week, and it went away in a couple of days, but now it's back. It's not too bothersome, but I would be interested to know what other women have done to deal with them."

So calling all mamas, any thoughts for our friend?

Breastfeeding Tips

June 28, 2006

Do you have questions? Well this news story might have some answers. This Q&A with Dr. Joan Meek, a pediatrician and author of the American Academy of Pediatrics' new mother's guide to breastfeeding, appeared on the MSNBC website.