Re: Continuing saga of my grandson

[Guest guest]

Ilene, if you are still having trouble finding a local dentist to release your

grandbaby's tongue, please consider coming to Albany to see Dr Kotlow. He is a

founding member of the IATP (International Affiliation of Tongue-tie

Professionals)

Here is his info:

Dr. Lawrence A. Kotlow, DDS

www.kiddsteeth.com

340 Fuller Road

Albany, NY 12203-3647

You can see his presentation on tongue tie here:

http://www.kiddsteeth.com/infantdentalcare2010.pdf

warmly, norma

Norma Ritter, IBCLC, RLC

www.NormaRitter.com

[Guest guest]

Ilene I always tell my clients to supplement as much as the baby wants. and they almost always use bottles. they usually call to report "i suddenly have a different baby! He's so happy! and sleeps! thank you!" I also tell moms that baby should be able to stop eating because he wants to--not because there's just no more food at the table. HE gets to decide, not us!best, Beebe, M.Ed., IBCLC Lactation Consultant/Postpartum Doula www.second9months.comBreastfeeding Between the Lines: http://second9months.wordpress.com/--- Subject: Continuing saga of my grandsonTo: Date: Wednesday, May 12, 2010, 3:36 AM

Jumping on here to try to answer some of the questions that have come

up....

,

We tried to get in to see Dr. O'Callahan.. .no availability until the

21st :-(

So we are trying still to find someone local and deal with insurance

issues as well.

This whole thing has been enlightening to view from the other side

what a new mom

struggling with milk supply and tongue tie may have to go through!

Yesterday I

was finally brought to tears (I thought I had made an appt w Dr.

O'Callahans office

for this Friday but when I called back to verify they had no record

of it :-( so we

were at square one again) and then angry that new moms have to persevere

through all this.

For the comments about TT and peristalsis: Is this evidence based? I ask

because it seems to me that babies using artificial nipples on

bottles (formula or EBM)

would not have "correct" peristalsis either, yet they seem to move

bowels appropriately no?

Clarification on situation:

They are not using any formula to this point or any artificial

nipples including pacifiers.

Feedings at breast are frequent but not supplemented at breast due to

frustration using

the tubing at nipple. I suggested to finger feed a 1oz supplement

after each feeding

(hoping to approx 10oz) but not sure how this is happening or if they

are being consistent

with it. Or even if that is the "right" amount she should be

supplementing. Maybe she should

just fill the reservoir and let the baby take what it needs? I

originally based the amount on

a pre/post feed but haven't checked again in a week if the amount

transferred has changed.

The scale is at her house and she could check anytime but I didn't

want to undermine her

confidence anymore however at this point I'm really questioning if

the baby is getting enough

due to lack of bowel movements.

She does informal sharing with her cousin providing some supplement

and the

rest from a donor milk bank but the baby spits up the donor milk so

they are not too

happy about using it. She is also pumping and feeding what she pumps

although yesterday

she reported little success with pumping. Not pumping every feeding

only about 4x I think.

She is taking Domperidone and fenugreek. I just suggested More Milk

Plus to her.

She reports the baby's behavior to be "normal" not fussy, not

lethargic. I don't have a wt.

from yesterday and once again no bowel movements after the 3 from the

evening/night before.

Where to go from here and questions I need help with:

1. We must make sure the baby is getting as much food as he needs!

How do we do this correctly? How do I make sure mom is actually

feeding the supplements and not

being stingy because it's not an unlimited supply and she doesn't

want to use formula and the more

supplement she uses the more inadequate she feels? (I suspect this

may be happening)

Also how does this affect future parenting/bonding?

2. We will get the TT taken care of...somewhere!

This will happen but it's not the answer to everything I fear.

3. We must address what is happening with mom's supply.

What is the least emotionally damaging way of tracking supply and the

least complicated

protocol for increasing it?

4. I feel like if I add one more thing mom is going to throw in the

towel and so I've been

less aggressive than I should be thereby compromising the baby's

health! I'm patiently

waiting the two week old check up on Thur. If not at BW I'll will

insist that mom

offer larger supplements. If she feels more inadequate we'll just

have to deal with that

rather than risk not feeding the baby appropriately. Don't know if

I'm being alarmist because

it's my grandson but I've always listened to my gut and it's saying

FEED THE BABY! Should

I be so panicked this early in the game? The lack of stools really

has me thinking something's

still not right.

Thanks for all your help, I'm a little embarrassed posting this as I

fear the mothers feelings of

inadequacy have trickled down to me! Truthfully I've not had to deal

with real supply issues

and TT before in a client. I have really only seen mothers that need

support for normal type

situations or maybe small easily adjusted supply issues due to

mismanagement of bfing.

Of course the first really involved client has to be my DIL right?

Ilene Fabisch, IBCLC

[Guest guest]

Ilene -- I'm so sorry this has been such a struggle for all of you. The emotional pain you are all in came through so clearly in your email that I got a lump in my throat.

I know there are many people on this list with much more experience then me so I am not going to try and answer everything you asked. However, two things stand out to me in your email.

You said: > Also how does this affect future parenting/bonding?

I think sometimes those of us who feel so strongly about breastfeeding can lose perspective when we are in the thick of things. While we all know that breastfeeding promotes bonding, a lack of breastfeeding does not mean there will necessarily be reduced bonding. Your daughter can choose behaviors that promote bonding -- lots of skin to skin contact, practicing attachment parenting principles, babywearing, never bottle propping, etc. -- and all of these can happen even if he never gets another drop of mama's milk. Maybe being reminded that she has the power to choose how she parents in a million other ways will help her not pin all of her mothering confidence on breastfeeding. And, if she's worried about disappointing you, she may need to hear very directly from you that you will still love her, be proud of her and support her as a parent no matter what happens with breastfeeding.

You also said... > What is the least emotionally damaging way of tracking supply and the least complicated protocol for increasing it?

Sometimes when a mom has had this immensely complex relationship with feeding, I feel like one of the best things I can do is to help her get a little emotional breathing space from all the intensity. It helps with all those feelings of being overwhelmed and sometimes gives moms a new sense of resolve to keep going. For moms who are in this place, I like to start with a question from my days as a family therapist. "If you had a magic wand you could wave that would make this situation less overwhelming / more manageable / simpler (pick your phrase), what would it look like?" Ask mom to be specific and she will usually give you good clues about what will work best for her. Second, I like to suggest Genna's method of power pumping (http://www.lowmilksupply.org/powerpumping.shtml). Combined with that (and I think this might have come from Dee Kassing), I like to have the moms rubberband some washclothes over whatever she is pumping into so she can't see how much she's pumping. I've found 's method feels much less rigid for moms who have been on the "hamster wheel" of pumping on a very prescribed regimen and covering up the bottles reduces stress.

This doesn't deal with how much baby is getting at all -- just helps readjust / reframe mom's experience to make it more managable. Hopefully, if he is not at BW or above on Thursday, the pediatrician can be the one to tell mom to increase the supplement.

Take care,

Carroll, MA, IBCLC, LLLL

Lactation Solutions

[Guest guest]

Also, Ilene, I tell my moms if they don't get any milk when they pump after a feeding "that's great! that means the baby did a good job getting everything he could." remind her that the pumping is not to get more milk, but to tell her body to produce more milk. better to let the pump work on "empty" breasts than the baby... Beebe, M.Ed., IBCLC Lactation Consultant/Postpartum Doula www.second9months.comBreastfeeding Between the Lines: http://second9months.wordpress.com/--- On Wed, 5/12/10, Ilene Fabisch

wrote:Subject: Continuing saga of my grandsonTo: Date: Wednesday, May 12, 2010, 3:36 AM

Jumping on here to try to answer some of the questions that have come

up....

,

We tried to get in to see Dr. O'Callahan.. .no availability until the

21st :-(

So we are trying still to find someone local and deal with insurance

issues as well.

This whole thing has been enlightening to view from the other side

what a new mom

struggling with milk supply and tongue tie may have to go through!

Yesterday I

was finally brought to tears (I thought I had made an appt w Dr.

O'Callahans office

for this Friday but when I called back to verify they had no record

of it :-( so we

were at square one again) and then angry that new moms have to persevere

through all this.

For the comments about TT and peristalsis: Is this evidence based? I ask

because it seems to me that babies using artificial nipples on

bottles (formula or EBM)

would not have "correct" peristalsis either, yet they seem to move

bowels appropriately no?

Clarification on situation:

They are not using any formula to this point or any artificial

nipples including pacifiers.

Feedings at breast are frequent but not supplemented at breast due to

frustration using

the tubing at nipple. I suggested to finger feed a 1oz supplement

after each feeding

(hoping to approx 10oz) but not sure how this is happening or if they

are being consistent

with it. Or even if that is the "right" amount she should be

supplementing. Maybe she should

just fill the reservoir and let the baby take what it needs? I

originally based the amount on

a pre/post feed but haven't checked again in a week if the amount

transferred has changed.

The scale is at her house and she could check anytime but I didn't

want to undermine her

confidence anymore however at this point I'm really questioning if

the baby is getting enough

due to lack of bowel movements.

She does informal sharing with her cousin providing some supplement

and the

rest from a donor milk bank but the baby spits up the donor milk so

they are not too

happy about using it. She is also pumping and feeding what she pumps

although yesterday

she reported little success with pumping. Not pumping every feeding

only about 4x I think.

She is taking Domperidone and fenugreek. I just suggested More Milk

Plus to her.

She reports the baby's behavior to be "normal" not fussy, not

lethargic. I don't have a wt.

from yesterday and once again no bowel movements after the 3 from the

evening/night before.

Where to go from here and questions I need help with:

1. We must make sure the baby is getting as much food as he needs!

How do we do this correctly? How do I make sure mom is actually

feeding the supplements and not

being stingy because it's not an unlimited supply and she doesn't

want to use formula and the more

supplement she uses the more inadequate she feels? (I suspect this

may be happening)

Also how does this affect future parenting/bonding?

2. We will get the TT taken care of...somewhere!

This will happen but it's not the answer to everything I fear.

3. We must address what is happening with mom's supply.

What is the least emotionally damaging way of tracking supply and the

least complicated

protocol for increasing it?

4. I feel like if I add one more thing mom is going to throw in the

towel and so I've been

less aggressive than I should be thereby compromising the baby's

health! I'm patiently

waiting the two week old check up on Thur. If not at BW I'll will

insist that mom

offer larger supplements. If she feels more inadequate we'll just

have to deal with that

rather than risk not feeding the baby appropriately. Don't know if

I'm being alarmist because

it's my grandson but I've always listened to my gut and it's saying

FEED THE BABY! Should

I be so panicked this early in the game? The lack of stools really

has me thinking something's

still not right.

Thanks for all your help, I'm a little embarrassed posting this as I

fear the mothers feelings of

inadequacy have trickled down to me! Truthfully I've not had to deal

with real supply issues

and TT before in a client. I have really only seen mothers that need

support for normal type

situations or maybe small easily adjusted supply issues due to

mismanagement of bfing.

Of course the first really involved client has to be my DIL right?

Ilene Fabisch, IBCLC

[Guest guest]

Ilene,

You can also see a Siegel in Long Island.

http://www.lioralsurgery.com/oral-surgeon-mineola-ny/oral-surgeon-dr-siegel.html

As to peristalsis--well, I have certainly observed it clinically. Which is a

vicious cycle, causing gut damage that leads to more food sensitivity.

You mentioned earlier on that she appeared to have insufficient ductal

tissue--if that is true, then goat's true is the most important herb for her.

She can also use GoLacta and shatavari.

When I have moms feeling very low, I really reinforce how important nutrients

are--for mom--EFAs and vitD in particular. Green foods. We do not make good

choices (or milk) from a place of nutrient-deficiency.

Tow, IBCLC, CT, USA