Hello breastfeeding mamas, breastfeeding supporters and advocates! This is my very first blog post. I think this is super important for me to share, as it shows that breastfeeding can have its serious challenges, even for a lactation consultant. My own experience has changed and helped my practice as a registered nurse (RN), as a lactation consultant (IBCLC), and as a breastfeeding mama.
I gave birth to my sweet little girl Demi Beatrice 5 weeks ago, on Sept 21, 2015. She is my first baby. Since I was 18 years old, I've have had the most amazing breastfeeding dreams. I couldn't wait to finally have that unique closeness to a child that I would create through the breastfeeding experience. After coaching hundreds and maybe thousands of parents on breastfeeding for over 7 years at NY Presbyterian Hospital Weill Cornell, it was finally my turn and I thought everything would be perfect. I thought it HAD to be and was supposed to be perfect for this serious breastfeeding advocate and lover. The deep love for my baby and the connection was there right away with the feeds, but what also came with it was terrible pain. I tried everything to make the latch correct. I knew and had studied exactly what the latch was supposed to look like and feel like. After only a few days, the damage became so severe, I had fissures on both nipples. Within a week and a half, I started having horrific pain (unlike anything I had ever experienced) that penetrated through my breasts out to my spine. These pains were happening between the feedings, during the day, and waking me through the night. During the feeds, it felt like knives were shooting through my nipples. I knew what I was experiencing was NOT normal.
I sat one day thinking back to my lactation studies and diagnosed myself: I was having vasospasms. I remembered reading about vasospasms and having thought to myself back then how horrible they were for women to go through. Between feeds, especially in the cold, the nipple turned white and the pain would start. Vasospasms are caused by severe damage to the nipples and a lack of blood supply. How could this be happening to me?! It just didn't see fair. I had brought Demi to a ENT week 1 of her life knowing day 1 that she was not feeding properly. He "poo-pooed" her more prominent upper lip frenulum, never asked to see the damage to my nipples, and said "you know this, breastfeeding hurts" and told me there was nothing he was going to do. I thought, "ok. Ill give it more time. Maybe things will get better as she gets a bit older." I suffered through 3.5 more weeks and finally I called my midwife and told her I couldn't handle the pain, and I needed to try Nifedipine (this is a blood pressure drug that is used as a last resort for the treatment of vasospasms). The problem with taking this medication is the issue itself wasn't fixed yet so I knew this would only be a quick fix (you take it for only 2 weeks). But I was desperate. She also gave me Dr. Mona Gabbay's number: the ONLY breast specialist MD in NYC. (Hows that even possible?) I called Dr Gabbay who had me send photos of my nipple damage and my daughters upper lip and tongue. She said Demi's upper lip was prominent and we discussed how the fissures on my nipples were on the shaft not the top. She gave me a different ENT's number than the one I had seen. Her name was Dr. Dahl. At this point, my nipples themselves were actually healing, but the pain remained and only seemed to be getting worse. I set up an appointment for that Monday (today) with Dr Dahl. (*After 4 days on Nifedipine, I realized it was not helping at all and had stopped taking it.)
At my appointment, Dr. Dahl changed everything for me. When she walked into the exam room, she asked me what was going on. I started to tell her how I was an IBCLC and how I went to see another ENT, etc etc... and she cut me off and said "I am about to change your practice. Now, tell me, what is going on?" So, I said "I am in so much pain." She smiled and said "so lets fix this". She told us that it was not about the actual frenulum (thats the stretchy tissue under your tongue) or a lip tie: it's about the gape. So what that means is the way Demi was opening her mouth and moving her jaw was incorrect, causing her to chomp down on my nipples. She was unable to properly move her jaw because of her gape/frenulum, which did not allow the nipple to go past her hard palate and into the correct part of her mouth. And no matter how long I waited to see improvement, it never would have improved. Because of her improper gape, it was harder for her to get the milk out-- so she was working much too hard, and feeding way too long (most feeds were over an hour). She also said eventually I would have had a supply issue and I've been very lucky to have so much milk (Demi was back at her birthweight by day 4 and gained 2 pounds by 1 month!)
Dr. Dahl snipped her tongue and her upper lip with a scissors as I held her in my arms on top of a Boppy pillow. She cried for a few seconds and bled a tiny amount of blood from both sites. Dr. Dahl rocked her in her arms and then put her on my breast. I felt and saw an immediate difference. Because I had had significant damage (which she explained was healing because 'that's what our bodies do - it gets used to things'), it was possible that the vasospasms would continue for some time. The pain with feeding would get better and better as my nipples continued to heal with Demis new gape.
After the appointment, I cried with happiness.... Just the thought that the pain could stop was so overwhelming. I had never lived in pain before, and at this point it had been 5 weeks trying to cope and function. To me, breastfeeding was too important and the truth is, I'd always be willing to suffer through this pain so that I could have this bond with my baby. Even if I had to feel it always, it really was worth any pain. But, the fact that the pain would possibly be gone, that I could stop curling my toes, biting my lip, crying through and between feeds, and I could really start to enjoy this experience fully, the way I've always dreamed.... It was everything to me.