Oral trauma?

by Stacey Bentz

LHaving nursed Geena until she was 35 months and having been a breastfeeding advocate for even longer, I thought what better way to demonstrate how much I had learned about nursing than to have another child.

This time things would be different. This time I knew how to hold the baby and how to latch the baby on. This time I had the resources to help me write the perfect birth plan so that nothing would interfere with the beginning of this nursing relationship.

It wouldn't be like last time. I wouldn't doubt myself and keep the case of
free formula "just in case". I would feed this baby whenever he wanted to
eat. I would "watch the baby and not the clock". I would carry this baby in the sling from day one. I would bring this baby to bed with me. I would not doubt that if he cried he probably wanted to nurse even if I had "just fed him an hour ago"!

Everything would be great. No sore nipples, no tears! HA!

My pregnancy was uneventful until my 41st week. My midwife informed me that if I didn't go into labor she would have to induce me. It was Thursday and she would let me wait out the weekend to see how things went...until she took my blood pressure and realized it was high.
"Be at the hospital at 6pm and we'll give you a dose of Cervidil."
Thankfully I started laboring on my own that afternoon so when my husband and I showed up at 6 she was pleased that we weren't starting from ground zero.

Labor progressed nicely. By 1a.m. I called my dear friend, Christine, to come help with the hard labor. My midwife was on-hand and periodically checked the baby with a Doppler.

When transition hit I crawled up on the bed on my side to seek some relief. The baby was side-lying and laying on my side was more comfortable than any other position.

Now, I felt the urge to push and in the middle of a huge contraction with me pushing with all my might my midwife decides she absolutely needs to hear the baby's heartbeat. She reaches between my shoulders and my knees (which were drawn up to my chest, still with me side lying) and can't get a good position on my abdomen. She can't hear anything and starts to freak.

"You have to push that baby out of there, right now!" she says. So with one mighty push (my deliveries are usually this fast anyway) out comes my beautiful baby boy! 9.5 pounds!!!

As per my instructions the cord remains attached and he is placed on my
chest. He is staring up at me and I'm gazing down into his blinking eyes (no ointment, please). It was exactly how I had imagined it. Next I would put him to the breast and see if he was interested in getting to know me better.

But no! My midwife decides he's not "pinking up" well enough for her and "we're just going to take him across the room to make sure he's breathing OK."

He gets taken from me and whisked across the room. In my post-delivery fog I wonder out loud if he's OK and why he was taken. After what seems an eternity I look across the room and he is being held by his armpits and they are shoving a tube down his throat!

"Is that necessary?" I yell to my midwife, at which point she calmly tells them, "That's enough. Bring him back."

"Now, quick Stacey, latch him on so he has a good glucose reading when they prick him." What? I said no tests, no pricks, no anything right after
birth. "Well, you still need to latch him on!"

I have been surrounded by breastfeeding counselors since the time Geena was 3 months old and had been a counselor myself for nearly 3 years and what followed was the closest thing to a nightmare that I have ever experienced in real life.

Johnny wouldn't latch on. My gentle coaxing only frustrated him. I did what I could to convince him but he wasn't having any of it. Fine, I think. He doesn't have to nurse right away. There's no hurry.

No! My midwife is insisting. She actually took my breast and shoved it in
his mouth. By this time I'm in tears and Johnny is too. "Leave us alone!", I tell my midwife, to which she replies, "OK, but he's going to have a bad score on the glucose test and then he'll have to have a bottle of sugar water!"

With the help of my husband and Christine we get everyone out of the room. Johnny latches on for a little while and after numerous trips from the nurse and much whining on her part I allow the finger prick and it comes back fine.

Fast forward two days. Johnny is clamping the back of his mouth so hard that when I force him to release my breast my nipple is completely white. He's cutting off the circulation to the tips of my nipples.

I called my friend Barbara who along with being a La Leche League Leader is also an IBCLC and runs a pump rental station. In tears I tell her that I can't stand the pain anymore and I need to rent a pump so I can feed my son. I had a manual pump laying around the house that I had used to pump. I was finger-feeding but it was time consuming and wasn't very effective.

I am now officially a failure because after years of counseling other women on how to breastfeed I cannot feed my own child. Barbara comforts me and tells me that some babies are high "tonic" and
sometimes that causes the clamping. We discuss alternative feeding methods and decide that cup feeding and training his tongue with my finger may help him overcome the tongue bunching and jaw clamping.

I start a stringent regimen of pumping and cup feeding but to no avail. When I take him to the Dr.'s at one week he has lost a considerable amount of weight. I am told that I am to bring him back in five days and if he hasn't gained "we might have to give him the bottle!" (I have grown to hate that word!)

I call Barbara in tears. Not only am I not able to breastfeed my son but now I am a failure at cup feeding also. She reassures me that I'm doing the best that I can and that the weight loss is well within 10% babies can usually loose. We decide I'll up the pumping and feeding and see if we can't fatten him up.

The only way I can describe the next visit to the Dr.'s office is to say it
was the visit from hell!

He had not gained but had lost still. Not more than 10% yet but still had
lost. The Dr. questions me as to why I don't just give him the bottle and I say we're doing well with the cup feeding. I'm using my pinkie finger to train his tongue to loosen up and the cup feeding is encouraging him to extend his tongue out of his mouth.

"Well, what happens when he needs 8 ounces? Are you going to still cup feed him?" Hmm... Way to encourage! "No, hopefully by then he'll be back on the breast!"

"HMPH!", she says. "OK, latch him on!" As I put my son to the breast she tells me that my breast is too large and that I'm going to cut off the air to his nose. I know my breasts are large, and I know that by pulling in on his feet his head will pull back and he will have adequate room to breath.
"Push on your breast to get it out of the way!"
"That's OK. I've got it under control"
"He can't breath like that!"
"I have it under control." Johnny is happily sucking. At this point she reaches over and pushes on my breast and proceeds to pull so hard my nipple pops out of his mouth!
"You've pulled my nipple out of his mouth!"
"Well, he couldn't breath!", she mumbles under her breath.
"Could you assess his suck and tell me what you think the problem is? Is he tongue tied or high tonic?"
"The only way we can assess his suck is to give him a bottle!"
"What? Can't you stick your finger in his mouth and see what he's doing and figure out why?"
"No! If he can drink from a bottle there's nothing wrong with his suck!"
Huh??!?
"Come back next week, and he'd better had gained some weight!"

I was crushed. There was something wrong with my baby but the only thing these Drs. cared about was making sure his suck was permanently ruined by giving him a bottle. Of course she had told me there was no such thing as nipple confusion. That it was a figment of mother's imaginations.

So again I call Barbara in tears. There's something wrong with Johnny and no one will help him. She suggests I call a pediatric PT or OT. They work with high tonic babies and maybe they can set my mind at ease. Of course I have already read in my Breastfeeding Answer Book that some babies who exhibit this type of sucking problem have a neurological defect!! That certainly didn't make me feel better!

I call a number for the physical therapist and she asks me some basic questions. One of the questions was if the staff at the hospital used the blue bulb syringe to suction Johnny after birth. No, I say, they stuffed a tube down his throat for some unknown reason (it wasn't on his chart).

Bingo! Oral trauma which led to oral aversion! What? I've never heard of this. It's not mentioned in any of the books! What was she talking about? She then tells me that deep suctioning, as well as aggressive blue bulb suctioning, has been known to cause oral trauma which makes the baby not want anything even near his mouth let alone inside it. It can cause the baby to try to protect the throat from foreign objects (read nipple) by clenching the back of his mouth thereby cutting off the circulation of the nipple (or pinkie finger, depending on what you're sticking in there).

After hearing this I called Christine and asked her what exactly happened
when they took Johnny from me because it was still very much a blur. "Oh, they had already suctioned him 2-3 times before you said anything!" ARGH!

Johnny is now almost a year old and nursing like a champ. It took about four weeks of pumping and cup feeding for him to be able to nurse without clamping down. I'm extremely thankful for all my friends in the lactation field. If it hadn't been for my intimate connection I don't think I would have been successful.

Even after all this time has gone by I still cry when I tell this story. It should have never happened. I hope my story can save some else from having to suffer unnecessarily.

Stacey Bentz