The Plan

After talking with Jennifer Tow for several hours the other day, there are problems with Ruby that we didn’t even know about. After watching her attempt to nurse, drink a bottle, and accessing our history and diet, there is much work to be done.

Problem 1: My Milk Supply

Jennifer suspects that due to Ruby’s inability to nurse properly, my milk supply may not have ever been fully established. If it was, then there is a good possibility it was compromised early on. As of right now, I can only pump between 3.5 – 5 ounces every three hours. That just simply isn’t enough for a six month old baby, particularly one that has much catching up to do.

Solution: Take herbs and change diet

    • I am to order a galactogogue tea called Pure Abundance. This tea was made by a mama, struggling with milk supply also. I must contact her personally to order it.
    • Take Go-Lacta
    • In the meantime I am taking More Milk Plus from Motherlove (More Milk Plus Special Blend was the top recommendation, but Whole Foods doesn’t carry it).
    • The diet changes were discussed in my previous post. But I am eliminating Gluten and Dairy.
    • Increase Vitamin D – need to take 1000 IUs for every 25lbs of body weight. I started taking more and my milk has increased.
    • I am eating one avocado a day. This will be a particular challenge for me, as I hate them with a brutal passion. I think they taste like mashed up grass. Time to get my creative juices flowing and find ways to make this awful tasting stuff bearable. Calling my Sister-in-law will be a start. She supposedly makes really good guacamole.

The reason for eating an avocado is this: There is fat contained within the fruit that stimulates communication in the body between the intestines and the breasts. When the gut is damaged by improper eating habits, lack of good bacteria, etc, this communication is compromised, resulting in less milk production.

Futher ideas to help increase my supply:

    • Obtaining a breast shield for my pump that is the correct size
    • hand expressing milk after the pump has pulled down all it can
    • I’m also considering un-weaning Loretta
    • Getting Ruby back to the breast

Problem 2: Ruby uses the wrong muscles to eat

Because of her inability to move her tongue to eat, Ruby compensated by using different muscles. She engages her neck, shoulder, and chest muscles when eating. Even now when she is drinking from a bottle she brings her shoulders up near her ears, pulls her chin down into her chest and tenses all these muscles.

Solution: Chiropractor and Craneal Sacreal Therapy (CST)

Jennifer found a chiropractor that is experienced and knowledgeable of Ruby’s condition and the treatment thereof.

I have very little understanding of CST, but have been told by several people that I trust that it will be very effective in treating this problem.

Update: Had first CST appointment on Wednesday (June 22). She said that she was able to give Ruby a few “releases” and for a few breif moments, Ruby actually relaxed completely while taking a bottle. So this actually seems pretty optimistic. The problem is that it will take several visits and she doesn’t take my insurance. But my chiropractor said he is going to find me another CST that does participate with our insurance.

Update: No CST in town will take my insurance. Found a chiropractor that does SOT and Vector Points. He adjusted her palate bone and her sucking has improved significantly.

Problem 3: Possible Tongue Tie Reattachment

Following Ruby’s initial tongue clipping, I wasn’t given to exercises to do with her to prevent it from reattaching. It is possible that it may have reattached for this reason.

Solution: Re-evalutate her tongue and possibly re-clip it

I was initally concerned about the treatment of this. The only ENT in town that would touch her tongue was the doctor who originally clipped it. The only reason he was willing to do what he did is because he clipped it while she was under general anesthesia for a hernia repair.

But Jennifer has friends in low places. She has connections to a doctor in Gainesville who is willing to re-evaluated and possibly re-clip her tongue in an office visit. W00t!

Update: Dr. Sandra Sullivan contacted me PERSONALLY to re-clip Ruby’s tongue that day (June 17). It turns out that her tongue did not re-attach, but instead, wasn’t clipped far enough. The only way to tell if the tongue has been freed is if the infant has mobility. This is impossible to tell if she is sudated.

After the clipping, they were able to get Ruby back to the breast. It was so wonderful, having her nurse for the first time in over a week. They had me use a bigger nipple shield (I was using 16mm, they brought me 24mm) and dipped it in sugar water. Some may consider it to be cheating, but I’m ok with cheating.

Update: June 24: Recieved a call from Dr. Sullivan requesting another follow up appointment with Ruby for Tuesday, June 28, to do more clipping of her tongue and of the upper lip. She didn’t clip it all the way the first time because she didn’t want to do too much at one time since Ruby is six months old. She also plans to have their occupational therapist look at her to make sure she is using her tongue properly. Because their therapist is doing that, I plan to cancel the Beckman follow up appointment. No sense in having two of them involved.

Problem 4: Ruby’s slow (or lack of) weight gain

Jennifer believes that this is in large part due to a gut problem that is inabling her to absorb her nutriently properly.

There are several reasons that Ruby has an unhealthy digestive system:

    • While in utero, an infant’s digestive system is dormant. Once the infant is born and begins to move his/her tongue while nursing, the movement of the tongue awakens the digestive track. Due to the restriction of her tongue, her digestive system may not have become fully operational. This is why many tongue tie babies only have bowel movements once a week. The stool just sits in the intestines.
    • When Ruby went on her nursing strike, I was unable to pump enough for her and had to use store bought formula to supplement. Formula is dead (as opposed to breast milk, which has living cells in it). It doesn’t provide the same nutrients, fiber, and bacteria that breast milk does. Therefore it compromises the digestive system.
    • My diet and intestinal flora will strongly influence the baby’s health and intestinal flora. There’s a popular and true statement that is applicable here. “Heal the mother and you will heal the baby.”

Solution: There are several things that need to happen over time to fix these problems.

    • Give Ruby probiotics
    • Make my own formula
    • The chiropractor will help to fully awaken the digestive track
      • He has an adjustment he does to her back that stimulates the nervous that travel to the intestines. Since she has been seeing him (June 17) she has been having 1-2 bowel movements a day.
    • Correct my diet and take probiotics myself
    • Have the tongue re-clipped
      • Dr. Sandra Sullivan contacted me PERSONALLY to re-clip Ruby’s tongue that day (June 17).
Problem 5: Ruby isn’t nursing
Solution: Get her back to the breast by using a series of transitions.

1. Bottle feed Ruby upright (so she still has to work to draw milk out of the bottle). Insert the tube of the homemade SNS into the corner of her mouth. The SNS will be empty, but she shouldn’t be sucking in air either because it is hooked up to an empty syringe. This is to get her used to having the tube in her mouth.

2. Bottle feed Ruby upright. Instead of inserting the tube after she is already eating, place the tube on the side of the bottle so that she takes both into her mouth at the same time.

3. Put breastmilk/formula into the SNS.

4. Clog the bottle so she become used to getting milk only from the SNS. This will make sure she is actually sucking to draw the milk out of the SNS and get her used to the flow of it, without the panic of not having the bottle. (to clog the bottle, use ice cold water and put some coconut oil in it. I learned this when I orginally added coconut oil to the formula. It solidified and clogged the bottle).

5. Feed her according to #4. Towards the end of the feeding switch her to my finger with the SNS. Over time, switch her a little sooner each time. Until her she exclusively eating from my finger and the SNS.

6. Feed her with my finger and the SNS. Towards the end of the feeding, switch her to my breast with the SNS. Over time, switch her a little sooner each time until she is exclusively eating at the breast with the SNS.

7. Nurse her with the SNS. During periods of letdown, take the SNS out of her mouth. If she becomes frustruated when the flow slows, put the SNS back in.

8. Overtime she should get used to the flow of the breast and not panic when the flow of milk slows inbetween letdown.

If needed: to get her onto my finger or breast, apply vanilla.

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