Even Lactation Consultants Get Engorged

While pregnant with our seventh child this past fall, the thing I was most looking forward to about the birth was getting to nurse a baby again. When our older children were small, there was a period of about nine years where I was continuously either pregnant or nursing, and during this time I studied human lactation, and practiced being a lactation consultant, and ultimately achieved my goal of becoming an IBCLC. Baby #6 was 1 year old when I officially began my private practice. Our newest baby—she was born at the winter solstice, and her name is Edith—arrived after a gap of eight years, dozens (hundreds?) of lactation clients later. I was pretty sure going into her birth that I knew everything I'd need to know about nursing her. 

 
Edith Marta, one hour old.

Edith Marta, one hour old.

 

The second thing I noticed about my baby daughter after she was born, after her noticing her sex, was her tongue tie. This sounds kind of terrible in retrospect, but I assure you that this baby's tongue tie was no subtle thing. The nurse attending the delivery also happened to be an IBCLC, and she noted Edith's tongue straight away as well. We anticipated that our baby might arrive with some tethered oral tissue ("TOT" as it's called in the lactation world) due to family history, but I had certainly hoped for a different outcome. Despite her restricted tongue, baby Edith began nursing within minutes of her arrival; she did not struggle to attach. What a relief! And how fantastic to feel the sensation of a suckling baby once again, several years after weaning my next-youngest child. 

The "fantastic" sensation did not last long. It really hurts to nurse a tongue tied baby! By day two, my nipples were quite painful and raw on the faces, the way they often get to be when the nursling has a tongue tie. I saw so many of my clients in my mind's eye as I scrunched my eyes shut, and curled my toes, bracing against the sharp pain of Edith's mouth attaching to my nipples. We made an appointment to bring her to Dr. Shamey, a pediatric dentist and my preferred provider for the treatment of TOT, for a revision as soon as possible. 

In the meantime, we brought baby Edith home to her eager and adoring older siblings. Everyone wanted to hold her, of course, and my wife—Edith's other mother—and I had to fight for our own turns to snuggle with our newborn. On the evening of day 3, when I stood in my shower, attempting to massage my terribly engorged breasts, I realized that I had not been doing a great job of following my own advice. "Keep your baby skin to skin on YOUR chest, as much as possible in the first week," is one of my oft-referenced tips for the early days of nursing. Close and near-constant contact in the first week after birth can help your hormones and ensure that baby nurses as frequently as possible, helping to bring the milk in swiftly and reducing the incidence and severity of engorgement. It turns out that it's not easy to be your own lactation consultant! I had let my desire for the rest of the family to bond with the baby stand in the way of what would have likely been an easier transition for my body if I had kept baby Edith on me more of the time.

Though I've sent many, many newborns to ENTs and pediatric dentists for tongue releases over the years, bringing my own baby to see Dr. Shamey was not an easy move to make. I was glad for the opportunity to be on the other side of the experience, to have a taste of what it might feel like to my clients when they bring their babies for TOT revision, and at the same time, I felt tempted to back out of the appointment! Even knowing everything I know about the benefits of releasing a tongue tie, and the disadvantages of having a tongue tie, part of me still wanted to just leave Edith exactly as she was. I barely slept the night before the appointment. But in the morning, I knew we had to follow through with bringing her in. 

The procedure was quick, Dr. Shamey was especially loving and pleasant, and when Edith nursed immediately after, the only word I could think of to describe the sensation was "gentle." Within a couple of days, my nipples were completely healed, and my wife and I were becoming relatively proficient at doing the [dreaded] exercises to help prevent Edith's tongue from reattaching to the site where it had previously been tethered.

Edith is seven months old now, and nursing her has been smooth sailing since her tongue revision on day 5. Those first few days weren't easy, though, even for me as an IBCLC and experienced mother. The fresh reminder of how much it can hurt to nurse a new baby makes me want to shout from the rooftops about the importance of GETTING HELP when nursing is anything other than straightforward and pleasant. So: call me! :)

 
Edith and me, July 2018.

Edith and me, July 2018.