What's up with all the buzz about tongue ties? Read on to find out the basics of why this topic might matter to you and your baby.
Tongue tie, or ankyloglossia, is a physical condition that limits the movement of the tongue. Between 1-12% of infants are born with this condition (Ghaheri, 2016). This can occur near the front of the tongue (anterior tongue tie), or the rear of the tongue (posterior tongue tie). Because the mechanisms of breastfeeding rely on a vacuum system within the baby’s mouth, not a “stripping” motion of the baby’s tongue as previously thought, having an infant with a tongue tie or lip tie could interfere with having a successful breastfeeding experience. While tongue tie is only one of many possible reasons for a challenge in breastfeeding, if any of the following problems present themselves during early breastfeeding, the possibility of a tongue tie should be assessed by a qualified professional:
According to Ricke et al, “The presence of tongue tie triples the risk of weaning in the first week of life.” (Ghaheri, 2016). For parents who have a goal of continuing breastfeeding, but are experiencing any of the challenges listed above, it is important to rule out an anatomical reason for why those breastfeeding challenges are occurring. In other words, many breastfeeding challenges are common and can occur for various reasons, and tongue/lip tie may be one of them. According to Dr. Ghaheri, all published studies on the subject find that after tongue ties have been identified and corrected surgically, breastfeeding outcomes improved for both the lactating person and the infant.
When looking for a provider to assess for possible tongue tie/lip tie and perform a revision if indicated, the following are considered best practices: 1. The provider will fully release the ties, including posterior tongue tie and lip tie if necessary (release of an anterior tongue tie without release of the posterior tie will rarely lead to improvement in breastfeeding). 2. The provider is supportive and knowledgeable of breastfeeding and works closely with IBCLCs. 3. The provider does not use general anesthesia on infants.
For lactating parents who have the goal of breastfeeding, it is important that they feel supported in their goal. As postpartum doulas, we help families find and explore all the resources available that may help them reach their goal. This is important not only for the baby’s health, but also because we know that women who wanted to breastfeed but couldn’t have two times greater the risk of developing postpartum depression compared to women who wanted to breastfeed and were able to do so successfully for as long as desired (Maternal Child Health Journal, Aug 2014, as presented by Ghaheri, 2016).
If you have questions or concerns about your baby, talk to an International Board Certified Lactation Consultant (IBCLC). And, if you have concerns with the information you've been given and are not feeling like your breastfeeding struggles have been resolved, find a second opinion. Our postpartum doulas and certified lactation counselor can help you find the answers and resources you are looking for. Our goal is to help YOU reach your goals regarding feeding your baby and preserving your own wellbeing and mental health.
Presentation. Tongue/Lip Tie and The Impact on Breastfeeding. Bobby Ghaheri, MD. February 26, 2016, Good Samaritan Regional Medical Center, Corvallis, Oregon.
There are many kinds of birth labor. Whether your baby arrives from your own body or by other means, the longest labor you will endure is the process of becoming a mother or parent. It's a major shift in your identity--who you know yourself to be. It can be rattling, disorienting, and exhilarating. So here are four things to expect the first year after you have a baby:
1. You will discover new things about yourself. Becoming a parent will stretch you beyond your known borders, and you will become more than you were before you had a baby. Your baby will grow at an astonishing rate in its first year of life, and so will your heart.
2. It will suck sometimes. There will be moments when you will want to quit. This is normal, and it is healthy to admit how much of a drag it can sometimes be to take care of a small human being. You'll hear people say, "being a mother/parent is the hardest job in the world." But this isn't a "job." You cannot quit, and you will always be your baby's parent, every hour of every day, for the rest of their life, and there really aren't any vacations. Expect that there will be moments when you will feel totally overwhelmed. In those moments of sleep deprivation, frustration, or anxiety, what will you do? That's the question, and that's where you will discover your edge--where you will begin to grow as a parent. In our culture we so often think we have to or should be able to do everything on our own, and that asking for help is a sign of weakness. We may even tell ourselves we don't deserve help and support. If that's a common theme in your life, you'll come up against that internal script over and over again during your baby's first year. Your baby relies on you entirely. We like to think we have an endless supply of energy and love, but we don't. We need other people. In your baby's first year, you will probably need to rely on other people more than you ever imagined. It's not weakness, it's biology.
3. You will need to lower your expectations. Preparing for a baby involves a lot of dreaming about what you want most for your child. Of course you want the best for him. Of course you want to give him everything, and BE everything he needs. And of course you want to keep doing the things you love, too. Before baby comes, it's hard to imagine exactly how much your life will change, but it will. And if you can allow some flexibility with your expectations going into it, you'll have a much easier time adjusting to the way things really are. Whether it's the way your house looks, the amount of time you'll have to spend doing the things you enjoy, or simply taking care of your body and eating well, things will change with the baby's arrival. Again, people say, "being a mom/parent is a full-time job," and in reality, it requires much more of you than a 40-hour-per-week job does.
4. You will parent your own way. You'll probably read some parenting books. You will find the "experts" that you are drawn to, and you will agree with a lot of what they have to say. You will reflect on how you were raised and decide how you want to do things differently with your child. You will notice other parents whom you admire, and you will notice parents doing things you know you don't want to do with your own child. Your parenting will not look like anyone else's, even if you are inspired to emulate someone else's parenting style. There is absolutely no "right way" to parent. Every family is unique, and you will find your own way. Trust yourself. You can do it!
Check out the handout below to learn more about how you can get the best support for your childbearing year, and why it matters.
Treat yourself well and hire a doula. Your baby deserves it!
YOU deserve it, too.
Click here to meet the excellent birth and postpartum doulas of the MidValley Doula Network.
Corvallis, Oregon has a great birth community. Oregon's laws support both home birth midwives and midwifery care in-hospital. The birth community state-wide is active, long-standing, and reaches across social and economic differences. We have a local doula network, a birth network, two birthing centers within an hour's drive, and another birthing center (hopefully) coming soon to Corvallis. "Who's your doula?" is a question pregnant women in this area are used to hearing. The full spectrum of childbirth education classes are accessible in town or just a short drive away. The hospital in Corvallis is used to women coming with a birth plan. There is a culture of support around pregnancy and birth.
After the baby is born, there are a ton of things to do with wee ones. We have mama-baby play groups almost every day of the week, and a plethora of possibilities for outdoor play with young babies and toddlers. You can even take your baby to an early childhood education class, starting from birth! There are so many things for babies in this town, I can't even come close to listing everything (but check this out).
So what's lacking in our birth community? Postpartum support for moms. Rachel Brinker has seen this gap for years, and in May she officially launched her business, Corvallis Proud Mama Support Services, to help address the need for in-home support for new moms and their families.
Unless she is under the care of a direct-entry midwife, a new mother typically won't see her healthcare provider for another six weeks after she leaves the hospital. She and her partner (if she has one) get the message that they are expected to handle life with a newborn on their own. If it gets to be too much, they might feel like it's because of a personal failing rather than a societal one. It's easy to see how these feelings of not being "good enough" or "strong enough" could set a new mom up for developing postpartum depression. But caring for a newborn baby as an isolated two- (or one-) parent unit is a relatively new idea, and one that does not best serve women, their partners, or their babies.
Breastfeeding support for struggling moms is available from lactation consultants and peer support groups like La Leche League, but that support is limited to online/phone communication or traveling to an office with a sore post-childbirth body and a newborn in tow. For some women, these hurdles are big enough that they decide to "make do" and not seek out help. Trying to "make do" without support for the breastfeeding mom and baby can increase a mom's stress and anxiety levels as she struggles to feed her baby, and can lead to a shorter duration of breastfeeding than she had originally hoped for.
Additionally, many women experience pelvic floor issues like incontinence and and abdominal weakness or instability after having a baby. These issues can easily be exacerbated by daily acts of mothering (lifting and carrying a baby around with less-than-ideal alignment, sitting a lot to feed and soothe a baby, babywearing, etc.) but they may not have been told by their providers how to protect their bodies and help it heal well from pregnancy and childbirth. Did you know that 53% of women have a diastasis recti immediately postpartum and 36% still have one at seven weeks postpartum? Do you know how to move safely and effectively if you do have a diastasis so that you don't make it worse?
And did you know that no, actually, you do not have to pee your pants every time you sneeze for the rest of your life? There are things you can do (Kegels are part of it, but not the whole answer). Many women retain the mindset from previous generations that incontinence is "just how it is after you've had a baby." Did you know there is just a thing as pelvic floor physical therapy and that in other developed countries, it's the standard of care that every woman leaves the hospital with a prescription for it?
Perhaps the biggest gap in our birth community is the fact that support groups for women who are experiencing postpartum depression, anxiety, and other mood disorders, have been inactive in Corvallis for quite a number of years. Even the support group in Albany has recently been cancelled.
All of this points to the general lack of postpartum support in our culture at large, not just in Corvallis. Traditional cultures all around the world honor the postpartum period as a unique and temporary time that requires intensive rest, shelter from the outside world, relief from day-to-day responsibilities, and support-both practical and emotional-from others who are knowledgable and experienced in what to expect during this time, But in contemporary U.S. culture, it is rare that the parents of a new baby will have that kind of support in place. Rather, the typical postpartum scenario is that relatives come to visit from out of town for a few days after the baby is born (possibly making more work for the parents rather than less), and after that...well, there's not much. Of course friends can be a great support if they've read up on how to be helpful to parents with a new baby. But sometimes it doesn't work out that way.
Recent research supports what women already know; having practical and emotional support postpartum, receiving adequate childcare education, and making maternal sleep a priority helps prevent postpartum depression and anxiety. Studies also confirm that when mothers feel supported by their partners, it's one of the best predictors for successful breastfeeding. Guess which professionals provide all this kind of support--helping partners know how to support the breastfeeding mom and baby, assisting with practical support around the home, being available on-site to answer questions about newborn care, and helping parents get more sleep? Postpartum doulas. We are experts in what's "normal and typical" in the postpartum period, for babies, for breastfeeding, for moms, for partners. We support you through the transition to having a new baby. Having that professional presence can make all the difference.
We have a culture of talking to pregnant women about All The Plans: where they plan to birth, how they plan to birth, who will be in the room, whether they'll be revealing the gender of the baby before the birth, what color they are painting the baby's room, whether they'll be using cloth or disposable diapers, which prenatal yoga class they're going to, and on and on. If we care about the mental health and wellness of new mothers as much as we care about pregnant women and new babies, we need to add another topic to those conversations.
"Who's your postpartum doula?"
Proud Mama Support Services is the only doula service in the Mid-Willamette Valley that focuses exclusively on postpartum support. This means we are not on call as a birth doula or midwife for other client's births. This means more availability for postpartum support when you need it.
Exciting things are happening here at Corvallis Proud Mama Support Services. We are putting our mission into action. We are committed not only to support parents in those early days with in-home care, but also to addressing the lack of support for postpartum issues such as postpartum body recovery and postpartum mood disorders. We are very pleased to announce that a WellMama postpartum support group will soon be starting again in Corvallis, with Rachel of Proud Mama Support Services and some fabulous mental health professionals at the helm.
And as we've written about before, Rachel will begin teaching a mom + babe (pre-mobile babies only) mamalates core recovery class for moms and pre-mobile babies at Live Well Studio on Thursdays from 2:30-3:45, starting on September 24. Click here to learn more about group core recovery classes as well as private mamalates sessions.
So the next time your friend, acquaintance, or patient announces she's pregnant, don't forget to ask her, "Who's your postpartum doula?" New parents need support in their homes, and that's what we provide. We are proud to be extending our amazing culture of support around birth to the postpartum period and working to make our birth community the very best it can be!
People are understandably a bit skittish at the thought of hiring a postpartum doula. Families are not necessarily at their best during the postpartum period. It's hard to find time to shower. Both parents are sleep deprived. The mother is sore, swollen, and weepy. Older siblings are reeling from their world being turned upside down. They're thinking, "WTF is going on around here? What happened to my world?" Everyone is hungry, tired, cranky, overwhelmed, and unsettled.
Why on earth would you want a stranger to come into your home to see you at your worst? Because we are trained to support you during the worst times, without judgement and without the baggage of complicated relationships outside of the postpartum time. You being at your worst is exactly why you want to hire us instead of relying on your friends and family in those moments. Drama is the last thing you need to be dealing with when you are caring for a newborn and recovering from childbirth.
On the other hand, there is a sweetness to the postpartum period that is so incredibly precious and fleeting, it should be savored carefully and slowly. Above all, families need to protect and shelter themselves from the outside world during their transition with the newest family member because those first moments will never come again, and they don't belong to anyone else but the parents and siblings of the newborn. Boundaries around your special time with your new baby can easily be overstepped by well-meaning relatives and friends who can't wait to get their loving hands on that baby and cuddle them endlessly. That's all well and good, unless it creates more work for you or interrupts the bonding process between you and your infant. Unfortunately, in the first few weeks, it usually does.
I recently received this review in my inbox, and I think it sums up very well what I do as a postpartum doula.
Thanks, Janel B.!
In many ways, a postpartum doula is like a family member who takes care of you when you are at your worst, but without all the emotional baggage and potential drama that comes with lifelong relationships. A doula fills a unique support role in your life for a short amount of time. We remain professional while providing compassionate judgement-free care.
Ready to see if I'll be a good fit for your family?
Check out any pregnancy or parenting magazine and all you'll see are images of Pinterest-worthy homes with beautiful decor and perfectly organized baby clothes. They'll even be folded. The moms will be glowing, freshly bathed, and fit. There won't be any bodily fluids leaking out of them. Their boobs will be of a reasonable size--not completely engorged with milk; no blue veins, no stretch marks.
Does your life look like this? Mine doesn't either.
If you've just had a baby, no one should expect it to, especially you. You genuinely have more important things to do, like keeping a small human alive, and maybe finding a few minutes to take a nap.
Real life with a real baby does not look magazine perfect.
When I go to someone's house who's just had a baby, I do not expect it to be clean. I'll say that again. I do not expect it to be clean. I expect dirty dishes in the sink. I expect crumbs on the carpet. I expect water glasses everywhere. I expect piles of laundry all over the house. I expect things to be imperfect.
Because I've been there, and I realize now I was way too hard on myself. I was too concerned about what other people would think when they came over to visit. I worried that they would feel uncomfortable if the house was messy. I tidied. I put the laundry away. I picked up the piles of crap and put them in a bedroom and shut the door. But I was the one who had just had a baby! I vacuumed just a few days after giving birth and while I was recovering from a fourth degree tear.
Why do we hold ourselves to these ridiculous standards?
Part of my job as a postpartum doula is to give your family a hand with light housework. Don't feel bad about it. It's part of my job. Really. So don't pre-clean for me, or anyone else for that matter.
Looking back now, I don't know why I felt the need to make it look like things at our house were "back to normal." In reality, I was completely exhausted and in a ridiculous amount of pain. I had no business trying to do housework. When you've just had a baby, there is no "getting back to normal." There is only adjusting to the new normal.
So as your postpartum doula, I'm not going to clean to Pinterest standards. I'm going to help you adjust to the new normal and make sure you can see the bottom of your kitchen sink at least once a day.
My advice is to revel in the postpartum period and let go of whatever you are feeling guilty about, or feeling like you are failing at because this is one of the few times in life when you have the perfect excuse to let those things go.
1. When she came over today, I had just gotten up after a long night with the baby. I was still in my pajamas, the dishes from dinner were still in the sink, and there was baby paraphernalia scattered all over the living room. I hadn't brushed my teeth yet, or eaten breakfast. She came in, but didn't judge the state of the house or me. After checking in with me about how the night had gone, she made some suggestions for how I could get more sleep while still meeting all of my baby's needs during the night. I hadn't thought of those things before--they seem so simple and obvious, but my sleep-deprived brain didn't think of them. She suggested things like having water and snacks by the bed so I don't have to go the kitchen when I'm thirsty or hungry in the middle of the night from nursing, and using the dimmest light possible when changing the baby's diaper so my sleep isn't further interrupted by turning the overhead lights on. So glad she's here!
I want to take a moment to outline the process I'm going through for certification with DONA International. Most people probably have no idea what it takes to get certified as a postpartum doula.
There's nothing that says doula have to get certified, and lots of experience can certainly lend a lot of credibility to someone's professional work. Not all doulas feel that certification is an important step in being a professional caregiver. But I do think it's important, so I want to share with you what it's all about.
DONA International has been around for a long time, and has always believed that actual research on the role of the doula is essential. They've been instrumental in producing some major findings that show continuous care through labor can dramatically improve outcomes for mom and baby, and that proper social and emotional support in the postpartum period has a preventative effect against postpartum depression and increases the success of breastfeeding. (Read DONA's position papers below!)
I respect DONA as an organization because I think their professional standards are very high, and I have a thing about integrity. So here's what I've been working on to become certified as a postpartum doula:
1. Be a professional member of DONA and adhere to their Standards of Practice and Code of Ethics.
2. Complete a 3-hour breastfeeding class, an online lactation study program, or training as a breastfeeding counselor or other lactation professional.
3. Attend 27 hours or more of in-person postpartum doula training.
4. Complete an entire reading list of books on the following topics:
6. Submit at least three good evaluations from the partner, spouse, or other significant adult support person of the mothers from #5.
7. Write a 300-500 word account for each certifying postpartum experience.
8. Signed confidentiality release forms from all clients whose information is being used for certification.
9. A 500-1,000 word essay on "The Value of Postpartum Support"
10. Develop a resource list of at least 45 local resources for clients from at least 30 different categories such as:
12. Provide two professional character references.
13. Current Adult and Infant CPR certification
When you are deciding on who you'll hire as a doula, consider whether a formal certification process is an important piece for you. Lots of people can be caring and comforting, but not everyone has the same level of skill, training, and education. You and your baby deserve the best, and I look forward to serving you with the integrity, education, and code of ethics that comes with formal certification.