A Letter To A Lactation Consultant

Posted on: September 19, 2016 | Breastfeeding, Childbirth, Postpartum

The following is a letter that was written to a lactation consultant.  The identifying information has been changed.  It is important to remember that we never should be discrediting what a client is telling us is happening or lose her trust by speaking negatively to other providers about her.  Every client matters.  Every experience matters.  Every feeling matters.

I’m writing you to give an update on our breastfeeding journey. If you remember, my son Ryan was born in May, he is 11 weeks today. He was born at a hospital farther north, and because of his lack of weight gain, we sought out your help. I stopped coming after a meeting with Cindy. I even promised her I would come back for another appointment, but after I went home and cleared my head, I realized it was time to follow my very strong mother’s intuition instead.

So why am I contacting you now? I’ve imagined writing this email many times, but have decided each time to try to let it go. I didn’t know how much of my journey would be perhaps helpful to you and Cindy. Even writing this now, I struggle to reign in my raw feelings and gather my thoughts. When I think back to those first weeks, it stings knowing I lost precious time with my newborn son worrying that I was hurting him or neglecting him. I was made to feel by the pediatrician and Cindy that it was my pride getting in the way of helping my son thrive, when I knew that wasn’t true.

I was breastfed to the age of three, my sister is still breastfeeding her three year old, I’ve gone to LLL meetings since I was pregnant, I’ve read and researched, and knew the first and last place you go for ultimate support is an IBCLC. I was as prepared and knowledgeable as I could be. I wasn’t positive breastfeeding would work out and come easily, but I never anticipated such a difficult start. After the pediatrician was concerned about weight gain, I came to you right away. In those very early days of postpartum, I was more desperate and helpless than I could ever have imagined. I knew immediately to go to the source that would help guide me to breastfeeding success. To my surprise, between you and Cindy, it was apparent after the first appointments that I was running out of options, especially natural ones, to get my baby on the right track. Pumping and formula were my last hopes, I was informed. These were the two things I knew could jeopardize our nursing relationship for good, but I was told I was putting my son at great risk. I cried endlessly trying to figure out, “Do I listen to my gut and knowledge or the medical professionals?” They shouldn’t be at odds, from everything I had learned.

Fortunately, I had the LLL leaders, and dear family and friends supporting me. Without them, and my strong intuition and conviction, I doubt I would have successfully continued to breastfeed at all. This may seem dramatic, but I have talked to mothers in our community who have had similar nursing issues, who reached out for help, but didn’t have the personal knowledge or personal support that I did. They have to exclusively pump, supplement, or have given up all together. Please let me be clear about how these stories came to me. I posted in the local breastfeeding Facebook group asking for any advice or thoughts based on the breastfeeding issues we were having. Mothers, some I knew and some I didn’t, came to me wanting to know which lactation consultants I saw; because they found their experiences to be strikingly similar. They carry with them regrets of not listening to their gut and thoughts of what could have been.

Despite their issues, they encouraged us.

A few mothers felt strongly that the problems I described pointed to a tongue tie; despite being told by the pediatrician that it was minor and wouldn’t be a detriment to breastfeeding. You agreed with the doctor, acknowledging baby and I were well matched because of my nipple shape. Each time I have seen a new medical professional regarding the ties since, the first thing they ask is “What did the pediatrician and lactation consultant say?” The very professionals who ideally could’ve pointed me in the direction of a pediatric dentist; because the ties were not minor and my nipple shape does not do anything to help. Without that original guidance, we had to find our own way.

Going back to the start, after the last lactation consultation, we were scheduled to see the pediatrician. We knew he would not be happy with the lack of weight gain. Cindy said she would call him on our behalf and tell him that we are working on it. We went into see him and he had indeed talked to Cindy and was armed with a condescending speech and formula samples. Honestly, it felt like the professionals we trusted had now tag-teamed us. That was the last time I would bring Ryan to this pediatrician; the same one who I had gone to as a child through young adulthood and had a special relationship with. That is how strongly I felt we were heading down a very wrong path.

I cancelled the following appointment with you, put down the pump and just nursed my baby skin-to-skin. I nursed and nursed and did nothing but nurse. I relaxed, trusting I was doing the best thing I could for him, because I know how stress can affect milk supply greatly. I took care of myself too. I drank lots of water and ate lots of good food. He started gaining, although slow, and I was thrilled. (We have access to a baby scale.) All of that intervention, stress, and pumping, was going against everything I knew was best in those early weeks.

As I wrote previously, thanks to the women in the Facebook group, we then started pursuing the tongue tie issue. But without clear guidance, it was a long process. First we got the anterior tongue tie clipped by a family practitioner the day I was supposed to have my next appointment with you. Baby started gaining more but after that, I had a strong suspicion there was more to it. As he was gaining, my head got clearer, and I started seeing all of these other “tie” symptoms we were both having. Despite perfecting positioning, I still had a “lipstick” crease on my nipple, a LOT of pain, he was getting too much air in with unlatching constantly, the slow weight gain, and the list went on and on. So we then went to a pediatric dentist who did a laser revision of not only the anterior tongue tie but also an upper lip tie. He was not experienced in posterior tongue ties and so that was left without being evaluated or revised. With all of the stimulation from baby nursing and the release of ties, my supply went up and baby’s weight skyrocketed. It was amazing to see. As I learned more about posterior ties, I felt strongly that he had one. I waited many weeks, hoping for more improvements, not wanting to put him through another revision.

But with the great pain I was in and his gas and fussiness from taking in air, I knew it was finally time to find an experienced pediatric dentist and get evaluated. This dentist identified two areas that needed to be revised, and also identified other issues like a high palate and small mandible. She revised baby and even gave me tips on a specific latch based on advice she received at the recent International Lactation Consultant Association Annual Meeting. I am now seeing a private lactation counselor who is helping me navigate all of this new information.

After we went through the initial tongue tie revisions, I was told over and over again that working with a IBCLC was imperative to success. But how would I get the specific help I needed if I didn’t get it in the first place? How could I get knowledgeable help from those who told me his minor tie wouldn’t be a concern?

Today, thanks to the support I mentioned earlier, and my intuition and personal research, I have a healthy, strong, alert, happy, exceptional, exclusively breastfed son who is in the top percentiles and has deliciously chunky thighs.

Thank you for taking the time to read this. I know you care and are passionate about helping mothers and babies. I felt it through our conversations and your overall gentle spirit. I thank you for that. My main reason in reaching out is not to criticize, but to hopefully encourage:
1) more education
2) an even deeper empathy for mothers who seek your help
3) and a different and unique approach to each mother and child who come for help, as there are so many things that can complicate that precious breastfeeding journey.

Thank you,

A New Breastfeeding Mother

I was asked to share this by the author, in hopes that even just one woman struggling with breastfeeding can be helped.  Please know that if a provider gives you advice that goes against your instincts, seek out a second opinion.  It does not hurt to seek out more information and either have the first confirmed or get information that may help you.  This was not shared to down play the importance that an IBCLC can play in a breastfeeding journey, but rather as a word of encouragement for mothers struggling.