Stella’s great-grandma, Connie, made her a mini chocolate cake today, just because she’s sweet like that. I decided to add to the fun and turn the mini cake into a birthday cake for her baby doll, complete with a candle and the “Happy Birthday” song. Stella thought it was quite fun 😉
I’m continually amazed by my husband’s ability to make pretty much anything 🙂 Check out this awesome Little Helper Stand he made for Stella so she can stand safely at the counter to help with things she loves to help with like cooking, washing dishes, making coffee, and other fun activities. He found the plans in the October/November 2013 issue of Handy Magazine.
Several months ago, we discovered that Stella had an upper lip tie and posterior tongue tie. I won’t go into detail about them here, since a quick internet search will give you plenty of information. Instead, I want to talk about what the warning signs were, because as far as breastfeeding is concerned, the earlier you can identify and revise a tie, the better.
If I hadn’t been so determined to breastfeed, I would have given up. I’m sharing our story because I’m passionate about the benefits of breastfeeding. I understand that some women don’t have a choice because their bodies will not allow them to breastfeed. I also understand that some women make the informed choice to not breastfeed. But, I also believe that many women who do want to breastfeed are robbed of having a real choice in the matter because of undiagnosed, unrecognized issues such as these — issues that have a solution, but need to be recognized by healthcare professionals.
Here’s how it went for us.
My first clue should have been that nursing was extremely painful for the first few months. My complaints of pain were often met with a sympathetic, yet dismissive, “Yeah, it can be a little painful in the beginning while you’re getting used to it.” But it was more than “a little painful.” It was excruciating. And it wasn’t just while I was getting used to it. It lasted well past the three month mark. I even remember crying sometimes when it was time nurse her because I was so sore and trying to get her to latch correctly was exhausting, painful, and frustrating for both of us.
The reason it was painful was because Stella had a “shallow” latch (a common symptom of lip and tongue ties). She rarely opened her mouth wide enough and always curled her upper lip under.
I tried using shields, which did help with the pain, but was met with disapproval from my lactation consultants. I started to feel guilty about using the shields and was concerned they could negatively impact my supply, so I worked to “wean” her off of them.
Despite the incorrect latch, Stella gained weight normally. After a few months, the painful nursing subsided (or so I thought) and we had what I thought was a normal nursing relationship for the remainder of her first year. As it turns out, she never had a correct latch. The relief I felt was due partly to the fact that she learned to compensate for the ties by changing the way she sucked so she could actually get milk somewhat efficiently (which is actually pretty amazing, if you think about it — infants are so cool 🙂 ) and partly due to me just getting used to the painful nursing.
For various reasons (including the WHO’s recommendation), nursing until at least the age of two is important to me, so I continued nursing after Stella turned one. When she was around 13 or so months, breastfeeding became very painful again. This time, I started searching for answers.
Through countless Google searches, reading several research articles, and posting a dozen questions on the Tongue Tie Baby Support Group on Facebook, I came to the conclusion that Stella did, in fact, have a lip tie. I emailed photos to Stacy Cole, DDS, in Fort Worth, Texas, who is one of the leading practitioners in the field of infant/child laser frenectomy. He confirmed my suspicions and informed me that when a lip tie is present, there is almost always (more than 90% of the time) a posterior tongue tie present, as well. Sure enough, Stella had both. Her lip tie was Type IV, the most severe. The reason the nursing pain and bad latch returned after several months of less painful nursing is because babies’ sucking patterns change from infancy to toddlerhood. Since her sucking pattern was changing, she was having to learn how to compensate for the ties all over again.
Based on the many issues that lip and tongue ties can cause — breastfeeding, speech, swallowing, digestion, jaw misalignment, tooth decay, tooth gap (which Stella has), weight gain — there was no question for us as to whether or not we were going to get the surgery for her. We scheduled our appointment for a few weeks later and we made the 8 hour drive to Texas. We took a lot of fun activities to keep her happy in the car!
I know many people think we’re crazy for traveling so far for the procedure. We chose Dr. Cole because he comes highly recommended and has much experience doing laser revisions on infants and toddlers. Through my research and stories from other moms in the support group, we knew it was important to have someone very experienced perform the procedure to insure it was done correctly and to reduce the risk of reattachment. There’s no way we were putting her through all of this only to have it reattach a couple of months later and have to do it all over again. Aside from Dr. Amy Grawey in Missouri (who was on maternity leave at the time), Dr. Cole was the closest provider we felt comfortable with. The support group I joined has a list of “preferred providers” based on experience, reattachment, effectiveness, etc., which is how we found him. It’s pretty tough to get on the list, so I knew he would be good.
When we arrived at the clinic and Dr. Cole examined Stella’s mouth, he couldn’t believe I had nursed for so long with how restricted her mouth was and how it would feel to nurse a baby like that. What relief! This painful nursing wasn’t all in my head! Finally, someone validated my feelings!
I’m not going to sugar-coat it – I thought the procedure was nothing less than horrifying. Stella was given Oral Versed to make her sleepy and sort of “out of it” and then a local anesthesia was injected near the surgical sites. (By the way, be emotionally prepared if you ever have to see your baby “drugged up” — that was not a good feeling.) She was awake for the entire procedure, just groggy. She was swaddled in a blanket and then her body was strapped to a board thing. Jacob was responsible for holding her head still. I bent down so she could see me and so I could speak quietly in her ear. I reminded her what was going to happen (we had talked about it a lot beforehand) and then I started to sing to her. They put glasses on her eyes to protect them from the laser beam, propped her mouth open with a mouth guard, and Dr. Cole began cauterizing the tissue, first her lip and then her tongue. She screamed and cried hysterically for the entire procedure, and while it took less than ten minutes, it was the longest ten minutes of my life. They say that babies aren’t really in much pain during the procedure and that they are mostly upset about people messing around in their mouth, but that was definitely not the case for Stella. I know my baby’s cries and those were most certainly cries of pain. I am ashamed to admit this, but I had to leave the room near the end of the procedure and go to the bathroom because I was going to either pass out or be sick from the anxiety of seeing her so upset and in pain. I’m getting sick to my stomach and teary-eyed writing this even now, and it’s been over two months. Dr. Cole and his staff were amazing though. I would travel there again in a heartbeat.
After the procedure was over, I immediately picked her up and she began to somewhat calm down. She was still groggy from the Versed, and that was really nervous-making for me. I kept asking if it was normal and they kept assuring me that it was. We were taken to a small room with a rocking chair where I tried to nurse, but she just ended up getting frustrated and more upset because her mouth was still numb and she couldn’t latch. She threw up a couple of times, probably from a combo of the Versed and the stress. That upset me, too, because she had never thrown up before. She finally calmed down and we went back to our hotel, where she threw up several more times, but was finally able to nurse, eat a couple of crackers, drink some water successfully, and keep it all down. And the nursing? WOW. The first time she latched post-revision, I actually cried because I had no idea it was supposed to be so painless.
We had a lot of people praying for Stella through the procedure and that we would be strong and calm for her. Oh, how I felt the power of those prayers. Jacob and I were unusually calm through the entire process, except for the few minutes I had to leave the room during the procedure. Stella did great through everything, given the circumstances.
The aftercare of the procedure involved stretching the sites twice daily and applying aloe for two weeks until they healed, to avoid reattachment. Those definitely weren’t fun either, but we got through them by talking her through the process and empathizing.
Full disclosure: Nursing didn’t stay wonderful. After a couple of weeks, she began to revert to the compensated way of sucking that she was so used to. This is common as babies begin to heal from the surgery. We started cranio-sacral therapy for her (usually recommended with this procedure) with a chiropractor who specializes in it and began seeing some improvement. We are still working for that awesome latch, but I have a feeling that her latch may never be perfect because of how she learned to compensate for so long.
So, with the stress, travel, horrifying procedure, upsetting after care, and still-not-great latch, do we regret having it done? No. She began nursing better and eating more, didn’t choke every time she took a drink of water, produced new sounds (starting the SAME DAY she had the procedure done), gained weight, and though she had always been a happy baby, she began smiling and laughing more frequently. She had always been within a normal weight range, but gained only one pound from the time she was 10 months old to the time she was 15 months. We had the procedure done and she gained one pound in four days. We noticed many improvements and, all in all, I’m glad we had her ties revised.
I was certainly happy about all of the improvements we saw, but it also made me feel regretful and depressed that we (and various healthcare professionals) failed to recognize this problem. Thinking of all the issues we could have avoided by having it revised in her first month of life is sickening. It’s been several months now since I discovered the ties and I’ve had some time to cool down, but I stand by my opinion that, when I presented with nearly all of the nursing symptoms related to a lip/tongue tied baby, Stella should have been checked immediately. La Leche League advises, “Nipple soreness that increases or lasts beyond the first week should be interpreted as a warning that something is wrong.”
I found through my research that dentists, pediatricians, family doctors, and even lactation consultants are often misinformed or under-informed about ties. I’m in the process of writing an informational letter to the lactation department at the hospital where I delivered to encourage their staff to check for lip and tongue ties on babies (they are pretty common), especially when nursing moms present with the symptoms related to it. I’m hoping that this information can help someone who may be in the same situation I was. Since we’ve had a lip/tongue tied baby, chances are higher that our future babies will have the problem. I’m glad that I will now know to check them immediately and we will have the issue revised as soon as possible after birth.
Dr. Lawrence Kotlow is the leading expert in the field of child frenectomy and his website has good information, if you need it. Also, if you think your child has a lip or tongue tie, you can send him your pictures via email and he will give you his opinion free of charge. Dr. Cole (the dentist we went to) will do the same thing.
For information about correct vs. incorrect latching and sucking, click here.
I know that gentleness and respect “work.” It’s the foundation upon which I ran my infant/toddler classroom and the way I now interact with my own one year old daughter. Sometimes though, in the midst of a difficult situation, I overlook the obvious. It’s nice to be reminded through interactions, like this one, of the power of empathy and respect:
Stella had a fever before bed last night (teething), so I gave her some Tylenol. She has been HATING taking it. I had to give it twice the day before (which is a lot for a mom who RARELY gives meds!) and she cried and got very worked up both times. I had to put the syringe in her mouth with her resisting. I kept telling her it was yummy (even though I tried it and it was disgusting) and tried to make a game out of it by pretending to drink it myself — “Mmmm! It’s good! Look, Mommy’s drinking it! Here, you try!” — but it just made her more upset.
Last night, the same thing was happening, but then I realized that she could see right through the tricks (duh). She knew that I was being fake and dishonest with her and she was probably feeling very unheard.
I stopped and said, slowly, calmly, and kindly, “Stella, I know you don’t like the way this tastes and you don’t want to drink it. You have a fever and your teeth hurt and I have to give you medicine. It will help you feel better. Will you please take this medicine?” She looked at me for a moment and then reached out for the syringe with a cringe-y look on her face (like she knew it was going to taste bad) and she put it in her mouth. I pushed a little out and she swallowed it, made a “yucky” face, and turned away. I said, “Thank you for taking some of your medicine! There’s still some left. Will you take some more, please?” She did the same thing over and over until it was gone. I said, “You took all of your medicine! Thank you so much!” She looked at me with a big smile. I picked her up and she laid her head on my shoulder — a stark difference from the day before when the medicine-giving ended with a teary-eyed, distraught one-year old and a mommy who felt the same.
She totally didn’t want to take the medicine, hated the way it tasted, but was cooperating because I empathized with her and gently invited cooperation rather than trying to force compliance. Wow!!!
Stella’s first birthday party was a great success! She was a bit overwhelmed when everyone arrived, but soon warmed up to all of the attention and enjoyed watching everyone and playing with her cousins. Here’s a run-down of the whole shebang!
Theme: “Sunshine, Lemonade, and Fun!” Oh, and pink. There was lots of pink.
Treats: Homemade ice-cream (made by Nana and Papa and Great-Grandma and Great-Grandpa), homemade semi-healthy chocolate cupcakes (with not-so-healthy frosting :)), and pink lemonade.
Tissue paper pom-poms. Stella LOVED the poms. I put them up a few days before her party while she was napping. When she got up from her nap, she noticed them right away and started clapping, pointing, and giggling with excitement! She couldn’t wait to get her hands on them!
Antique birthday poem (that my mom gave me for my birthday last year).
Buntings made with scrapbook paper and ribbon.
Giant “1” on the wall made from pictures of Stella’s first year.
Activities for the older kids: Balls, water balloons (they didn’t last long!), sidewalk chalk, and bubble station.
Gifts: Books; dress; Royal’s t-shirt; farm puppets; a baby place-setting from Tiffany’s; and drawings by her cousins.
Favors: Homemade almond butter granola bars.
We took like 200 photos (thanks Cassidy)! Here are a few of my faves:
Stella will get to celebrate with more presents again tomorrow at Nana and Papa’s house and then with just Mommy and Daddy on her actual birthday (Tuesday). What? You know you want a week long birthday celebration, too 🙂
As the party was winding down, my brother-in-law asked me what the one word was that I would use to describe the first year. My answer — joyful, fast, and life-changing (yeah, yeah, I know that’s three (four?) words). With more time to think about it though, I think the one word that would best describe it all is “blessed.” God has blessed us so much through the gift of Stella. Even at age one, I can already see her kind soul and loving heart shining through. Her smile makes my heart sing, she can move me to tears with her contagious laughter and sweet hugs and kisses, and her mind amazes me every day. She is simply a joyful little person and I am blessed to be her mommy. Those smiling eyes say it all.
Happy 1st Birthday, Stella!
I post a lot of pictures to my Facebook page of Stella engaging in sensory play. I try to offer some form of sensory play every day (it doesn’t always happen though) and I enjoy sharing what we do to give other parents ideas. In almost every picture’s comment section, you’ll find someone asking a variation of, “Doesn’t she put that in her mouth?” or “How do you keep her from eating that?” It’s a common question and a valid concern, so I decided to go ahead and blog about it.
To answer the question, yes, Stella puts things in her mouth. In fact, she puts almost anything into her mouth that she can get her little hands on! Mouthing is a typical (and good!) baby behavior because it is one of the important ways they learn about their world. Putting objects in her mouth helps a baby discover obvious things, like taste and texture, but also not-so-obvious things, like size and shape.
Because mouthing is an important part of babyhood, and because I believe it’s important to avoid constantly telling a baby, “no,” I don’t offer a lot of things to Stella that I’m not comfortable with her putting in her mouth. That being said, my comfort level may be different than yours…and that’s okay! I’m comfortable with her putting most of our sensory items into her mouth. Some of these things include:
-Play dough (I make ours, so I know exactly what’s in it)
-Salt (to a certain point, anyway)
-Paper/cardboard (until it becomes soggy and could break off in her mouth)
I haven’t always been comfortable with babies putting things in their mouths. Even after learning about the importance of letting babies explore with their mouths, it took at least a year of working with babies every day at an early learning center for me to actually feel comfortable with it.
How did I become okay with it?
I had to be mindful of my feelings and question whether I was redirecting a child from putting something in their mouth because it was actually a safety issue or simply because I didn’t want them to (for any number of arbitrary, often unnecessary reasons). I did this by pausing before I said, “That’s just for your hands,” and asking myself, “Why not?” (Asking yourself, “Why not?” before reacting to something your child is doing can be a powerful tool in lots of areas, but more on that in another post.) If I couldn’t think of a really good and legitimate answer to “Why not?” then I didn’t redirect. Instead, I just went with it. “I bet that play dough tastes really salty.” “How does that flour feel in your mouth?” “That rice is probably kind of hard, huh?”
Just because I allow Stella to explore things with her mouth, doesn’t mean I would let her eat a handful of salt, rice, play dough, etc. I’ve offered sensory experiences since she was a tiny infant — I think we were playing with rice by the time she was three months old (I didn’t let her put sensory items in her mouth until after she started solid food at six months though), so she has had a lot of exposure to it. Often, she will put something in her mouth a few times and then she’s satisfied (because I let her actually have the experience) and will just use her hands.
Even though I feel comfortable with Stella exploring a lot of things with her mouth, there are obviously some things I can’t allow for safety reasons (mostly choking hazards) — water beads, dry beans, rocks, etc. In cases like these, I just do lots (and lots, and lots, and lots) of modeling and redirecting when necessary — “These are just for your hands.” “Keep them out of your mouth.” “Look how we can…(squeeze these water beads, drop these rocks, scoop these beans, etc.).” It takes a lot of patience. I also don’t offer these types of sensory experiences unless I am going to be right beside her the entire time to help her keep them out of her mouth. Not cleaning up the kitchen with her on the floor nearby. Not visiting with a friend. Not checking Facebook. RIGHT BESIDE HER and actively engaged, making sure it’s not going in her mouth.
If you want to offer sensory experiences and want to allow your child to mouth things, but aren’t entirely comfortable with it yet, you could start out by acknowledging what they’re doing — “You’re putting the play dough in your mouth. I bet that tastes salty.” — and then try to gently redirect — “I’m going to roll my play dough into a ball. Oh, that’s neat! Now I’m going to squish it! Do you want to try!?” This way, you’re not denying them their experience or telling them, “no,” but you’re also attempting to get them engaged in a way you’re more comfortable with.
It can take a lot of exposures to sensory play before a baby or toddler will avoid putting the objects in their mouth and actually use her hands to play with it instead, but it’s so worth it! Remember, they can’t learn if they don’t ever have the opportunity!
So, is your jaw still dropped from reading that I let my 8-month old put play dough in her mouth? It’s okay; I’m used to people thinking I’m a little crazy when it comes to babies 🙂 A few years ago, I would have thought the same thing! Just give it a try — it may surprise you how quickly your baby can learn!
Have you heard of baby-led solids? Basically, it means skipping purées and baby cereals and moving straight into “real” foods cut into large chunks that baby can easily grasp and gnaw on. Putting food into the baby’s mouth for them (i.e. spoon feeding) is avoided. The thought behind it is that a baby isn’t ready for food until she can put it into her mouth herself. It puts Stella in charge of whether she eats or not, and how much.
My plan had always been to make my own baby food purées and I had lots of yummy combination ideas I wanted to try out! But, after researching baby-led solids, I changed my mind about purées and decided that doing a baby-led approach is what would be best for Stella. Here are a few reasons why we enjoy this approach:
1. Stella is in control of what goes into her mouth.
2. I feel more comfortable with her learning to chew and maneuver food while her gag reflex is still closer to the front of her mouth. The gag reflex is what protects us from choking and it moves further back on the tongue as a baby grows.
3. We believe that “food before one is just for fun.” WHO, AAP, CDC, and probably other organizations that I don’t know of, recommend that baby’s primary nutrition through the first year of life is breast milk. Right now, giving food to Stella serves only as an introduction to various flavors, smells, and textures of food….not nutrition. By letting her feed herself, I can be sure I’m not making her eat too much of the “fun” stuff (not a lot of the food actually makes it into her mouth!) and that her main source of nutrition is still breast milk. I can also feel confident that she is gaining experience with and understanding of real food.
4. It’s fun! We love watching Stella figure out new foods that we introduce to her and she always gets excited about eating. It has also been exciting to watch her progress. She started out by mostly squishing, poking at, and smearing the food around her tray, but as she has gained more experience and watched us eat, she now actually puts the food in her mouth intentionally.
5. It’s less work. I would be lying if I told you this wasn’t a motivator for us to do baby-led solids! We eat lots of fruits, veggies, whole grains, and lean meats, so we almost always have something with our meal that Stella can have, too. I don’t have to prepare something different for her than what I’m already preparing for us.
So, are there any drawbacks? Well, let’s face it…handing your baby half of a banana, a couple of slices of avocado, or a pear doesn’t always end without a mess. Actually, it never does 🙂 Baby-led solids is MESSY and, understandably, that can be enough reason for some parents to choose a different approach. I don’t mind the mess, because I believe that exploring the textures of food (i.e. getting messy!) is an important part of the process of learning about food. But, if the idea of wiping banana out of your baby’s hair and ears and armpits (and, and, and…), then, baby-led solids probably isn’t for you. It’s not always that messy, but it definitely can be.
What about choking!? This is the most common question people ask me when I tell them about baby-led solids. I worry about it, too (then again, I worry about everything), but I worry less about it now than I did in the beginning. It’s important to understand that gagging is different from choking. Gagging is good. Choking is bad. Like I mentioned earlier, gagging is what protects us from choking on our food, so if a baby is gagging, it means she is working through it. If a baby is choking, she will not be able to make noise and may start to turn blue. Stella has gagged on her food several times (and, yes, I was scared and started to take action before realizing she was working through it on her own), but she has never actually choked on anything.
This article about baby-led solids has really great information about why introducing food in this manner isn’t a cause for increased concern of choking (see the section labeled “Won’t he choke?”). I would recommend reading the entire article if you’re considering trying the approach. You should also discuss it with your baby’s doctor.
I don’t follow baby-led solids as whole-heartedly as some parents do. For example, once in a while, I will give Stella bites of food off of my spoon or give her a piece of food with my fingers, but I always let her come to the food rather than putting the food into her mouth myself. For the most part, we let her feed herself.
This is not an “all or nothing” approach. You can adapt it to work for your family. If the idea of a mess makes you squirm or you’re concerned about choking but are still interested in baby-led solids, then I would recommend just starting out with something that’s within your comfort zone. If choking is your worry, then an overripe banana is a good option. If the potential mess is holding you back, then try baked sweet potato fries.
Understandably, not all parents are comfortable with a baby-led approach to solids. What do you think about it? Is it something you would try?