Transcript: Oral Anatomy and the Effect on Breastfeeding
The Boob Group
TBG038 Baby Oral Anatomy Breastfeeding
[00:00:00]
Please be advised, this transcription was performed from a company independent of New Mommy Media, LLC. As such, translation was required which may alter the accuracy of the transcription.
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Veronica Tingzon: While baby's latch may look absolutely perfect from the outside it can often be what’s going on inside of his or her mouth that can cause a breastfeeding challenge. What’s a mom to do when her baby’s oral anatomy is making breastfeeding difficult? I’m Veronica Tingzon, an International Board Certified Lactation Consultant and owner of The Original Comfort Food in San Diego, California. Today we’re discussing how a baby’s oral anatomy can affect breastfeeding. This is the Boob Group Episode number 38.
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Robin Kaplan: Welcome to the Boob Group broadcasting from the Birth Education Centre of San Diego. I’m your host Robin Kaplan. I am also an International Board Certified Lactation Consultant and owner of the San Diego Breastfeeding Center. At the Boob Group we’re your online support group for all things related to breastfeeding. Did you know that we have a Boob Group Club? All Boob Group Club members will get access to all of our archives episodes plus bonus interviews, transcripts and special discounts and giveaways from our partners plus you can interact with all this great content through the web or through our free Boob Group App available in the Apple and Amazon Market place. Today, we’re joined by two lovely panelists in the studio. Would you please introduce yourselves ladies?
Laura De La Torre: My name is Laura De La Torre, I’m 32 and I’m currently – I’m 33 actually. I’m currently a stay-at-home mom to my first son Theodore who is three months old.
Regula Schmid: I’m Regula Schmid, I’m 41 since we’re talking about age. And I know I got that right, it is 41. I’m currently a stay-at-home mom with my three year old daughter Vivian and my twin boys Bayani and Florian, who are seven months. And before that I used to be a school principal.
Robin Kaplan: Well, welcome to the show ladies, it’s a pleasure to have you.
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Robin Kaplan: So, we have a comment from one of our listeners and it’s from Samantha from Kentucky. Hi Boob Group, I have a question about the Boob Group Club. How do I listen to the archive episodes once I’ve joined? I have downloaded the app but all the archive episodes are still locked, help.
Sunny: Hi Samantha, this is Sunny. I’m one of the producers on the Boob Group. Okay, so we’re so happy that you downloaded our app. When you are in the app, go to the settings page. If you go to the settings page, you will have to log in using your log in information and then what happens when you go back to the episodes page, all of the episodes then are unlocked. Right now, you’re probably seeing like little lock symbol next to the ones that are on our archive. So, once you log in, it will remember you each time unless you to choose to log out. And then it unlocks all of the episodes, so you can listen to us that way, you can get all of the great archive content that way, or even through our website. All you have to do is go to theboobgroup.com and click on the member’s link to log in.
[Theme Music]
Robin Kaplan: Today on the Boob Group, we’re discussing how a baby’s oral anatomy can affect breastfeeding. Our expert Veronica Tingzon is an International Board Certified Lactation Consultant and owner of The Original Comfort Food in San Diego, California. Thanks so much for joining us Veronica and welcome back to the show!
Veronica Tingzon: Thank you for having me, I appreciate it.
Robin Kaplan: Sure, so Veronica, what are some anatomical anomalies that can affect the way a baby breast feeds?
Veronica Tingzon: There is several, but the ones that are most, I guess common or most prevalent in breastfeeding, is the first one that everybody’s heard of is the tongue tie which I know you had Dr. James Ochi over here and he talked about tongue tie and where the placement of that frenulum which is the little band underneath the tongue, how it’s place, the thickness of it, how it moves. There is also the labial frenulum which is the little band underneath the upper lip tying the upper lip to the gum. And a nurse things that are a little bit less talked about but still very common, the structure of the palate, whether it’s high, whether it’s grooved, whether it’s arched, whether it’s slanted, low lying gums. And also the other anomalies that are even less common but also happen is, if a baby is born with a tooth or if the baby has cleft palate or a cleft lip. So, those are things that you can look at as anatomical things that can cause difficulties to breastfeeding.
Robin Kaplan: Okay, and ladies, how did your babies oral anatomy affect breastfeeding and was it a challenge right from the beginning, Regula?
Regula Schmid: All three of my babies were tongue tied. Vivian was born tongue tied so severely that she couldn’t move her tongue at all. And so that was clipped within 24 hours of her being born but she still could not draw milk out of the breast and she was clipped two more times which made it not be resolved until she was three months old. So, she could not draw sufficient milk out of the breast until she was three months old. Going into the second pregnancy, and having a second set of children. We were prepared and we were prepared also to know that there are not just very obvious tongue ties, there are also posterior tongue ties that you can’t see that clearly. And so, we had the boys checked out immediately when their output after birth was not sufficient and sure enough, they were both tongue tied as well, they each had a postural tongue tie when that got clipped they instantly started peeing and pooping just fine. So, they have been nursing like champs since then.
Veronica Tingzon: That’s amazing how quickly it resolves that.
Robin Kaplan: It can, for sure and again but you did recognize as well that even with Vivian. That having a tongue clipped sometimes take a while as well which is so hard because there is no way to even be able to predict, how soon after clipping a baby will be able to nurse effectively, I should say.
Veronica Tingzon: Yeah, exactly. One of the things that I’ve noticed in my practice is that especially with who you go to, to clip the tongue, whether you go to a pediatrician in ENT, somebody who’s done a lot of hours in clipping infants tongue, not an older child who’s doing it for other purposes like speech impediments or things like that. What will happen is that they don’t clip it far back enough. So, often times what happens with the forward interior tongue tie like what Vivian had, it leads into a posterior tongue tie and they just only clipped that forward frenulum and don’t do anything about the back and then you’re still left with a baby who can’t use their tongue properly.
Robin Kaplan: Yeah. How about you Laura? What was your sons on oral anatomy like and was it a challenge right from the beginning?
Laura De La Torre: His latch, his ability to latch on was a problem from the beginning. Once he did latch on consistently starting when he was about 16 days old, it was about four days into breastfeeding at that point that I sought out the evaluation for posterior tongue tie because it became super painful. Nursing became excruciating actually and I actually had called you, Robin and you suggested the evaluation for the posterior tongue tie.
So, we did get that clipped with Dr. Ochi and then he went back to not wanting to latch for another six weeks of not wanting to latch. And then now that he’s been latching all like there is no more pain like that at all. Like in, so obviously there was definitely other issues with latching but then the posterior tongue tie also was affecting his ability to breastfeed.
Robin Kaplan: And Veronica, since we’re mentioning Dr. Ochi and the fact that he did, we interviewed him on the show quite a while ago, can you explain how does a tight frenulum affect breastfeeding and do they always need to be clipped?
Veronica Tingzon: Let me answer that last part first. Tongue ties do not always need to be clipped. The frenulum can resolve itself, it can start stretching out, the baby can start learning how to work around his or her ‘impediment’ and they can figure it out. When you’re looking at a baby who is just not figuring it out, they’re just smacking the chin up and down like a piston versus making the jaw movement in an elliptical fashion. You can kind of pretty much tell who is going to be able to transition and who is not going to be able to.
And so those are the ones that I refer for an evaluation for the tongue tie. But the reason why a tongue tie doesn’t allow the baby to strip enough milk from the breast is because the baby is not able to stretch the tongue far out enough. And I kind of make the analogy with my clients that if you take those exercise bands and you stretched them and there is the different circumference of exercise bands. The really skinny one you can stretch it all day long and you’re like, ‘wohoo! I’m working out,’ you know. And then there is the medium size when you’re like, ‘okay this is a little bit more difficult’ and then there is a really, really thick one and you’re like, ‘I can’t move a thing, it’s so hard to move.’ And that’s kind of what I tend to look at tongue tie like. There is the one that’s really pliable and elastic and you know it’s placed in the right perfect sweet spot that you can move the tongue. And then there is the one where, oh my gosh, it stick, it’s inelastic, it’s fibrous, it’s placed in a place where it does not allow for free movement of the tongue and that’s where you get into your problems.
Robin Kaplan: Okay. And something that I see in my practice and I’m sure you do as well is that often times, tongue ties and lip ties go hand in hand. And so, why would a tied upper lip cause a breastfeeding problem and is there anything a mother can do to encourage her baby lips to flange out.
Veronica Tingzon: Yeah, first of all that the reason why that the upper lip being tied down to the gums, you know it tends to hurt a mom’s nipples very badly. Because what happens is you don’t get that big fish lip look, the flange out of the lips. And so, it causes the baby to have his gums more exposed and there is no teeth or gums involve in breastfeeding but when your lips can’t hang on, because the lips are like the Velcro that hang on to the breast. If the lips can’t hang on, then they dig their gums and to be able to hold on so they don’t lose that latch and then mommy gets really, really sore or bloody or whatever and then it’s just not a good thing.
And some moms do flare out with their fingers the lips and they can certainly do that and some moms do some exercises where they start kind of massaging that labial frenulum so that it can stretch. But once again, some will stretch and some won’t. Some are just too fibrous and impliable and they won’t go anywhere.
One of the things that I just want to make a note about – I know there is a lot of brouhaha, different doctor say there is no such thing as tongue tie and then there is other doctor that say yes tongue tie and then there is parents who say, ‘I don’t want it that, I don’t want to hurt my baby and I don’t want to clip this.’ But you’ve got to understand that both the tongue tie and also the labial frenulum, this is not just a breastfeeding issue. This has implications beyond just breastfeeding. And so if the baby is having difficulty with undulating their tongue for a breastfeeding, they’re having difficulty undulating their tongue to swallow which can cause a lot of choking. And that goes for their whole life time, causes their palate to go up because of the way that they use their tongue and that can, later on in life as adults, can lead to apnea. So, and then with the lip usually when they have that tight labial frenulum that frenulum goes around the gum and tends to have a lot of dental malocclusions involving braces and all of that because you will usually have a gap tooth baby for that one so.
Robin Kaplan: Okay, no, there thank you, I really appreciate you bringing those up. Veronica, what if a baby’s tongue is really disorganize and has a difficult time creating a rhythmic with sucking motion and I see this oftentimes when the baby’s tongue has been released or even babies who I can’t find - there is no frenulum whatsoever underneath them and for some reason their tongue is just – they have a really typical time organizing. What can a mom do to help her baby become more efficient?
Veronica Tingzon: That’s fine because that tongue was my older son. That and he is why I became a lactation consultant and he just had one of those just really long loose tongues that it’s just too big for his mouth and it still is. He’s 15 and a half and he still talks like he’s got a ball of mush in his mouth and it drives me nuts. But what you would do with that type of tongue is you can do some sucking exercises with your finger or with a pacifier and I know I said that dreaded P word. But there are correct ways to use a pacifier when you’re breastfeeding and they are incorrect way to use it. So, I just want to make that disclaimer. It’s not a pacifier like here, just stick the pacifier in their mouth. So, I tend to use a pacifier, the ones that they give at the hospital that has a little happy face, little – they are usually kind of a green color. What I do is I stick my finger into – there’s like an orifice like a little opening on the back side of it. And what you can do is you can actually coax the tongue down with the pacifier nipple and you would coax it down and kind of try to draw it outwards and then kind of waggle it back in and then coax it down again and bring it outwards. That’s one way you could do that with your finger also. But I tend to find that the pacifier works a little bit better because you don’t have to used as much pressure with your finger to do it, it’s a little bit more gentle.
Robin Kaplan: And so it’s almost like a tug of war?
Veronica Tingzon: Kind of a little bit, yeah.
Robin Kaplan: So, they’re kind of holding onto while you’re pulling your finger and it’s drawing the tongue out.
Veronica Tingzon: Correct, correct. And then the other thing that I definitely like to use is a bringing forward of the cheeks and so you would kind of squeeze the cheeks, we called it in Lactation the dancer hold. And you’d kind of bring him in and you don’t want to depress the cheeks inward, you want to draw them forward towards the breast as you’re actually breastfeeding and it takes a little bit of talent. But that also creates a really nice seal so that the baby can start doing that correct sucking motion. And it seems to me that once the baby kind of like it clicks they kind of get it, then they’ve pretty much always got it. It may not always be perfect until they start practicing more but they will definitely start getting it more and more. So, I think that just kind of showing them what they’re supposed to do, teaches them to do what they’re supposed to do.
Robin Kaplan: Ladies, how are you able during that time period when your babies were not effectively breastfeeding, did you do any techniques to help bring their tongue out or any stretching exercises or anything that you think positively impacted them so that way they could eventually, exclusively breastfeed, Regula?
Regula Schmid: I didn’t, with the twins it just got resolved so quickly. They were organizing their tongue almost instantly. And with Vivian, like I said she had that first clipping and nothing really happen after that and then she had two more clippings and even after the third clipping, she had some craniosacral therapy but I’m not sure whether that did the trick either. I think she just needed time and she needed time at the boob, directly at the boob with no nipple shield, I just had to endure the pain and she had to learn how to suck with that new released loose tongue.
Robin Kaplan: Yeah, absolutely. How about you, Laura?
Laura De La Torre: Yes, I also did craniosacral and I had one chiropractic session also for all of the issues and also, you know, along with the tongue tie, but I did not do any of the stretching exercises. Theo was almost like, even though he didn’t have any trauma he had come out kind of seeming like a trauma infant-like his birth had been traumatic because of his behavior. So, I didn’t want to be doing anything else super traumatic for him personally and the clipping was traumatic enough. So, I did not put my fingers in there anymore. Once he finally did latch he was still fairly disorganized and I mean the latching at nine weeks. Once he finally did latch then he was still kind of disorganized and it was the same thing as Regula said, I just nursed him and nursed him, and nursed him and nursed him and just he’s gotten better over the last month.
Robin Kaplan: Were you going to mention something, Veronica?
Veronica Tingzon: Yeah, I was going to mention that I love craniosacral therapy and I think that frenotomy, which is the tongue clipping that we’re talking about. Frenotomy and craniosacral therapy kind of go hand in hand in my opinion because once they do have that, that tongue clipping, they tend to have that loose tongue, they tend to like to suck their tongue and to be honest with you, a tongue sucking baby is my worse baby nightmare of all. Because you can’t get them to divorce their tongue from their palate and it creates even more of that high palate and whatnot. So, having the craniosacral therapist open up that palate and kind of free the tongue down and kind of coax it back to where it supposed to be, it’s a wonderful, wonderful tool.
Robin Kaplan: And about that topic of the high palate, I know that they can also present some breastfeeding challenges and so, what exactly is this and what can a mother do to help the situation and will the palate eventually spread out?
Veronica Tingzon: Yes, it will eventually spread out and actually breastfeeding helps it a lot because it kind of trains the mouth to go where it’s supposed to go. One of the reasons or some of the reasons that the high palate happens either: A. Very traumatic birth like you were talking where they get squeezed too tightly through the vaginal canal and because baby’s bones are so malleable, they are meant to move. And so, they move and they kind of get kind of disjointed or whatever and the palate is one of those particular surfaces that is not really fused together and so it will move during the palate. I’m sorry during the birth canal.
And the other one that happens is that when babies are in the womb they tend to do behaviors to suit themselves and so one of them is sucking and so either they’ll suck their thumb or they’ll both suck their tongue in the womb and the one who was sucking their tongue in the womb is usually the tongue tied one that comes out and sucks their tongue outside of the womb and they are the ones that tend to have these problems. And it kind of all fits together in a nice little box, painful nice little box but they kind of go hand in hand.
Robin Kaplan: Okay, well, when we come Veronica will discuss what a mother can do when her baby is dealing with a weakened suck and other anatomical issues and so, we’ll be right back.
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Robin Kaplan: Well, we’re back with Veronica Tingzon, an International Board Certified Lactation Consultant and owner of the Original Comfort Food in San Diego, and we’re talking about how a baby’s oral anatomy can affect breastfeeding. So, Veronica every once in a while I will meet a baby who suck is weaker then I would expect and is really unable to transfer as much milk as he needs during a feeding. What can cause a baby to have a weakened suck?
Veronica Tingzon: There’s a couple of different things. One of them is birth trauma, the fact that their jaw can be offset where one side is protruding further forward then the other and everybody has that. You just have to kind of look and see like what side is it so you’d have to you know face the baby and the direction that’s closest or jutted closest forward to the breast and that’s one way to resolve that one or craniosacral therapy. The other one is prematurity. Babies just don’t have enough fat in their cheeks in order to gather that strength to be able to form a really, really good suck or even just a baby who’s term but very low birth weight will have that same problem.
And then different things like how sedated they are when they are coming out. My perfect world would be everybody giving natural childbirth but a lot of these babies come out very sedated and so then they just don’t really want to suck. And so, there is different ways to go about getting either one these situations going. The one with the sedated baby is just a little bit of time to get them through their sedation, skin to skin, I cannot tell you how important skin to skin is during that time period. It’s amazing what a baby can do to transition if they’re just with their mom and not in the box. For the term baby that’s low birth weight or the pre term baby that’s low birth weight, it’s just going to take a little bit of time in fattening up. So, a lot of the things that I do with particular baby is either give them a little bit of bottled breast milk first or do the SNS first so they don’t have to work quite as hard and then let them do a little bit more sucking on their own without having to expand as many calories as they are. A lot of people do their supplementation afterwards, but this particular type of baby needs it upfront. And for the baby with the anatomical difference in proportion of their face, that one just you know, craniosacral and chiropractic can help resolve that or like I said facing the baby in the direction that is farthest protruding forward.
Robin Kaplan: It’s funny you mentioned chiropractic, I just started chiropractic work about six weeks ago and she did x-rays of my body and my skull is totally diagonal like where it supposed to be flat. And my mom barely breastfed me because it was so painful and I look at how my body has shifted based on having this body that is slightly tilted. And so it manifest later on and so that’s why chiropractic or craniosacral therapy can be so helpful for babies because then they don’t end up with chronic back pain as a 36-year old woman.
Veronica Tingzon: You know, and it’s funny because a lot of moms are so resistant to it, it’s going to hurt my baby, I’m like really, it’s going to help your baby and it’s going to help them for their lifetime. Not just right now, it’s amazing what it can do for a lifetime.
Robin Kaplan: Absolutely. Is this something that a mom should speak with her pediatrician about with low – weakened suck? You’re laughing.
Veronica Tingzon: I’m sorry I don’t mean. You know, there are so many pediatricians. I think it’s kind of split down the middle 50-50 but, then again I am in an area where it’s very pro breastfeeding, it’s very pro knowledge about different alternate forms of medicine incorporating eastern philosophy into western philosophy. So, I don’t know how that is everywhere, I can’t tell you what it would be like in the midwest, let’s say where there is lower breastfeeding rates and what not. The reason I laugh is because I have met with so much resistance from certain pediatrician groups. Because they are like, ‘oh there is that lactation consultant again, she’s such a hippy’ and it’s really not I mean and I even had one pediatrician go so far as to tell the mother that I was working with, don’t ever listen to the lactation consultant, she doesn’t know what she’s talking about. And he said, tongue tie does not exist, high palates do not exist. So, it’s very difficult for us to be able to really give that information to the mother because then there’s somebody messing on the other side and so then we’re going through this power struggle, but the doctor, the doctor is the almighty doctor. Here he said and so, it’s very difficult for me to really let them know, ‘look, I’ve done this for many, many years. I know exactly what’s going on.’
Robin Kaplan: And there’s research to back it up too.
Veronica Tingzon: Yeah, and there is a research to back it up, exactly.
Robin Kaplan: Okay, to kind of switch the topic on different type of anomalies; what about lock jaw, and how can this effect breastfeeding?
Veronica Tingzon: Lock jaw is really something that it’s over time, it’s been caused by these certain types of behaviors. The lock jaw, for example, is from -- a lot of the time that tongue sucker, once again has that tongue placed up on the top of the palate and they tend to squeeze the TMJ, which is the Temporomandibular Joint, which is basically the hinge of the jaw. And so, because they are so tight there and they don’t drop down that jaw it becomes this very tight thing that later on in life will be a chronic problem and cause lock jaw and whatnot.
Robin Kaplan: So, what can a mother do to remedy the situation and who should she be talking to about this?
Veronica Tingzon: She can do a little bit of massage on the TMJ, circular massage to kind of help open the baby’s mouth up and those sucking exercises that we talked about with the pacifiers or the finger, that’s great one also. You can also do the same sucking exercises, believe it or not with a bottle. You can’t really do them on the breast because the nipple of the breast is too soft to be able to ply the baby’s mouth down. But the person who you would want to refer them to is, once again, either a craniosacral therapist, a chiropractor, and osteopath also can help them with that.
Robin Kaplan: Is this something an occupational therapist or pediatric occupational therapist might help with?
Veronica Tingzon: They can’t. The one thing about occupational therapist is that they are looking at it most of the times more from the bottle feeding standpoint and that’s fine. There are some occupational therapist that are directed towards the breastfeeding component also and as a matter of fact, at my hospital we have an incredible occupational therapist who’s also an IBCLC, International Board Certified Lactation Consultant and she’s incredible and she does get these babies. She get micro premise to breastfeed.
Robin Kaplan: And then our last topic of the day which obviously deserves its own episode but the cleft palate and clipped lip, what are the chances that a baby would, one of these would be able to breastfeed?
Veronica Tingzon: You know, I have actually seen a lot of cleft lip and palate babies be able to breastfeed, the cleft lip babies actually have a pretty good success rate.
Robin Kaplan: It’s all about getting the section.
Veronica Tingzon: Yeah, it’s all about getting the section. So, if we can kind of squeeze the breast into filling that space, that cleft we can get it done. Sometimes using a nipple shield will help that as well. But sometimes the cleft palate baby has a more difficult time obviously because there is a – you can’t get that negative pressure when there is an opening there. A lot of the times we have those moms pump and just continued to pump until that baby can have that cleft resolved and then hopefully we can start doing some breastfeeding at that point in time. But then again, that’s up to that baby.
Robin Kaplan: Absolutely. And before we end I would just love to ask our panelists because obviously you spend a lot of time working on breastfeeding with your children, you know, nine weeks, three months to where they finally became efficient. What kept you going and – I know you’re laughing, right? But how did you keep going because I know that I see this with my mom so that I worked with how overwhelmingly emotional it is to continue with something that is not yet met where it needs to be and be comfortable so. What kept you going, Laura?
Laura De La Torre: I don’t know.
Robin Kaplan: Sheer stubbornness, right?
Laura De La Torre: It was, I tell people I’m just a little crazy and a little stubborn and I just felt like exclusive breastfeeding was my goal, like prenatally and it never occur to me that that wouldn’t happen. So, when it wasn’t happening I just feel like there was just no other option. And I would just tell him that all the time too, this is non-negotiable. So, I also had a lot of support from other moms texting me every day and asking me how I’m doing and the donor milk and my midwives and lactation consultants and so the breastfeeding community itself was really, really supportive and that help a lot too.
Robin Kaplan: How about you, Regula?
Regula Schmid: Well, I was at first told that I had no milk and that’s why Vivian wasn’t able to get milk and I never believe that. I didn’t think that my body couldn’t do this. So, I was confident in my body that my body could do it. And then when I was told that she had a posterior tongue tie as well as that wasn’t just taking care of what clipping the interior one, that was a little bit of a relief because he gave me new hope.
So, I went from hope to almost no hope but still going to have little bit of new hope and then almost no hope and a little bit new hope with the third clipping and I just thought of it as a lesson that I was teaching my daughter, we never give up. And I remember nursing her and our attempting to nurse her, sitting on the couch saying Vivian, we will never give up. And we didn’t and she’s three years old and still nursing.
Robin Kaplan: She’s a doll. Well thank you so much Veronica for your insight into how a baby’s oral anatomy can affect breastfeeding. And for our Boob Group Club members our conversations will continue after the end of the show as Veronica will answer few more questions on this topic. For more information about our Boob Group Club, please visit our website at theboobgroup.com.
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Robin Kaplan: Before we end today’s show here is Amber McCann sharing tips for the best online breastfeeding resources.
Amber McCann: Hello Boob Group listeners, I’m Amber McCann, an International Board Certified Lactation Consultant and the owner of Nourish Breastfeeding Support just outside of Washington D.C.
I’m here to answer some of your most common questions when it comes to finding quality breastfeeding resources online such as, I’ve got a freezer full of milk that I pumped, where can I donate? I once had a mother call me to tell me that she was so proud that she pumps so much milk that they were having to pour it down the sink, nothing strikes terror in the heart of a lactation consultant quite like that. Many birth giving mothers are also pumping and can gather an excess of milk. I have heard of mothers who needed to purchase new upright freezers for all their milk. If you are ever in situation where you have more milk than your baby needs, would you consider donating some to HMBANA designated milk bank? HMBANA stands for the Human Milk Banking Association of North America. And they are tasked with gathering, processing and distributing donor milk all over the country.
For this fragile infant’s donor milk can literally be a matter of life or death. Won’t it feel really good to be part of that miracle? One note, please understand that there a number of other ‘milk banks’ that take the donations from mothers and sell the milk at a profit. So, make sure that the bank you’re considering is a HMBANA designated one. Please check them out www.hmbana.org. Thank you for listening. I’m Amber McCann and I’d love for you to check out my website at www.nourishbreastfeeding.com. For information on my business and a little more about where to get connected with great online breastfeeding support. Or join me on my Facebook page at www.facebook.com/nourishbreastfeeding. And if you have a great online breastfeeding resource you like to know about, please sent me an email. You can do it to amber@nourishbreastfeeding.com or share it on the Boob Group Facebook page. Be sure to listen to the Boob Group each week for more fantastic conversations about breastfeeding and how to find great breastfeeding support.
Robin Kaplan: Thank you so much to our experts, panelists and all of our listeners. If you have any questions about today’s show with the topics we discussed please call our Boob Group hotline at 619-866-4775 and we’ll answer your question on an upcoming episode.
If you have a breastfeeding topic you’d like to suggest, we would love to hear it. Simply visit our website at the boobgroup.com and sent us an email through the contact link. Coming up next week, we have Anney, Cherri and Jennifer back on the show to talk about what life has been like during their baby’s seventh month in our series Breast Feeding Expectations.
Thanks for listening to The Boob Group; because mothers know breast.
[Disclaimer]
This has been a New Mommy Media production. Information and material contained in this episode are presented for educational purposes only. Statements and opinions expressed in this episode are not necessarily those of New Mommy Media and should not be considered facts. Though information in which areas are believed to be accurate, it is not intended to replace or substitute for professional, Medical or advisor care and should not be used for diagnosing or treating health care problem or disease or prescribing any medications. If you have questions or concerns regarding your physical or mental health or the health of your baby, please seek assistance from a qualified health care provider.
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Episode Transcript
The Boob Group
TBG038 Baby Oral Anatomy Breastfeeding
[00:00:00]
Please be advised, this transcription was performed from a company independent of New Mommy Media, LLC. As such, translation was required which may alter the accuracy of the transcription.
[Theme Music]
Veronica Tingzon: While baby's latch may look absolutely perfect from the outside it can often be what’s going on inside of his or her mouth that can cause a breastfeeding challenge. What’s a mom to do when her baby’s oral anatomy is making breastfeeding difficult? I’m Veronica Tingzon, an International Board Certified Lactation Consultant and owner of The Original Comfort Food in San Diego, California. Today we’re discussing how a baby’s oral anatomy can affect breastfeeding. This is the Boob Group Episode number 38.
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Robin Kaplan: Welcome to the Boob Group broadcasting from the Birth Education Centre of San Diego. I’m your host Robin Kaplan. I am also an International Board Certified Lactation Consultant and owner of the San Diego Breastfeeding Center. At the Boob Group we’re your online support group for all things related to breastfeeding. Did you know that we have a Boob Group Club? All Boob Group Club members will get access to all of our archives episodes plus bonus interviews, transcripts and special discounts and giveaways from our partners plus you can interact with all this great content through the web or through our free Boob Group App available in the Apple and Amazon Market place. Today, we’re joined by two lovely panelists in the studio. Would you please introduce yourselves ladies?
Laura De La Torre: My name is Laura De La Torre, I’m 32 and I’m currently – I’m 33 actually. I’m currently a stay-at-home mom to my first son Theodore who is three months old.
Regula Schmid: I’m Regula Schmid, I’m 41 since we’re talking about age. And I know I got that right, it is 41. I’m currently a stay-at-home mom with my three year old daughter Vivian and my twin boys Bayani and Florian, who are seven months. And before that I used to be a school principal.
Robin Kaplan: Well, welcome to the show ladies, it’s a pleasure to have you.
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Robin Kaplan: So, we have a comment from one of our listeners and it’s from Samantha from Kentucky. Hi Boob Group, I have a question about the Boob Group Club. How do I listen to the archive episodes once I’ve joined? I have downloaded the app but all the archive episodes are still locked, help.
Sunny: Hi Samantha, this is Sunny. I’m one of the producers on the Boob Group. Okay, so we’re so happy that you downloaded our app. When you are in the app, go to the settings page. If you go to the settings page, you will have to log in using your log in information and then what happens when you go back to the episodes page, all of the episodes then are unlocked. Right now, you’re probably seeing like little lock symbol next to the ones that are on our archive. So, once you log in, it will remember you each time unless you to choose to log out. And then it unlocks all of the episodes, so you can listen to us that way, you can get all of the great archive content that way, or even through our website. All you have to do is go to theboobgroup.com and click on the member’s link to log in.
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Robin Kaplan: Today on the Boob Group, we’re discussing how a baby’s oral anatomy can affect breastfeeding. Our expert Veronica Tingzon is an International Board Certified Lactation Consultant and owner of The Original Comfort Food in San Diego, California. Thanks so much for joining us Veronica and welcome back to the show!
Veronica Tingzon: Thank you for having me, I appreciate it.
Robin Kaplan: Sure, so Veronica, what are some anatomical anomalies that can affect the way a baby breast feeds?
Veronica Tingzon: There is several, but the ones that are most, I guess common or most prevalent in breastfeeding, is the first one that everybody’s heard of is the tongue tie which I know you had Dr. James Ochi over here and he talked about tongue tie and where the placement of that frenulum which is the little band underneath the tongue, how it’s place, the thickness of it, how it moves. There is also the labial frenulum which is the little band underneath the upper lip tying the upper lip to the gum. And a nurse things that are a little bit less talked about but still very common, the structure of the palate, whether it’s high, whether it’s grooved, whether it’s arched, whether it’s slanted, low lying gums. And also the other anomalies that are even less common but also happen is, if a baby is born with a tooth or if the baby has cleft palate or a cleft lip. So, those are things that you can look at as anatomical things that can cause difficulties to breastfeeding.
Robin Kaplan: Okay, and ladies, how did your babies oral anatomy affect breastfeeding and was it a challenge right from the beginning, Regula?
Regula Schmid: All three of my babies were tongue tied. Vivian was born tongue tied so severely that she couldn’t move her tongue at all. And so that was clipped within 24 hours of her being born but she still could not draw milk out of the breast and she was clipped two more times which made it not be resolved until she was three months old. So, she could not draw sufficient milk out of the breast until she was three months old. Going into the second pregnancy, and having a second set of children. We were prepared and we were prepared also to know that there are not just very obvious tongue ties, there are also posterior tongue ties that you can’t see that clearly. And so, we had the boys checked out immediately when their output after birth was not sufficient and sure enough, they were both tongue tied as well, they each had a postural tongue tie when that got clipped they instantly started peeing and pooping just fine. So, they have been nursing like champs since then.
Veronica Tingzon: That’s amazing how quickly it resolves that.
Robin Kaplan: It can, for sure and again but you did recognize as well that even with Vivian. That having a tongue clipped sometimes take a while as well which is so hard because there is no way to even be able to predict, how soon after clipping a baby will be able to nurse effectively, I should say.
Veronica Tingzon: Yeah, exactly. One of the things that I’ve noticed in my practice is that especially with who you go to, to clip the tongue, whether you go to a pediatrician in ENT, somebody who’s done a lot of hours in clipping infants tongue, not an older child who’s doing it for other purposes like speech impediments or things like that. What will happen is that they don’t clip it far back enough. So, often times what happens with the forward interior tongue tie like what Vivian had, it leads into a posterior tongue tie and they just only clipped that forward frenulum and don’t do anything about the back and then you’re still left with a baby who can’t use their tongue properly.
Robin Kaplan: Yeah. How about you Laura? What was your sons on oral anatomy like and was it a challenge right from the beginning?
Laura De La Torre: His latch, his ability to latch on was a problem from the beginning. Once he did latch on consistently starting when he was about 16 days old, it was about four days into breastfeeding at that point that I sought out the evaluation for posterior tongue tie because it became super painful. Nursing became excruciating actually and I actually had called you, Robin and you suggested the evaluation for the posterior tongue tie.
So, we did get that clipped with Dr. Ochi and then he went back to not wanting to latch for another six weeks of not wanting to latch. And then now that he’s been latching all like there is no more pain like that at all. Like in, so obviously there was definitely other issues with latching but then the posterior tongue tie also was affecting his ability to breastfeed.
Robin Kaplan: And Veronica, since we’re mentioning Dr. Ochi and the fact that he did, we interviewed him on the show quite a while ago, can you explain how does a tight frenulum affect breastfeeding and do they always need to be clipped?
Veronica Tingzon: Let me answer that last part first. Tongue ties do not always need to be clipped. The frenulum can resolve itself, it can start stretching out, the baby can start learning how to work around his or her ‘impediment’ and they can figure it out. When you’re looking at a baby who is just not figuring it out, they’re just smacking the chin up and down like a piston versus making the jaw movement in an elliptical fashion. You can kind of pretty much tell who is going to be able to transition and who is not going to be able to.
And so those are the ones that I refer for an evaluation for the tongue tie. But the reason why a tongue tie doesn’t allow the baby to strip enough milk from the breast is because the baby is not able to stretch the tongue far out enough. And I kind of make the analogy with my clients that if you take those exercise bands and you stretched them and there is the different circumference of exercise bands. The really skinny one you can stretch it all day long and you’re like, ‘wohoo! I’m working out,’ you know. And then there is the medium size when you’re like, ‘okay this is a little bit more difficult’ and then there is a really, really thick one and you’re like, ‘I can’t move a thing, it’s so hard to move.’ And that’s kind of what I tend to look at tongue tie like. There is the one that’s really pliable and elastic and you know it’s placed in the right perfect sweet spot that you can move the tongue. And then there is the one where, oh my gosh, it stick, it’s inelastic, it’s fibrous, it’s placed in a place where it does not allow for free movement of the tongue and that’s where you get into your problems.
Robin Kaplan: Okay. And something that I see in my practice and I’m sure you do as well is that often times, tongue ties and lip ties go hand in hand. And so, why would a tied upper lip cause a breastfeeding problem and is there anything a mother can do to encourage her baby lips to flange out.
Veronica Tingzon: Yeah, first of all that the reason why that the upper lip being tied down to the gums, you know it tends to hurt a mom’s nipples very badly. Because what happens is you don’t get that big fish lip look, the flange out of the lips. And so, it causes the baby to have his gums more exposed and there is no teeth or gums involve in breastfeeding but when your lips can’t hang on, because the lips are like the Velcro that hang on to the breast. If the lips can’t hang on, then they dig their gums and to be able to hold on so they don’t lose that latch and then mommy gets really, really sore or bloody or whatever and then it’s just not a good thing.
And some moms do flare out with their fingers the lips and they can certainly do that and some moms do some exercises where they start kind of massaging that labial frenulum so that it can stretch. But once again, some will stretch and some won’t. Some are just too fibrous and impliable and they won’t go anywhere.
One of the things that I just want to make a note about – I know there is a lot of brouhaha, different doctor say there is no such thing as tongue tie and then there is other doctor that say yes tongue tie and then there is parents who say, ‘I don’t want it that, I don’t want to hurt my baby and I don’t want to clip this.’ But you’ve got to understand that both the tongue tie and also the labial frenulum, this is not just a breastfeeding issue. This has implications beyond just breastfeeding. And so if the baby is having difficulty with undulating their tongue for a breastfeeding, they’re having difficulty undulating their tongue to swallow which can cause a lot of choking. And that goes for their whole life time, causes their palate to go up because of the way that they use their tongue and that can, later on in life as adults, can lead to apnea. So, and then with the lip usually when they have that tight labial frenulum that frenulum goes around the gum and tends to have a lot of dental malocclusions involving braces and all of that because you will usually have a gap tooth baby for that one so.
Robin Kaplan: Okay, no, there thank you, I really appreciate you bringing those up. Veronica, what if a baby’s tongue is really disorganize and has a difficult time creating a rhythmic with sucking motion and I see this oftentimes when the baby’s tongue has been released or even babies who I can’t find - there is no frenulum whatsoever underneath them and for some reason their tongue is just – they have a really typical time organizing. What can a mom do to help her baby become more efficient?
Veronica Tingzon: That’s fine because that tongue was my older son. That and he is why I became a lactation consultant and he just had one of those just really long loose tongues that it’s just too big for his mouth and it still is. He’s 15 and a half and he still talks like he’s got a ball of mush in his mouth and it drives me nuts. But what you would do with that type of tongue is you can do some sucking exercises with your finger or with a pacifier and I know I said that dreaded P word. But there are correct ways to use a pacifier when you’re breastfeeding and they are incorrect way to use it. So, I just want to make that disclaimer. It’s not a pacifier like here, just stick the pacifier in their mouth. So, I tend to use a pacifier, the ones that they give at the hospital that has a little happy face, little – they are usually kind of a green color. What I do is I stick my finger into – there’s like an orifice like a little opening on the back side of it. And what you can do is you can actually coax the tongue down with the pacifier nipple and you would coax it down and kind of try to draw it outwards and then kind of waggle it back in and then coax it down again and bring it outwards. That’s one way you could do that with your finger also. But I tend to find that the pacifier works a little bit better because you don’t have to used as much pressure with your finger to do it, it’s a little bit more gentle.
Robin Kaplan: And so it’s almost like a tug of war?
Veronica Tingzon: Kind of a little bit, yeah.
Robin Kaplan: So, they’re kind of holding onto while you’re pulling your finger and it’s drawing the tongue out.
Veronica Tingzon: Correct, correct. And then the other thing that I definitely like to use is a bringing forward of the cheeks and so you would kind of squeeze the cheeks, we called it in Lactation the dancer hold. And you’d kind of bring him in and you don’t want to depress the cheeks inward, you want to draw them forward towards the breast as you’re actually breastfeeding and it takes a little bit of talent. But that also creates a really nice seal so that the baby can start doing that correct sucking motion. And it seems to me that once the baby kind of like it clicks they kind of get it, then they’ve pretty much always got it. It may not always be perfect until they start practicing more but they will definitely start getting it more and more. So, I think that just kind of showing them what they’re supposed to do, teaches them to do what they’re supposed to do.
Robin Kaplan: Ladies, how are you able during that time period when your babies were not effectively breastfeeding, did you do any techniques to help bring their tongue out or any stretching exercises or anything that you think positively impacted them so that way they could eventually, exclusively breastfeed, Regula?
Regula Schmid: I didn’t, with the twins it just got resolved so quickly. They were organizing their tongue almost instantly. And with Vivian, like I said she had that first clipping and nothing really happen after that and then she had two more clippings and even after the third clipping, she had some craniosacral therapy but I’m not sure whether that did the trick either. I think she just needed time and she needed time at the boob, directly at the boob with no nipple shield, I just had to endure the pain and she had to learn how to suck with that new released loose tongue.
Robin Kaplan: Yeah, absolutely. How about you, Laura?
Laura De La Torre: Yes, I also did craniosacral and I had one chiropractic session also for all of the issues and also, you know, along with the tongue tie, but I did not do any of the stretching exercises. Theo was almost like, even though he didn’t have any trauma he had come out kind of seeming like a trauma infant-like his birth had been traumatic because of his behavior. So, I didn’t want to be doing anything else super traumatic for him personally and the clipping was traumatic enough. So, I did not put my fingers in there anymore. Once he finally did latch he was still fairly disorganized and I mean the latching at nine weeks. Once he finally did latch then he was still kind of disorganized and it was the same thing as Regula said, I just nursed him and nursed him, and nursed him and nursed him and just he’s gotten better over the last month.
Robin Kaplan: Were you going to mention something, Veronica?
Veronica Tingzon: Yeah, I was going to mention that I love craniosacral therapy and I think that frenotomy, which is the tongue clipping that we’re talking about. Frenotomy and craniosacral therapy kind of go hand in hand in my opinion because once they do have that, that tongue clipping, they tend to have that loose tongue, they tend to like to suck their tongue and to be honest with you, a tongue sucking baby is my worse baby nightmare of all. Because you can’t get them to divorce their tongue from their palate and it creates even more of that high palate and whatnot. So, having the craniosacral therapist open up that palate and kind of free the tongue down and kind of coax it back to where it supposed to be, it’s a wonderful, wonderful tool.
Robin Kaplan: And about that topic of the high palate, I know that they can also present some breastfeeding challenges and so, what exactly is this and what can a mother do to help the situation and will the palate eventually spread out?
Veronica Tingzon: Yes, it will eventually spread out and actually breastfeeding helps it a lot because it kind of trains the mouth to go where it’s supposed to go. One of the reasons or some of the reasons that the high palate happens either: A. Very traumatic birth like you were talking where they get squeezed too tightly through the vaginal canal and because baby’s bones are so malleable, they are meant to move. And so, they move and they kind of get kind of disjointed or whatever and the palate is one of those particular surfaces that is not really fused together and so it will move during the palate. I’m sorry during the birth canal.
And the other one that happens is that when babies are in the womb they tend to do behaviors to suit themselves and so one of them is sucking and so either they’ll suck their thumb or they’ll both suck their tongue in the womb and the one who was sucking their tongue in the womb is usually the tongue tied one that comes out and sucks their tongue outside of the womb and they are the ones that tend to have these problems. And it kind of all fits together in a nice little box, painful nice little box but they kind of go hand in hand.
Robin Kaplan: Okay, well, when we come Veronica will discuss what a mother can do when her baby is dealing with a weakened suck and other anatomical issues and so, we’ll be right back.
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Robin Kaplan: Well, we’re back with Veronica Tingzon, an International Board Certified Lactation Consultant and owner of the Original Comfort Food in San Diego, and we’re talking about how a baby’s oral anatomy can affect breastfeeding. So, Veronica every once in a while I will meet a baby who suck is weaker then I would expect and is really unable to transfer as much milk as he needs during a feeding. What can cause a baby to have a weakened suck?
Veronica Tingzon: There’s a couple of different things. One of them is birth trauma, the fact that their jaw can be offset where one side is protruding further forward then the other and everybody has that. You just have to kind of look and see like what side is it so you’d have to you know face the baby and the direction that’s closest or jutted closest forward to the breast and that’s one way to resolve that one or craniosacral therapy. The other one is prematurity. Babies just don’t have enough fat in their cheeks in order to gather that strength to be able to form a really, really good suck or even just a baby who’s term but very low birth weight will have that same problem.
And then different things like how sedated they are when they are coming out. My perfect world would be everybody giving natural childbirth but a lot of these babies come out very sedated and so then they just don’t really want to suck. And so, there is different ways to go about getting either one these situations going. The one with the sedated baby is just a little bit of time to get them through their sedation, skin to skin, I cannot tell you how important skin to skin is during that time period. It’s amazing what a baby can do to transition if they’re just with their mom and not in the box. For the term baby that’s low birth weight or the pre term baby that’s low birth weight, it’s just going to take a little bit of time in fattening up. So, a lot of the things that I do with particular baby is either give them a little bit of bottled breast milk first or do the SNS first so they don’t have to work quite as hard and then let them do a little bit more sucking on their own without having to expand as many calories as they are. A lot of people do their supplementation afterwards, but this particular type of baby needs it upfront. And for the baby with the anatomical difference in proportion of their face, that one just you know, craniosacral and chiropractic can help resolve that or like I said facing the baby in the direction that is farthest protruding forward.
Robin Kaplan: It’s funny you mentioned chiropractic, I just started chiropractic work about six weeks ago and she did x-rays of my body and my skull is totally diagonal like where it supposed to be flat. And my mom barely breastfed me because it was so painful and I look at how my body has shifted based on having this body that is slightly tilted. And so it manifest later on and so that’s why chiropractic or craniosacral therapy can be so helpful for babies because then they don’t end up with chronic back pain as a 36-year old woman.
Veronica Tingzon: You know, and it’s funny because a lot of moms are so resistant to it, it’s going to hurt my baby, I’m like really, it’s going to help your baby and it’s going to help them for their lifetime. Not just right now, it’s amazing what it can do for a lifetime.
Robin Kaplan: Absolutely. Is this something that a mom should speak with her pediatrician about with low – weakened suck? You’re laughing.
Veronica Tingzon: I’m sorry I don’t mean. You know, there are so many pediatricians. I think it’s kind of split down the middle 50-50 but, then again I am in an area where it’s very pro breastfeeding, it’s very pro knowledge about different alternate forms of medicine incorporating eastern philosophy into western philosophy. So, I don’t know how that is everywhere, I can’t tell you what it would be like in the midwest, let’s say where there is lower breastfeeding rates and what not. The reason I laugh is because I have met with so much resistance from certain pediatrician groups. Because they are like, ‘oh there is that lactation consultant again, she’s such a hippy’ and it’s really not I mean and I even had one pediatrician go so far as to tell the mother that I was working with, don’t ever listen to the lactation consultant, she doesn’t know what she’s talking about. And he said, tongue tie does not exist, high palates do not exist. So, it’s very difficult for us to be able to really give that information to the mother because then there’s somebody messing on the other side and so then we’re going through this power struggle, but the doctor, the doctor is the almighty doctor. Here he said and so, it’s very difficult for me to really let them know, ‘look, I’ve done this for many, many years. I know exactly what’s going on.’
Robin Kaplan: And there’s research to back it up too.
Veronica Tingzon: Yeah, and there is a research to back it up, exactly.
Robin Kaplan: Okay, to kind of switch the topic on different type of anomalies; what about lock jaw, and how can this effect breastfeeding?
Veronica Tingzon: Lock jaw is really something that it’s over time, it’s been caused by these certain types of behaviors. The lock jaw, for example, is from -- a lot of the time that tongue sucker, once again has that tongue placed up on the top of the palate and they tend to squeeze the TMJ, which is the Temporomandibular Joint, which is basically the hinge of the jaw. And so, because they are so tight there and they don’t drop down that jaw it becomes this very tight thing that later on in life will be a chronic problem and cause lock jaw and whatnot.
Robin Kaplan: So, what can a mother do to remedy the situation and who should she be talking to about this?
Veronica Tingzon: She can do a little bit of massage on the TMJ, circular massage to kind of help open the baby’s mouth up and those sucking exercises that we talked about with the pacifiers or the finger, that’s great one also. You can also do the same sucking exercises, believe it or not with a bottle. You can’t really do them on the breast because the nipple of the breast is too soft to be able to ply the baby’s mouth down. But the person who you would want to refer them to is, once again, either a craniosacral therapist, a chiropractor, and osteopath also can help them with that.
Robin Kaplan: Is this something an occupational therapist or pediatric occupational therapist might help with?
Veronica Tingzon: They can’t. The one thing about occupational therapist is that they are looking at it most of the times more from the bottle feeding standpoint and that’s fine. There are some occupational therapist that are directed towards the breastfeeding component also and as a matter of fact, at my hospital we have an incredible occupational therapist who’s also an IBCLC, International Board Certified Lactation Consultant and she’s incredible and she does get these babies. She get micro premise to breastfeed.
Robin Kaplan: And then our last topic of the day which obviously deserves its own episode but the cleft palate and clipped lip, what are the chances that a baby would, one of these would be able to breastfeed?
Veronica Tingzon: You know, I have actually seen a lot of cleft lip and palate babies be able to breastfeed, the cleft lip babies actually have a pretty good success rate.
Robin Kaplan: It’s all about getting the section.
Veronica Tingzon: Yeah, it’s all about getting the section. So, if we can kind of squeeze the breast into filling that space, that cleft we can get it done. Sometimes using a nipple shield will help that as well. But sometimes the cleft palate baby has a more difficult time obviously because there is a – you can’t get that negative pressure when there is an opening there. A lot of the times we have those moms pump and just continued to pump until that baby can have that cleft resolved and then hopefully we can start doing some breastfeeding at that point in time. But then again, that’s up to that baby.
Robin Kaplan: Absolutely. And before we end I would just love to ask our panelists because obviously you spend a lot of time working on breastfeeding with your children, you know, nine weeks, three months to where they finally became efficient. What kept you going and – I know you’re laughing, right? But how did you keep going because I know that I see this with my mom so that I worked with how overwhelmingly emotional it is to continue with something that is not yet met where it needs to be and be comfortable so. What kept you going, Laura?
Laura De La Torre: I don’t know.
Robin Kaplan: Sheer stubbornness, right?
Laura De La Torre: It was, I tell people I’m just a little crazy and a little stubborn and I just felt like exclusive breastfeeding was my goal, like prenatally and it never occur to me that that wouldn’t happen. So, when it wasn’t happening I just feel like there was just no other option. And I would just tell him that all the time too, this is non-negotiable. So, I also had a lot of support from other moms texting me every day and asking me how I’m doing and the donor milk and my midwives and lactation consultants and so the breastfeeding community itself was really, really supportive and that help a lot too.
Robin Kaplan: How about you, Regula?
Regula Schmid: Well, I was at first told that I had no milk and that’s why Vivian wasn’t able to get milk and I never believe that. I didn’t think that my body couldn’t do this. So, I was confident in my body that my body could do it. And then when I was told that she had a posterior tongue tie as well as that wasn’t just taking care of what clipping the interior one, that was a little bit of a relief because he gave me new hope.
So, I went from hope to almost no hope but still going to have little bit of new hope and then almost no hope and a little bit new hope with the third clipping and I just thought of it as a lesson that I was teaching my daughter, we never give up. And I remember nursing her and our attempting to nurse her, sitting on the couch saying Vivian, we will never give up. And we didn’t and she’s three years old and still nursing.
Robin Kaplan: She’s a doll. Well thank you so much Veronica for your insight into how a baby’s oral anatomy can affect breastfeeding. And for our Boob Group Club members our conversations will continue after the end of the show as Veronica will answer few more questions on this topic. For more information about our Boob Group Club, please visit our website at theboobgroup.com.
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Robin Kaplan: Before we end today’s show here is Amber McCann sharing tips for the best online breastfeeding resources.
Amber McCann: Hello Boob Group listeners, I’m Amber McCann, an International Board Certified Lactation Consultant and the owner of Nourish Breastfeeding Support just outside of Washington D.C.
I’m here to answer some of your most common questions when it comes to finding quality breastfeeding resources online such as, I’ve got a freezer full of milk that I pumped, where can I donate? I once had a mother call me to tell me that she was so proud that she pumps so much milk that they were having to pour it down the sink, nothing strikes terror in the heart of a lactation consultant quite like that. Many birth giving mothers are also pumping and can gather an excess of milk. I have heard of mothers who needed to purchase new upright freezers for all their milk. If you are ever in situation where you have more milk than your baby needs, would you consider donating some to HMBANA designated milk bank? HMBANA stands for the Human Milk Banking Association of North America. And they are tasked with gathering, processing and distributing donor milk all over the country.
For this fragile infant’s donor milk can literally be a matter of life or death. Won’t it feel really good to be part of that miracle? One note, please understand that there a number of other ‘milk banks’ that take the donations from mothers and sell the milk at a profit. So, make sure that the bank you’re considering is a HMBANA designated one. Please check them out www.hmbana.org. Thank you for listening. I’m Amber McCann and I’d love for you to check out my website at www.nourishbreastfeeding.com. For information on my business and a little more about where to get connected with great online breastfeeding support. Or join me on my Facebook page at www.facebook.com/nourishbreastfeeding. And if you have a great online breastfeeding resource you like to know about, please sent me an email. You can do it to amber@nourishbreastfeeding.com or share it on the Boob Group Facebook page. Be sure to listen to the Boob Group each week for more fantastic conversations about breastfeeding and how to find great breastfeeding support.
Robin Kaplan: Thank you so much to our experts, panelists and all of our listeners. If you have any questions about today’s show with the topics we discussed please call our Boob Group hotline at 619-866-4775 and we’ll answer your question on an upcoming episode.
If you have a breastfeeding topic you’d like to suggest, we would love to hear it. Simply visit our website at the boobgroup.com and sent us an email through the contact link. Coming up next week, we have Anney, Cherri and Jennifer back on the show to talk about what life has been like during their baby’s seventh month in our series Breast Feeding Expectations.
Thanks for listening to The Boob Group; because mothers know breast.
[Disclaimer]
This has been a New Mommy Media production. Information and material contained in this episode are presented for educational purposes only. Statements and opinions expressed in this episode are not necessarily those of New Mommy Media and should not be considered facts. Though information in which areas are believed to be accurate, it is not intended to replace or substitute for professional, Medical or advisor care and should not be used for diagnosing or treating health care problem or disease or prescribing any medications. If you have questions or concerns regarding your physical or mental health or the health of your baby, please seek assistance from a qualified health care provider.
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