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How to Identify and Deal with Lip Tie and Tongue Tie

After having problems establishing a breastfeeding relationship with our first three children, I discovered what a lip tie was. After having our fourth child, I finally learned what a tongue tie was. Had I known about these two conditions from the very beginning, it would have made things a heck of a lot easier! This is the information I have gathered doing extensive research, talking to experts, and through my own experience. This is the information I wish I would have had with my first child from day one and what I would like to tell anyone else who is going through the same thing.

First of All, Let’s Talk About Frenula

Frenula is the plural form of frenulum. A frenulum (also called frenum when in relation to the upper lip) is a small fold of tissue that secures a mobile organ in the body. The maxillary labial frenum is the membrane that attaches the gums to the upper lip and the lingual frenulum is the membrane that attaches the base of the tongue to the floor of the mouth.

When a baby is growing in utero, the tongue starts to develop at about 4 weeks. By 6 weeks, the frenulum cells attaching the tongue to the floor of the mouth begin retracting from the tip of the tongue increasing the tongue’s mobility. Disturbances during this stage cause ankyloglossia, or tongue tie. The tip of the tongue will continue to elongate after birth which is why some people believe that the tongue will “stretch” with age and growth, although that is not the case.

Look at Your Frenula

Before going any further, I suggest that you look in a mirror and lift up your upper lip. You may notice a stretchy piece of tissue hanging out up there, and you might even be able to feel it with the tip of your tongue. You may also feel nothing. Next, lift up your tongue and look for the stretchy piece of tissue lying underneath. Move your tongue around and notice the range of motion you have. Then try sticking your tongue out. Notice how far you can stick it out. Can it go down the length of your chin or up to the tip of your nose or does it barely leave the confines of your teeth? After you explore your own frenulums, examine your spouses. The two of you will probably be much more willing participants than your children, and it will give you a good insight as to what to look for since genetics will probably play a role in the type of frenulums your children have.

Are the Frenula Causing Problems?

The mere existence of frenula does not constitute a problem, it is when they are so restrictive that they prevent breastfeeding from occurring that is a problem. When the frenum of the upper lip or the frenulum of the tongue start to cause problems, they are referred to as lip ties and tongue ties. If there is a lip tie, there is probably a tongue tie also, but a tongue tie does not necessarily indicate that there will be a lip tie.

What is a Tongue Tie?

Being tongue tied is medically defined as having ankyloglossia, which is caused by having an unusually short or thick membrane under the tongue that is attached abnormally close to the tip of the tongue and causes restricted movement of the tongue. People with more severe cases of tongue tie cannot stick their tongues out very far beyond their teeth.

Tongue Tie, Photo Credit: Kate via Flickr, 2008

Tongue Tie, Photo Credit: Kate via Flickr, 2008

This can cause breatfeeding problems with babies and speech problems as they get older. As an adult, the worst of the lingering effects are typically the inability to french kiss properly and the inability to lick an ice cream cone. Here’s a great 2 minute video describing what tongue tie is, the symptoms associated with it, and what it looks like to get it removed using the scissor method.

What is a Lip Tie?

Having a lip tie occurs when the membrane under the top lip is unusually thick and attaches under the gum line. It is not as common or severe of a diagnosis as being tongue tied, although it does have its own host of problems. I’ve read that severe lip ties will usually correct themselves by the time a child reaches adulthood due to tripping and falling or any other number of accidents that can lead to the lip tie being torn, but Dr. Kotlow, a leading expert in tongue and lip ties, believes this is not the case. He explains how if a severe lip tie is not corrected, “it can lead to dental decay on the upper front teeth, gaps (diastemas) between the two front teeth, orthodontic or periodontal problems later in the child’s oral development, and poor lip mobility or function, especially during smiling and speaking.”

Lip Tie

Lip Tie

Other resources that I’ve looked at say that once all of the permanent teeth come in, the gap may just fix itself. Here’s a great 2 minute video describing what a lip tie is, the symptoms associated with it, and what it looks like to get it removed using the scissor method.

Different Classifications of Tongue and Lip Ties

Although you cannot diagnose tongue and lip ties by looks alone, it’s a good place to start. One of the first things to look for to see if your baby is tongue tied is to see if your baby’s tongue makes a heart shape when he or she cries. This is a tell tale sign that it is being tethered too tightly to the floor of his or her mouth.

One of the best ways to look for a tongue tie is to lie the baby on his or her back on your knees with his or her head facing towards you and his or her feet facing towards your knees. Then, tilt the baby’s head back and stick your fingers underneath the tongue to elevate it. You can also get a pretty good look when he or she is crying. To look for a lip tie, look to see if the top lip flanges out while nursing. You can also simply lift up the top lip and look.

These pictures below have been compiled by Dr. Kotlow, one of the most renowned pediatric dentists, known for his skill at correcting tongue and lip ties. He comes highly recommend by Mommypotomus who also has a great blog about tongue ties. You’ll notice that there are many different classifications.

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Symptoms of Tongue and Lip Ties

Looking at the symptoms related to tongue and lip ties is actually the best way to diagnose them. So here are a list of symptoms to look for in both mom and baby that could be the result of tongue and/or lip tie.

  • Symptoms to Look for with Mom
    • Nipple pain and/or erosions
    • Nipple looks pinched, creased, bruised, or abraded after feeds
    • White stripe at the end of the nipple
    • Painful breasts/vasospasm
    • Low milk supply
    • Plugged ducts
    • Mastitis
    • Recurring thrush
    • Frustration, disappointment, and discouragement with breastfeeding
    • Weaning before mom is ready
    • Tired momma, from being up in the night every hour for feeding night after night after night
  • Symptoms to Look for with Baby
    • Poor latch and suck
    • Unusually strong suck due to baby using excess vacuum to remove milk
    • Clicking sound while nursing (poor suction)
    • Ineffective milk transfer
    • Infrequent swallowing after initial let-down
    • Inadequate weight gain or weight loss
    • Irritability or colic
    • Gas and reflux
    • Fussiness and frequent arching away from the breast
    • Fatigue within one to two minutes of beginning to nurse
    • Difficulty establishing suction to maintain a deep grasp on the breast
    • Breast tissue sliding in and out of baby’s mouth while feeding
    • Gradual sliding off the breast
    • Chewing or biting on the nipple
    • Falling asleep at the breast without taking in a full feed
    • Coughing, choking, gulping, or squeaking when feeding
    • Spilling milk during feeds
    • Jaw quivering after or between feeds
  • Symptoms I Had: With our fourth baby, Julian, I was not getting very much sleep because he was up every hour or two (or sometimes every 30-45 minutes) to nurse. And when I would nurse him, I wasn’t able to just lay down and nurse, I had to either sit up on the edge of the bed or in the rocking chair to help him latch on. My nipples weren’t really sore (after four babies, they got pretty tough), but he was rolling the nipple around in his mouth and falling off the nipple repeatedly. When he would nurse, there was a noticeable clicking sound from his inability to form a secure latch. He especially had trouble maintaining a latch during my letdown and he would sputter, choke, and pop off the breast. He would also fall asleep mid feed and as a result he didn’t fully drain the breast. This led to me getting plugged milk ducts (which I massaged away after applying a hot compress and drained completely using a breast pump) and I believe that this is what led him to have a lot of green poops (from not getting enough hindmilk). He was also taking in a lot of air during feedings which resulted in him being gassy, needing to burp and fart a lot, and getting the hiccups. When he had gas (which was often), he would get really fussy and squirm, wiggle, and grunt…even in his sleep. He would also puke a lot, but he also would nurse a lot, so weight gain was not an issue. Finally, at his six week checkup, the midwife noticed that he was tongue tied. Once I started researching the symptoms, it all made sense.

Temporary Relief

If you are waiting for a corrective procedure or trying to decide if you will get one, the following strategies may help to provide some temporary relief.

  • Stretch the Lip Tie – To help with stretching out both Ophelia and Julian’s lip ties, I would put my finger under their upper lips and roll up. I tried to remember to do this before every feeding. To help them latch on, I would have to grab my breast and angle the nipple down, wait until they opened their mouth, and then torpeedo my nipple in there! Once they latched on, I would sneak my finger under their lips to flange it out. By the time they were three months old, I didn’t have any problems with their lip ties anymore.
  • Sitting Up and Leaning Forward to Nurse – Getting a good latch is difficult enough as it is, but when you’re dealing with a lip and/or tongue tie, it’s even more challenging! This seems to help.
  • Burp Often – Because they are taking in a lot of air, it can help to burp during a feeding by either patting their backs or putting them up on your shoulder. I would also try to angle their bodies to make them more upright while nursing. Also, keep burping periodically even long after the feeding.
  • Hold to Sleep – Now, I’m a really light sleeper, so this works well for me, but it can be dangerous, so use this strategy with caution! What I do is prop a big tower of pillows in a U-Shape around me for support. Then I sleep with pillows propped under my arm and my head leaning against a pillow. When we sleep, I hold his upper body upright and about every 3o minutes or so when he gets fussy, I would pat his back, bounce, and rock him until he calmed down. We are six weeks after the procedure and Julian is 3 months old, and I still actually hold him while I sleep every night. I think I’m just used to it now!
  • Belly Band Over the Boobs – You know that thing that you put over your pants when you’re pregnant so that you can leave your pants unbuttoned as your belly grows? Well, I pull that over my breasts because my nipples are just so dang sensitive. It’s a much more comfortable alternative to wearing a bra at night and makes it easier to nurse too.
  • Air Time – Putting breast milk on my nipples and just walking around without a shirt on felt good (I just had to remember to close my curtains!)

Options Moving Forward

You have several different options depending on your specific situation. You will want to consider the following: the problems you’re having breastfeeding (If it’s not causing any noticeable problems, I would recommend leaving it alone.) the availability of a skilled practitioner in your area or your capability of traveling, your financial situation and insurance coverage, the age of your child (over 6 months is almost too late), and so on. Here is a list of the next possible steps.

  1. Wait and See – If your symptoms are not that bad or if you feel like they may be caused by something else (a poor latch, strong let down, flat nipples, etc.) you might want to take a wait and see approach. Dr. Kotlow however. strongly advises against this for a lip tie because he does not feel that it will get better with time. But with Ophelia and Julian’s lip ties, I saw that they did, although they were not extremely severe. It was really hard to get a good picture, but you can kind of see Julian’s below. It attaches below the gum line and was kind of tight at first, but seemed to stretch out over time. 

    Julian's Upper Lip Tie

    Julian’s Upper Lip Tie

  2. Best Time to Act – Keep in mind that the younger the child, the easier it is to deal with this procedure. Once you go through with the procedure, not only will your child have to physically heal, but he or she will have to learn how reuse his or her tongue based on the release and the new muscle use related to the increased mobility. The best time to get a procedure done is before the child is 3 months old, and really, the younger, the better. Usually, when the child is over 6 months old, the doctor won’t do the procedure in the office, and it will have to be done in the hospital with anesthesia.
  3. Pediatrician’s Opinion – We did not need a referral to get an appointment with a specialist, but you might, and this would be a good place to start to learn about your options. Just keep in mind that some pediatricians are not familiar with tongue or lip ties or worse yet, might not believe in them and make you feel silly for even asking. We took our fourth baby, Julian, to see his pediatrician because we had no idea where to even start. She said, “Yup, that’s a tongue tie!” and suggested that we see an ENT for a frenectomy (also known as a frenulectomy, frenulotomy or frenotomy – which is the removal of a frenulum). When he cries, you can see the heart shape of the tongue and how it is tethered to the floor of his mouth.
    Julian's Tongue Tie

    Julian’s Tongue Tie

  4. ENT – That’s an Ear, Nose, and Throat specialist in case you didn’t know (I didn’t). Some people feel like this is the best place to go for getting a tongue or lip tie procedure. For us, we needed something close that was in our network, and this was the only option. We had to pay $45 for the office visit and we were quoted that the procedure would be $450, but six weeks later, we have yet to get a bill. (Maybe insurance is covering it after all?)
  5. Pediatric Dentist – Some people feel like this is the preferred specialist for this procedure. I think that it all depends on what is most convenient for you. If you can travel and money isn’t an option, then you might have the freedom to research all specialists nationwide and find the best of the best.
  6. Scissor Method – This is the most common way of doing the procedure, and what we did with Julian. Depending on the severity of the tongue tie, a topical and/or local anesthetic may be used, the membrane may be clamped to stomp blood flow, a nurse (and you if you can handle it) will hold the baby down, the nurse will prop up the tongue with q-tips or some other tool, then the doctor will go in with one or two snips, and then he or she will then cauterize it with silver nitrate if there is a lot of bleeding. When Julian had his cut, I was really shocked by the amount of blood, but the doctor assured me it was normal. He breastfed right after the procedure and the bleeding stopped after a few minutes. (His next poop was pretty black from all of the blood he swallowed.) There is a concern with this method that the doctor won’t cut enough (I’m sure it’s scary going into a little baby’s mouth like that with a pair of scissors, especially if they are screaming!) and there won’t be a full release, but we did not have this problem.
  7. Laser Method – Some say that the laser method is superior because it can penetrate through more of the tissue for a more complete release and immediately cauterizes the wound, but it is not easy to find someone who will do this. (It takes a steady hand and a lot of skill.) Here’s a list of nationwide providers that will do the laser method.
  8. Questions to Ask – If you have several options within your area, it might be a good idea to ask some of the following questions to narrow your search such as: 1) How often have you done this procedure? 2) How often do your patients come back for a revision? 3) What is the procedure like? 4) What are your thoughts on the scissor method versus the laser method? 5) What do you recommend for aftercare?

After Care

After the procedure, some say that doing exercises to help the muscles learn what they are supposed to do and to make sure the tongue tie doesn’t reattach and scar tissue doesn’t form is absolutely crucial. I personally felt that my son would strengthen his muscles by nursing and that the wound would be given sufficient time being stretched every time he cried. (I mean, I wish I could soothe him perfectly so that he never cried, but that has yet to happen.) To be honest, I felt like he had been through enough and I could tell he was in pain when I tried to do the exercises, and I just couldn’t bear to put him through any more. I can see how the lip tie would reattach if the lip continued to not to flange out while nursing, but I can’t imagine that the newly detached lip wouldn’t flange out. At any rate, you may want to rub a finger over the wound periodically to ensure that it doesn’t reattach.

Typically, babies feel discomfort for the first 24 hours after the procedure. Older babies and toddlers will typically feel discomfort for the first 48 hours. Breastfeeding and skin to skin are the best first lines of defense. Arnica is a good natural method for pain relief, or there’s acetaminophen (dosage should be given based on the child’s weight not age). Ibprofen should not be given to children under the age of 2 months and topical numbing ointments containing benzocaine (Orajel/Anbesol) should not be given due to health risks.

After Julian’s procedure, he was in a considerable amount of pain for the first 48 hours. I ended up giving him some acetaminophen every couple of hours for the first two days and then periodically after that as needed. The wound was white for about the first 10 days and then it looked pink again. They say that with a successful tongue tie revision, you should be able to see a diamond shape. It was really hard to look under Julian’s tongue to see if this was the case but I could tell things were better based on our nursing relationship.

The Ideal Diamond Shape After a Tongue Tie Release

The Ideal Diamond Shape After a Tongue Tie Release

We are now 6 weeks past our frenectomy date and I feel like I am finally noticing a difference. To be quite honest, he improved ever so gradually, that it was hard to notice on a daily basis, but when I reflect back to the way things were 6 weeks ago, it’s really a night and day difference. The clicking went on for some time until it finally faded away. He still pops off the breast during my let down from time to time, but that could just be due to my really powerful letdown. He is sleeping better and best of all, I am able to nurse laying down! He still wakes up to feed every 2-3 hours, but that is WAY better than every 45 minutes! At first, I really questioned whether or not getting the procedure was worth it (holding him down screaming, the needle under his tongue for the local, and the blood spurting as the doctor cut all we’re absolutely brutal), but now I am definitely glad we did it. I think that maybe we would’ve had a better experience had we found a pediatric dentist who could do the laser procedure, but that just was not an option for us.

Body Work

Some people recommend chiropractic or CrainoSacral Therapy both before and after the procedure to help release the muscles needed to nurse. CranioSacral Therapy (CST) is a gentle, hands-on approach that releases tensions deep in the body to relieve pain and dysfunction and improve whole-body health and performance. In her article, CranioSacral Therapy: When Can It Help, by Dee Kassing, BS, MLS, IBCLC, she states that,

“If there is misalignment and imbalance of the skull bones, this can affect the function of the palate, tongue, and other structures of the head. This can cause the palate to be too high or uneven, or the facial muscles to be too tight. Imbalance of the structures of the head, as well as trauma from the birth process itself, can cause constant irritation to the nervous system. This constant irritation may also cause hypersensitivity, which can sometimes be the underlying cause for babies who gag and cannot accept anything in the center or back of the mouth.”

We took Julian to get some CST before his tongue tie release when he was about 5 weeks old, and while it didn’t make breastfeeding better per sae, it changed him in both subtle and powerful ways. He always seemed to be just a little bit fussy, and afterwards he was SO CALM. I would definitely recommended CST for every infant after birth (But that’s another post!). I kept meaning to take him for some post CST, but the timing just never worked out. It is definitely something I would recommend to anyone getting a frenectomy. To find someone who does CST, you can call chiropractic offices that specialize in infants and see if they recommend anyone.

Happy Julian

Happy Julian

More Personal Stories

Like I said, all of our children have had either a tongue tie, lip tie, or both. Too bad I didn’t learn about what they were until recently.

  • Ruby – Looking back, we had a very rough start to our breastfeeding relationship, and now I know that it was due to her having a lip tie. She couldn’t get a good latch, she was constantly popping off the breast, she would spit up A LOT, she couldn’t drain the breast and had green poop, she took in a lot of air while nursing because of the constant on and off and as a result she was very gassy and fussy. Now she is five years old and has a noticeable gap between her front teeth. And sure enough, when we lift her upper lip, there’s a lip tie. It doesn’t seem to be too serious, however, and we are hoping that the gap will close when her permanent teeth come in. If not…braces!
  • Elliot – Looking back, I can see that I had a lot of the same problems with Elliot that I have had with Julian. I just had no idea about tongue or lip ties at the time! I nursed Elliot until he was 18 months old, but had to wean him (before either of us were ready) because it was just too painful. Now, he is four years old and has some speech problems. He cannot say the /r/ or /l/ sound and has trouble with the /c/, /g/, and /th/ sounds. We had the ENT look at him when we were there for Julian’s appointment and he said that he definitely had a tongue tie, but that it wasn’t bad enough to warrant surgery. We have decided to just work with him on correctly pronouncing his letter sounds and hope for the best.
  • Ophelia – Our midwife pointed out that she had a lip tie right away even though I had no idea what that even was at the time. Per her advice, I worked on stretching it out as she suggested and flanging her lip out when she nursed, and it never really became a problem. When her baby teeth came in, there was no gap in between her top front teeth.
  • Julian – I noticed that he had a lip tie right away, so I was able to stretch it out and it wasn’t really an issue. I asked our midwife to look at it during our 6 week visit, and she discovered that he was actually tongue tied. And that is when all of this research began. Full circle.

For more reading on the matter, check out these resources: Breastfeeding a Baby with Tongue-Tie or Lip-Tie (Resources)

Julian’s First Ten Days

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I’m sitting on the couch right now watching The Land Before Time with Ruby and Elliot snuggled up close on either side of me. We just ate a huge pile of cookies and some fresh milk and now we’re all buried under silkies while Julian rocks peacefully in his swing. A fire is blazing, the snow blankets the world outside, and I feel very cozy staying inside and happy to not be tempted by the nice fall days that could lure me to do too much while instead I get to recover, rest, and recuperate. Ophelia is sleeping and Andrea just left after spending three wonderful days with us. Daddy is still at work for a couple of hours and then he has tomorrow off for Thanksgiving. Ruby had a half day today and she’ll be off from school on Thursday and Friday as well. These past ten days have been amazing, magical, life-changing, and completely wonderful and I want to go back to the beginning and try to remember how we got to this place.

For nine months we talked about what our lives would be like with a 4th. We imagined, we dreamed, we moved,  we prepared, we rearranged, we prepared some more, and we rearranged again, and again, and again. We were most concerned about how we would get through our bedtime routine and how I would handle taking care of a baby and three little ones. This new baby was the biggest reason for sending Ruby to school, and while it was difficult at first, I’m so glad that we stuck with it because she loves it so much, she is learning so many things, and I don’t know how I would have managed doing homeschool kindergarten and taking care of the other three.

But all of that planning and preparing couldn’t get us quite ready for what was to come as much as just diving in and getting used to this new life. I thought that we would need extra help especially preparing dinner and getting the kids to bed, but with a big winter storm snowing us in, we didn’t really get the help that I thought we would need, and it turns out, we didn’t need it!

I knew how important it was to have a baby moon, especially when Ruby was born and EVERYTHING was new to us. We didn’t want people coming over and telling us what to do before we had a chance to figure it out for ourselves. But with baby number four, I didn’t really think that a baby moon was possible or even necessary, but it turns out I was wrong! Whether we had planned for it or not, we got a baby moon! We had my mom, grandma, and sister there to help us on day one, and then we were on our own for the rest of the week. It was a wonderful week and it was so cool to see all of our lives transform as we became a family of 6.

Scott’s Transformation

The first person that I noticed to change and grow was Scott. He has always been an amazing father and husband, but he stepped up to a higher level than I even thought possible after this birth. I knew that I really needed to take advantage of his week off to recover so that I could take over when he left and so I spent a lot of time sleeping in, resting, sitting in one chair or another, cuddling, and demanding one thing after another. Scott was there before I could even ask him to come, he did things before I even saw that they had to be done, and he was constantly busy keeping the kids dressed, fed, and happy, the house clean and picked up, laundry taken care of, food prepared, the kitchen cleaned, and he was always there to make sure that I had everything that I needed. He was so attentive to our needs and so in tune with what needed to be done and I just fell in love with him all over again. In this week of sleepless nights where we were constantly at least a baby’s length apart, he made me feel beautiful, loved, appreciated, and so much more.

It’s just amazing how much our lives have changed since having kids and instead of trying to balance the way our lives used to be with the way our lives are now, we have simply embraced the way that they are now without any pretenses about trying to recreate the past. In some ways, I think this is an easier task for the mother. Carrying a child for nine months and then having them need you constantly during that fourth trimester forces you to be there. All a mother has to decide is if she’s going to do it begrudgingly, simply waiting for the sleepless nights and sore nipples to pass or if she’s going to embrace it with a passion that consumes her. Easier said than done, I know, but when you carry a child in your womb, you feel like they are a part of you forever and always. Even as my children grow, I still feel like we are connected by an invisible umbilical cord. Every joy they experience I do too and every sorrow they encounter is one that breaks my heart as well.

But the father is needed in a different way. One that isn’t quite obvious at first, but is just as important as the mothers’, albeit in a different way. I see our kids desperately seeking their father’s approval and love, and I see them beam and grow in very strong and powerful ways when he encourages them. He is more practical than me. Sometimes I look at my little angels as if they are perfect and can do no wrong, but he is so good about gently guiding them to learn about the rules of what is right and wrong. He tells them about the world and patiently answers all of their questions, he wrestles with them roughly when they need to fight and cuddles them gently when they need to be loved, he tells them about his passions and encourages them to seek theirs, he introduces them to new things that make them feel so cool, connected to him, and respected like how to fix computers, play Minecraft, cook, do dishes, enjoy books, and more. But the most important thing that he gives his children is his honesty. His love is honest—it is not forced, he does not do these things or give of his time because he is supposed to or it is expected of him. He truly enjoys it. He loves being a father and he tells me and the kids this constantly. To have a father who parents with such joy, not begrudgingly while wishing he could be out on the town or doing the things “he wants to do”. This is what he wants to do, this is who he wants to be, and our children will grow up with this knowledge at the very core of who they are.

Kids can sense when you’re doing something out of duty or if you’re doing it because you completely enjoy it with every fiber of your being, and it is obvious to anyone who sees Scott interact with his children that he is madly in love with them and loves to be with them. I think that this stems from the love that we share with each other. When you go back to the beginning of Scott and Stacey, you will find two people that are completely, madly, and deeply and passionately crazy for each other. This passion has grown deeper with every adventure, every change, and every child and we still can’t keep our hands off from each other just like when we were in the beginning stages of our relationship. I love him so much and the thought of spending our entire lives together watching these children who we birthed, raised, loved, and cherished grow into adults and have children of their own warms my heart and makes me happier than anything money, prestige, or status could ever offer. As we become grandparents and reflect on all that our love has created as we settle into our “golden years”, I simply can’t imagine a better future.

 

The Kids Have Changed Too

The way that Scott and I have changed and grown is more obvious, but as we welcomed Julian into our lives the kids changed too, although in more subtle ways. Ophelia was quite indifferent at first, but she is going through perhaps the biggest change of us all. Now she is no longer the little baby and mommy’s lap that used to be reserved just for her is now being shared my a helpless little infant. She loves standing on my footstool while I nurse and she says, “Baby! Baby! Goo goo ga ga!” It’s so cute! She gets a little jealous if Scott gets her up and she sees Julian on my lap, but then Scott will take Julian and I cuddle up with Ophelia and then she’s just fine. Other than that, she hasn’t really shown any other signs of jealousy. We’ve treated her like all of the other little siblings with a new baby and have tried to give her lots of extra attention and we haven’t pushed her to acknowledge the baby unless she is ready to do so. She loves looking at him and saying, “Baby sleeping!” or if he’s laying on the floor she’ll pet his head and say, “Baby. Gentle.” just like she would with a kitty.

Elliot has been through the roof happy with his new brother! After being so indifferent after Ophelia was born, it’s been so nice to see him so excited for a new sibling. His enthusiasm is so vibrant and he gets so loud, but Julian LOVES it and looks right at him. I think that he heard Elliot’s voice in the womb very clearly and really recognizes it. Elliot loves cradling his face and showing him things and talking to him about fighting and video games and Minecraft. He is so excited to have a brother and wants to know when he’ll be able to wrestle, fight, and play. It has been so nice having extra time with him while Ruby is at school and Ophelia is sleeping or busy. I know it won’t be long until he’s in school too or too busy to need me as much as he does, but for now, he’s my special cuddly guy and it’s just so fun to spend all day every day together.

Ruby is a little mother hen and she is truly quite helpful. She loves to tell Julian stories and sing to him and every time she sees him she wants to see if he’s awake and give him a kiss. She is always wondering why he is sleeping so much and wants to know if his eyes are open. “Sorry dear, he’s probably more awake at night than during the day”, I tell her. She is so good about getting me things that I need and keeping me company while I’m nursing or holding him. She is also so helpful around the house picking things up and helping us with cooking or other projects. We were so worried that she would want to stay home with us while Daddy had a week off, but she was really excited to get back into her school routine and hardly noticed what was going on at home while she was gone.

But through all of the positive aspects of change, there have been some bumpy and rough parts too. It’s hard to put my finger on what has been rough exactly, but there just seems to be a bit more angst, feelings that are hurt a little more easily, fights that erupt over seemingly unimportant things, and everyone just seeming to need a lot more attention. I’m so glad that we have limited our contacts and excursions and have instead focused on being a family and meeting the needs that everyone has as we stretch, grow, and change to welcome this new addition into our family.

 

Julian and I Get to Know Each Other

With this being my fourth birth, I feel like I kind of know what I’m doing now, but each child is different and unique and while there are certain techniques that are universal, these ten days after Julian’s birth have been all about the two of us getting to know each other.  First of all, after going through thrush with Ophelia, I was very happy in the end of this pregnancy to finally beat my reoccurring yeast infection by eliminating sugar and processed foods along with buying some really great cotton boy cut underwear. 🙂 But breastfeeding and sleep were still the two biggest challenges that I had to face.

 

Breastfeeding

Julian latched on right away and I thought we were going to have an easy breastfeeding relationship, but that hasn’t quite been the case. The initial latch on was painful, but that’s kind of normal, so I didn’t think anything of it until it was still hurting over a week later. My nipples were also kind of slanted, a tell tale sign of a bad latch. So I pulled up his lip in search of a lip tie, and sure enough…there it was! Ruby had this and as a result she wouldn’t latch on for very long which resulted in her taking in too much air, getting gas and hiccups and well as not nursing long enough to get the fatty hindmilk (green poop was a tell tale sign of this) which resulted in her being really fussy. I had no idea why until our midwife pointed out Ophelia’s lip tie. She said we could cut it with a scalpel, but I simply couldn’t imagine doing that! Plus, it could heal back together. She suggested rolling her lip up several times a day to stretch it out and after she latched on to make sure her top lip was rolled up by coaxing a finger underneath and helping it to flip up. By doing these techniques, her lip tie ended up not being a problem.

So, I’m implementing the same techniques with Julian, but getting results has been slow going. I can’t get him to latch on while reclining in bed and I either have to sit up and really lean forward or go to our rocking chair where we somehow always seem to find the perfect latch. I know that we’ll figure it out eventually, it’s just hard when he needs to eat every two hours throughout the night and I’m oh so very tired.

 

Sleep

I remember reading somewhere that babies are really tired after birth and so they will sleep pretty much nonstop for two days. I think that this happened with Ruby and maybe Elliot too, but I was not fortunate enough to have that for Ophelia or Julian. Part of it are the afterpains that totally shocked me with Ophelia. I was more prepared for them with Julian, but they were still painful. The uterus has more work to do to contract and get down to it’s normal size with each child and so the contractions that help it to do so that are brought about by nursing can be as intense as labor. I had an afterbirth tincture that I took to help with this, but what really saved me was having a heating pad ready to go. I put it on my belly and it really helped to melt the pain away.

That first night, I was able to swaddle Julian and lay him between us and he slept for one five hour stretch…the most he would sleep at night for the next ten days! I usually prop up about ten pillows all around me and hold my babies close while leaning back on a well positioned pillow to sleep at night, after I tried many times with no success to put Julian inbetween us, I ended up doing this with Julian too. It just takes awhile to get used to sleeping this way, but by day ten, I’m so tired that I could probably fall asleep standing up if I had to!

The next few nights, sleep was a bit more difficult. Julian would sleep really good during the day, but at night would get a little more fussy. I kept trying different strategies until I found something that worked. Sometimes he really liked it when we did skin to skin, other times he liked to be swaddled, and when I couldn’t console him in our bedroom (we tried to be quiet so as not to wake up Scott and Ophelia) I came out to the living room where he could be awake if needed. One time I had to swaddle him, have him suck on my finger, and shush him to get him to calm down, but he usually just wanted to be awake, so I would watch some Once Upon a Time until he fell asleep and then came back to bed.

It’s so easy to get frustrated in this first month when babies do not have their circadian rhythm or produce melatonin to help them sleep at night, but I know that the best thing to do it try to sleep any way that I can, get through these first four weeks, and know that eventually he will fall into a pattern and I will get more sleep. I feel like I’m really well equipped to survive for awhile without much sleep and it really helps that we don’t need to go anywhere or do anything. I took it easy as much as possible, especially during these first ten days, and that really helped.

 

My Recovery

I know from recovering from the other births that I need to take advantage of the extra help that I have in the beginning and do whatever I can to heal so that I can get back on my feet quicker and not backslide. I really didn’t bleed much at first and my bleeding kept stopping, but then if I would go up the stairs or walk around too much, I would bleed fresh blood again. I tried my best to not do too much, but there is really only so much that I can stand sitting around and running a household with three other children (even with help) requires a lot of work, so I didn’t worry too much about it.

My recovery downstairs was really quick. There was one little spot that stung if pee got on it, so I would spray a peri bottle on myself while I peed and sprayed some bactine on it afterwards. It stopped stinging on the third day. The thing that hurt the most were my hips from Scott pressing so hard on them! I think something may have gotten out of line on my left hip because it was so tender and hurt to even walk. It has taken ten days for the pain to fade and it’s almost gone now.

I tried wearing my girdle a few days after birth and I couldn’t even fit it over my belly. After Ophelia, I was determined to heal my diastus recti and I wore my girdle day and night which really helped me to get my figure back. But this time around, I knew that the process might take awhile longer and I am totally fine with that! There are more important things in the world than having a flat stomach. Once my stomach shrinks down a little more, I’ll try to wear it for a few hours at a time and then work my way up to wearing it for longer periods. I also look forward to working out again, but I’m going to give it a good six weeks before attempting anything.

 

Julian’s Growth

As soon as he was born, we saw his peaceful personality. Hardly a cry and those wide eyes looking around ready to take in everything the world has to offer. Coming into the world in such a peaceful atmosphere and settling in to the sounds he became familiar with in the womb certainly helped I’m sure, but I can tell that his personality will reflect these traits that we see right now. I am amazed at how well he’s able to turn his head to look at different voices that he hears. He does like to sleep a lot, but when he’s awake he is so extremely aware , focused and calm. Just like when he was in the womb, he likes to be awake right after we put all of the kids to bed. It’s such an amazing time for Scott and I as we snuggle up on the couch together and cradle him in between us so he can see both of our faces. And then we gently coo to him and he looks back and forth from Mommy to Daddy with his big wide eyes and his mouth pursed into a little o.

His limbs remain still and his body calm as he patiently accepts all that is happening around him, and then just like a snapping twig, he’ll erupt into a powerful and monstrous cry and we know that he’s had enough of the world and wants to be safely cradled back in his mother’s arms to nurse and be rocked back to sleep. I remember with Ruby how I would hardly be able to step into the shower without her screaming and crying, and once again, it could be just because we’re all more comfortable with this world of parenting, but Julian can stay with Daddy or others for quite a bit of time before needing Mommy again.

We bought a really nice (and expensive) swing thinking that he would like sleeping in it at night, but it’s just too loud of a contraption to keep in our bedroom so we have it in our living room and it works great for naps. After Julian was born, Scott and Elliot took a trip to Meijers for groceries and I had him pick up a little vibrating bassinet that is extremely portable and easy to move around. I drag it from room to room and Julian loves sleeping it is during the day, but at night, it’s just easier for me to hold him. We have a bunch of little bouncy chairs from the other kids, but he’s too little for them yet.

I love taking pictures and videos of him every chance I get. He changes so gradually, but when I look back to the beginning I can see the enormity of his change. I know that I am going to be busy and I may not write in my journal as much as I have in the past, but I wanted to remember every moment and feeling of Julian’s birth and how our family changed as he joined us.