Urban Satchitānandā: A mothers account of her quest to feed her baby (Mirabelle Dcunha (Mumbai | Jan 2012)
Saturday 14th January 2012
This is not a subject generally discussed or shared with anyone besides ones close family and friends. I share this because I feel the learning and awareness our experience has the potential to create is tremendous. If even one family is saved the intense pain and trauma such an experience brings and if I can share the positive learning we gleaned from it, a HUGE difference would have been made.
What is this taboo topic? Nursing, less subtly known as breast feeding. In Bombay in particular it appears to be a taboo to discuss this (unless its advice of what foods you should eat) . Everyone discusses the “labour pains” ( which in my experience, through physical and mental and spiritual preparation were very mild and quite pleasurable and exciting) but no one tells you, nursing (I’m using the less taboo word so I don’t offend some sensibilities) can be consistently painful.
In my own preparation for the little one, I did not give much attention to nursing, though I did attend a session by a La Leche League leader. My thinking was, birthing is where the intervention occurs, so let’s study about that, so we can make informed decisions as parents-to-be. Feeding I thought was most natural, like giving birth and since no doctors intervene, I didn’t need to prepare at all. Life always has a way of making me shift my beliefs with the aim to help me shed them all eventually.
The following is my recollection of the experiences of baby, daddy and me from her birth until the challenge of her feeding was resolved at 3.5 months. From guilt and pain and feelings of inadequacy caused by an internal locus of control and an aggressively pro breastfeeding and even more Nazi advice giving Indian society to visits to over 10 of the best doctors in this city to the discovery (thanks to our wonderful Lactation consultant Effath Yasmin) that our daughter had a posterior tongue tie. None of the doctors were able to diagnose, until connection was established with a NY based doctor over the internet and a local doctor was found in Mumbai and the surgical procedure for a posterior tongue tie was performed 3 times on baby and possibly for the first time in Mumbai or even India!
I share this not to seek your admiration or pity, I share this to empower women that are pregnant or will be pregnant or have friends that may be pregnant or trying to nurse. In an era of supposed women’s liberation, I take the courage to share, a very women centric experience so a difference may be made. I want to reiterate that doctors as wonderful as they are, do not have the intuition you have with regards to your baby. While most doctors recommended we feed Sivaanaa formula with best intentions in mind, doctors and our families and social circles must respect that how to meet our baby’s requirements is a personal choice and a personal right. The story is long, but I urge you to read on ....you never know when you may be able to help someone.
The streets are bleached ashen under the glare of the night lights. The moon and its powerful silence are obscured by construction cranes, unfinished buildings and the impatient honking of cars whose drivers are racing away seemingly ahead even when there is opportunity to relish the concrete city stillness. Pariah dogs languish in their familiar hunger. The last vegetable vendors are pushing their carts home. Cars jam the road to the airport- impatient, excited, in a hurry, apprehensive, overwhelmingly emotional, -- all of the above. A myriad stories incompletely told.
Today my being has taken over my mind and my pain body. I can only describe the is-ness of my being as an urban satchitananda; clarity of truth, existence and possibly a short lived but rare human bliss in the midst of urban functionality and a resilience that is unique to the people of Mumbai.
Why this clarity, this pervasive peace? Why this morsel of divine nectar? After 3.25 months of a God gifted challenge, our daughter is able to nurse freely. This day I have awaited more than the day I wed my soul mate, more than when our daughter was born. It is here. ‘Ask and you shall receive’ is the divine promise, always fulfilled in His time.
Little Baby Sivaanaa Magdalena is born. Desire for natural birth is thwarted by divine intervention when her head gets stuck in the birth passage after 14 hrs of an intense but very pleasurable labour. She is airlifted through a C section while lights are dimmed and powerful mantras pervade the OT.
I am in the most intense physical pain I knew up until then. Bedridden, unable to sit up and feed my child. Emotional bordering on irrational. Rudy is such a blessing.
Slowly recovering physically. Constant nightmares during the few winks of sleep. Why despite my yoga and our preparations as a couple and the most amazing spouse and calm gynac and third eye Ajna Chakra buzzing labour did we end up with a C-sec? A myriad other questions in the same vein. No answers just tears.
Add on several doctors visits. Baby dehydrated. Dr asks if I have enough milk (like how would a first time mum like me know what is 'enough ' and asks us to give formula. Formula is a Forbidden F word to me. But baby's dehydrating so I snap at the relentless pro natural fundamentalist voices in my head and get my first n hopefully last tin of formula. I use it sparingly. Trying to breast feed. Baby latching properly. Check. What's wrong then? Whip out the breast pump I got for occasional use. Maybe one lonely drop of mother’s milk in an hour.
I am bruised. Still depressed n overwhelmed. Recovering from surgery n hemoriids from natural birth. Possibly not lactating adequately. Baby’s latch meets all perfection criteria. Something must be wrong with me. My body's letting me down again. Frustration, anger, and deeper depression.
I'm sent an invite to a breast feeding workshop by a friend on FB. Baby is just 12 days old. We cart her to Goregaon. I learn even more fab things about breast milk n feel lower. We set up a private consult. Early diagnosis; possible birth trauma and mechanical tongue restriction. We need to address these and work on building up an inhibited milk supply . Recommended treatment; Cranio Sacral therapy. I'm still meditating or should I say intermittently tuning in, so I'm getting answers n guidance in bits.
We start cranio sacral therapy for Baby and me. My body and pain body need release from the trauma of the c-sec as well. I am helped and Sivaanaa loses her deep gag response. I begin expressing and pumping milk, one little drop at a time. Feels like a drought. Meanwhile we chart the little ones weight. She must stop dehydrating and at least get back to her birth weight. We note with tallies the number of pees and poos and their quality n quantity. Sivaanaa is such a peaceful baby. Yasmin our lifesaving LC (Lactation consultant) says we will have to take help of formula as a medical aid until her weight is regained. Me the natural birth n breast milk fundamentalist is left choiceness. Baby refuses the steel vati, the medicine dropper etc so we use a SNS (for those as clueless as I was it's Supplementary Nursing System. ) a tube with formula or expressed milk is taped to the breast to allow the double function of retaining the baby at the breast and stimulating the production of milk. Meanwhile I pump every two hours almost around the clock. The times that I miss, because I'm exhausted or sleepy I feel bad about. Rudy is always there hugging me, making breakfast, changing baby and just being the peaceful gentle nurturing soul he always is. I am low but I count my blessings every day. Somewhere along the way, I collect 100ml in a day’s pumping. It will account for 3 of her meals. I take a picture with the bottle. My most prized trophy ever! I dance around the room. Some hope gleams in my tired and anxious eyes.
All the dink laddoos, methi seeds, Ayurvedic capsules, organic lactation promoting teas etc have been consumed. I have visualised a Ganga of milk flowing from Shivas head. I have composed a ditty to get milk flowing- my personal lactation mantra. I know it’s only my stress keeping me from lactating. I must let go of my negative view of baby’s birth. All 3 of us prepared so well, that a c-sec could only be her choice in choosing how to come. Having had both experiences God gave me the learning that nothing is good or bad. Some things are preferable on a personal level, however none must be judged for who knows what drives their choices. SNS is not working. It's very painful, so to give me rest and allow me to focus on building supply, we use an infant feeding tube attached to a syringe. Poor baby, I cry every time I see that tube and syringe feeding her.
Did I mention that Yasmin our LC thought baby might have a posterior tongue tie based on how I'm getting bruised and distorted? We visit the best paediatricians in the city, the breast feeding experts, the works. We drive across town, stopping at kind friend’s houses so Rudy can feed and change Sivaanaa while I keep to my pumping schedule. So what did the doctors say, including one renowned senior paediatric doctor, who also happens to be an ardent breastfeeding advocate/expert ? Baby’s latch is perfect. She doesn't have a tongue tie and this statement without even looking at her mouth ! I was recommended to discard the bottle and feed for 48 hrs at the breast. The pain I was told is natural, though how women would opt to nurse their babies with this kind of 'natural' pain for aeons is totally unbelievable. So I did the 48 hour thing. I was desperate enough to try. Little fighter baby fed for 18 of 24 hrs and then again the next day. Eventually she was exhausted and sleepy and I was bleeding. That led to blood in her stools and more panic for me. How many times I swore I would give up and go the formula way. Yet there was a persistent intuition that I would be able to feed the little one.
Baby was now almost 3/4th on expressed milk though feeding from the tube. Sterilising and tube feeding was too cumbersome. Hooking it all up at night etc so, I convinced Yasmin to let us use the bottle. Actually I think it was more like an understated threat; we use the bottle or I quit. I was formula fed and I turned out slightly weird but happy.
Week .... I’m losing track here...
Baby never liked the bottle. Believe it or not there is such a thing as bottle stress and she had it. Shoulders up to her ears, forehead frowning, tightly clenched fists and tightly cringed toes. Poor little girl. It was very convenient though for all those times she felt hungry while we were in the car driving to the next doctor in our quest for answers. Doctors say once the baby has the bottle, it loses its preference for the breast. Maybe some babies or most babies....not this one.
Meanwhile we worked with Yasmin, slowly eliminating all possibilities or rather possible problems and were left with the tongue tie. As parents our observation was that our very peaceful and smiley child tended to gag and cough every time she tried to laugh, which was often. It was like something was yanking her tongue back. She also cried very softly and there was something distinctly different in her cry compared to those of other crying kids we observed at our many paediatric visits. Yasmin said a paediatric dentist was more likely to be able to help identify a tongue tie than a paediatrician since the former studied oral anatomy in more detail. And so we went to a well recommended paediatric dentist, who assured me baby has no tongue tie and I should be just glad I can feed her my milk through a bottle and stop looking for problems when there were none!
Finally, thanks to Yasmin, we sent a case report with her observations and a video of baby’s mouth as she cried to a dentist that specializes in tongue ties in Albany, New York. Dr. Lawrence Kotlow has helped many a child feed by performing a frenetomy, a surgical procedure to clip the frenum and free the tongue. He agreed with Yasmin’s report and said it appeared Sivaanaa had a tongue tie and definitely she had a lip tie but he couldn’t make a definite diagnosis from a video. He connected Yasmin with a Mumbai based laser dentist . There was hope finally. My intuition told me that it was most certainly a tongue tie and if the frenetomy was performed all would be well. So we proceeded to what hopefully was the end of our quest.
Dr. Suchetan Pradhan examined Sivaanaa in joint-consultation with Yasmin. He agrees with just a lip tie, no tongue-tie he says. Phew! He said he could use laser to sever the lip tie. He wasn’t sure it would make any difference to her feeding though. We decided to go ahead with it. It would help her dental development positively anyway, so why not. We were so nervous....read all about the procedure, risks etc.
Yasmin could not sleep that night because the pieces don’t fit in together. The presentation of baby oral function and feeding assessment indicated a posterior tongue tie. She had earlier spent lots of time patiently matching Dr. Kotlows video of how to diagnose a posterior tongue tie with Sivaanaas video, frame for frame. Such selfless dedication, this woman is truly called to do what she does) Now she sends Dr. Pradhan the finer details of her observations and Dr. Kotlows video on how to diagnose a posterior tongue tie
We go in for the lip frenetomy. Dr. Pradhan had received another call from Dr. Kotlow, so he decides to check her tongue again. Guess what he finds? A posterior tongue tie! We are so happy!
The labial frenectomy is in process...Sivaanaa is confused but trusting. Dr Pradhan and his wife Dr. Shalini are calm and organized. They keep us in the loop. We play mantra music through our phone. The procedure is over in 15 minutes...Sivaanaa seems fine. We go home, waiting to feed her and check if it’s worked. We are so proud of the little one...she was so brave.
Labial frenetomy made a 5% difference for me...not significant but it gave us hope. Two hours later the anesthetic gel wore off. Sivu was howling like we had never heard before. I hugged her close, gave her skin to skin but she kept crying. I swore to put a stop to all these breast feeding experiments. Enough is enough!
We got our dear homeopath Dr. Rashmi Jaising to prescribe homeopathy for the pain and soreness Sivaanaa was so intensely feeling.
A week later we were back to get the tongue job done. Nervous again. This ones tough. Why? Because a little baby is constantly moving her tongue so one wrong nip would lead to a catastrophe. Dr. Pradhan was going to do local anestheisa and administer chloral hydrate (a hallucionogenic called a sedative by the medical community) Anyway, they said they would try with only the anaesthetic gel. Dr. Shalini, his wife, suggested using the Indian bath position to stabilize baby’s head. It worked. Sivaanaa clamped down on Dr. Shalini’s fingers and that stabilised her tongue a bit. Drs and Rudy and me, spoke to her before, telling her how important it was to try and keep still and how proud we were of her and how brave she was. She looked in our eyes and drank every word in...she even smiled. It was like she knew all along that this would change her fate and that of many babies in India with similar challenges. How I thank God for giving us the gift of his presence!
Dr. Pradhan only does a little. He takes small breaks and talks to Sivu in between as do we. It’s done. We are home again. Guess what 80% difference. WOW.... I feel so good... she can almost feed now. Still incomplete though. We give it a week to sort of evolve. A week later, more frenetomy. Now I can feed her. The pain and distortion are almost gone. I would have liked some more, but Dr. Pradhan doesn’t think it’s necessary since she can now feed.
Right after the second lingual frenetomy procedure, Sivaanaa can laugh almost uninhibited. She makes all these sounds she couldn’t before. Hell she can cry an assertive adamant baby cry! She can roll her tongue from side to side. The most priceless thing ever was the first time she fed successfully. She obviously felt the difference too. He face had the patient enjoyment of a meditator....not wishing to go forward in time or backward, in the NOW and relishing each moment, silent and serene. When she was done, she came off, looked me straight in the eyes and gave me the most radiant, blissful toothless smile ever. I have been in heaven and it’s a sweet sweet indescribable bliss....
..........the street dogs continue to languish in their familiar hunger, the cars honk impatiently and the city races mindlessly. In the midst of all this sit Rudy, Sivaanaa and I, content in our urban satchitananda.
Sivaanaa refuses the bottle, even expressed milk in a bottle. She still smiles when she feeds, even in the middle of the night when she feeds with eyes shut. I wish the frenectomy was complete and the pain gone. Sivaanaa would not need to feed so often then. We would be truly free, but we accept that it may not be time for that yet. She came to challenge me to find my limitless strength, she came to empower, and she has made an example and a successful experiment so no other mother and child (and father) would willingly have to suffer like we did. A few days ago, another baby had a frenectomy and there is an improvement in her latch. More babies will follow. We hope the doctors will devote more time and energy studying the details of ensuring the procedure is complete, so our baby can be completely healed. Our journey has already empowered so many others. We are all so limitlessly blessed and presented with opportunities to find and share our bliss. Happy blissful living!
*All this was made possible because of the selfless care, empathy and understanding and deep study and knowledge of our lactation consultant Effath Yasmin. May she always be blessed.
We also commend the courage of Dr. Suchetan and Shalini Pradhan, doing a new procedure on an infant for the first time ever while taking every care to be safe.
And how can I ever thank my darling soul mate and husband Rudy for his relentless selfless love, service and support. May our souls be always inextricably linked forever.
It is impossible to thank God for his energy and presence, his faith in us and this well disguised opportunity to evolve our souls. We love God insanely and are truly humbled.
Published in Babyoye Online and Mother & Baby Magazine - https://babyoye.files.wordpress.com/2012/08/effath-yasmin-ibclc-mirabelle-sivaanaa-story.pdfbabyoye.files.wordpress.com/2012/08/effath-yasmin-ibclc-mirabelle-sivaanaa-story.pdf