I didn't think I had mother's intuition. With Louie I followed Plunket's guidelines pretty closely, finding most of it made sense. But Louie was a text-book baby and the 'norm' fitted him well. With Arlo, we have been on a bit of a different journey, a tough one but one that has ultimately led me to find and trust my intuition.
From our first few days together, pacing the birthing centre all through the night and day with him screaming, I knew something was amiss with Arlo and I didn't think it was simply the shock of this new world. Not having any clue what was wrong I wanted help, advice and most of all a diagnosis.
My midwife, doctors, birth centre midwives, lactation consultant, Plunket, Mothercraft, Osteopath, Naturopath....opinions were sought and diagnosis' made. Dozens of them. Now I feel we're somewhat near the end of this crazy odyssey and after all the advice I received I now know one important thing....trust my own diagnosis. As Arlo's mum, only I can pick out our path amongst the well-meaning recommendations of professionals and non-professionals alike.
It takes a lot of faith to disregard professional advice however, so perhaps, in writing our journey down I might give someone a little confidence to do so if they are coming up against a whole slew of sometimes contradictory advice and finding some of it just feel it doesn't suit. And I'd also like to keep a record of these tough days if not simply to remind myself how far we've come!
Note: I actively sought out all of this advice and it was given with our best interests at heart. In the end we discovered Arlo has silent reflux and a cows milk protein intolerance (and is super emotional and a mummy's boy! At this stage...)
Firstly though, a shout out to my midwife. I LOVED our midwife. She was practical, warm, professional, super-efficient and had been practicing for over 30 years. She knew her shit. And she never once dismissed my concerns nor really gave me 'advice', rather she offered many avenues to try; osteo, naturopath, Family Centre, Le Leche League etc. This is how it should be done in my opinion, belittling someone's concern about their baby, even if you're pretty sure it's just common baby stuff is not helpful. Nor is spouting absolutes or ill researched facts. It's a tough line to walk and she walked it beautifully.
Mothercraft: My Dr put my name down on the waiting list for Mothercraft after I burst into tired tears in her consultation room. By the time my name came up, things were looking much better, I was wearing Arlo to help him sleep instead of sitting in a dark room for 70% of the day trying to bounce him to sleep while Louie watched hours of tv. Here lies the road to depression. He had also started some reflux medication which seemed to have helped a bit. But I decided, hey, lets just go along to Mothercraft anyway. I'd heard great things and I thought having someone see my baby in a more holistic way, instead of just 15minutes a time at my Dr's appointment, would be really helpful in determining whether Arlo really did have silent reflux and to what degree.
It was a disaster. While it is an amazing facility and SO many mums and dads have been helped by these very skilled nurses, we just weren't a good fit. It wasn't the crying (they work on a controlled crying technique to get babies sleeping better), I've actually taken some of that advice on and I now leave Arlo to cry a bit more than I was, and to great results. No, it was that they were solely concerned with getting him to take a certain amount of milk (150-180mls) every feed, four hourly. Full bellies mean babies are not wakeful due to hunger and they can get on with sleep training them. Makes total sense.
It was a disaster. While it is an amazing facility and SO many mums and dads have been helped by these very skilled nurses, we just weren't a good fit. It wasn't the crying (they work on a controlled crying technique to get babies sleeping better), I've actually taken some of that advice on and I now leave Arlo to cry a bit more than I was, and to great results. No, it was that they were solely concerned with getting him to take a certain amount of milk (150-180mls) every feed, four hourly. Full bellies mean babies are not wakeful due to hunger and they can get on with sleep training them. Makes total sense.
But Arlo was only taking 110mls, absolutely consistently (they do a pre-feed weigh and a post-feed weigh) and they concluded he was hungry. The recommendation was that I pump immediately after a feed and top-up. I was told to only ever pump for 5 mins per side. But when I was unable to successfully pump in these very stressful circumstances, it was recommended I top-up with formula. I had Andy bring in my stash of frozen breast milk to allay their fears he was hungry (I had other ideas, see below). But Arlo didn't want a bar of topping up his 110ml feed and refused the bottle from me and the nurses. Their next advice was to completely stop breast feeding him for a day, until he got so hungry he took the bottle. This came with the risk that he wouldn't go back to breastfeeding.
Where I felt this advice was wrong for us:
1. I felt Arlo was not taking more milk because of his reflux. He knew exactly how much would allow him to feed without too much pain and limited every feed to this amount.
2. Not being allowed to pump more than 5 mins per side is not right for MY body. I take at least 5-10 mins to 'let-down' at home, fully relaxed. with a second let down if I keep the pump going even longer.
3. I felt by putting Arlo on the bottle, even for top-ups, I would be reducing the amount of time he would be at the breast in effect reducing my supply even further.
4. Forcing Arlo to take the bottle and risking him not breast feeding again was completely against what I wanted to do.
5. By advising me to force more food into him, it seemed we were overlooking the more important question of WHY he wasn't feeding more efficiently and WHY my supply was therefore dwindling. Assuming off the bat that it was hunger was not neccessarily true but they would not looking into other factors such as reflux until baby's belly was full...a bit of a catch 22.
6. And anyway, this amount that he 'should' be taking....who said? It was a figure based on the age of the baby, not their weight, size etc. Arlo was gaining good weight very consistently, on the 75 percentile mark. I wasn't worried about his weight.
7. And lastly, they wanted me to feed him 4 hourly instead of the 3 hourly feeds I had been working towards. This meant he didn't get enough calories during the day and went back to waking every 3 hours overnight instead of the one or two wake-ups we'd been having! It was enough to have me exhausted, emotional and packing my bags on day two!
Lactation Consultant: Arlo has a terrible latch, very clicky, sucky and he seemingly takes in a lot of air. I decided to seek a Lactation Consultant's help. She diagnosed tongue tie and lip tie pretty quickly and explained how common it was, possibly due to the increased use of folic acid in pregnancy. She told me that many dentists advise her to encourage her clients to have the ties snipped as there is no real purpose to them and they have the possiblity of causing speech impediments in the future. After some deliberation by me, Arlo's tongue tie was snipped. No improvement has been seen. I have since been told that there is a huge over diagnosis of tongue tie in NZ, especially in the Waikato and that in fact many dentists won't do them any more.
I saw her twice, once for the diagnosis and once for the snip. The first time she also mentioned that she thought I should switch feed (feed from both breasts a number of times per feed). At the second appointment, a few days later, she told me I should absolutely be block feeding (feeding from one breast only each feed). She obviously had no memory of telling me the complete opposite advice earlier.
Osteopath: Arlo was so upset at his Osteopath appointment that she had to work on him while I breast fed. I was told he probably had colic. No improvement noted.
Family Centre: much prodding and poking of breast, post and pre weigh. Under-supply diagnosed (= hungry baby). Lactation drops and Domperidone suggested. I am taking Domperidone but still unsure if this is necessary.
I was also told to "get him off the breast!" when he slowed down feeding, then taken to the pumping room to pump a top-up for him. I felt this was counter-intuiative when keeping a baby at the breast longer would assist my supply and negate the need for a pumping session!
Other contradictory advice I've been given includes: It is imperative you stop eating dairy/peanuts/eggs/broccoli/spinach/kale/tomatoes/chocolate/coffee/fish/grapes/citrus/cabbage/garlic/onions/juice; AND don't change your diet at all, the amount reaching baby is minimal. Baby hammocks are fantastic for reflux babies AND baby hammocks are THE WORST for reflux babies. Hold him a lot DON'T over hold him. Etc etc etc.
Basically any thing you do with your baby, there is advice not to do it. But fear not! Because there is also advice to continue doing it! Sometimes there's a whole philosophy based around one way or the other. It's exhausting and my brain spins with the contradictions.
But some good has come of the whole journey. While I may continue receiving and seeking advice, I now truly feel equipped and personally validated to make decisions based on MY knowledge of MY baby. And that alone feels like a load has been lifted.
- 10:04 PM
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