Loose Lip Levi

Challenges with nursing little Levi began, I think, when he was born. Knowing what I know now, I wonder if this contributed to Levi struggling to maintain his blood sugar, even though he seemed to be gaining weight well.

I noticed when Levi was less than a week old that when he was hungry and I would go to nurse him, he would often be very unhappy at the breast. He would seem to latch well, take a few sucks, and then come of crying and screaming. He would do this repeatedly (read: 30-40 times each nursing session I'm sure) until we were both frustrated. Usually, eventually, he would get over this episode and nurse for a bit on each side. This happened just about every time we would nurse.

Greg and I were frantic to figure out what the issue was, because we knew something was up. We spoke with a couple Family Physicians, Lactation Consultants, other mothers who had experienced similar things, and did our own research online. The top biggies for possible causes were: thrush (a yeast infection of the baby's mouth and mother's nipple), acid reflux, overactive letdown, excess gas and a food sensitivity.

We started treating for thrush even though we didn't have many of the symptoms. Since the treatment was basically harmless and all over the counter stuff, we tried it first. After 4 or 5 days we saw no improvement, so ruled out thrush.

I was pretty quick to rule out the overactive letdown as often Levi would come off screaming both when I was having a letdown and often when I wasn't. His fits didn't seem to be connected to milk flow (and of milk there was plenty).

Next we tried treating excess gas. We were super diligent about burping the poor guy and began using Oval drops and gripe water consistently throughout the day. After 4 or 5 days of this treatment, we saw little improvement and Levi continued to be quite gassy.

At this point I seriously considered cutting dairy from my diet as this can cause issues with babes. I was super hesitant to want to try this because I'm a vegetarian and dairy is a big source of protein for me. We decided to hold off on this option as Levi's issues had very little in common with this type of issue. I did, however, stop taking my prenatal vitamin as one piece of advice had mentioned the iron in the prenatal vitamin upsetting baby's tummy.

We really didn't want to treat for acid reflux if that's not what we had, but after learning that there was absolutely no harm that could be done, and that this treatment was comparable to giving Tylenol for pain or a fever, we went ahead with it. I filled the prescription for Zantac after one particular nursing session where Levi seemed to be in serious pain and it killed me to see him like that. We began giving him the Zantac close to 2 weeks ago now, when he was just 3 weeks old.

After 3 days on the Zantac we had a consultation at the Breastfeeding Clinic with a Lactation Consultant. At this point we discovered that Levi was not gaining weight well. Breastfed babies should gain between 4 to 8 ounces a week, and Levi was just gaining 4 ounces. Still within the norm, but barely. The Lactation Consultant observed me nursing Levi and didn't see any obvious concerns with latch, etc. One thing that did raise a little red flag for her was when I pointed out an observation that Levi seemed to have difficulty maintaining his suction when he was on my breast and I could often pull him off without having to break his latch. She mentioned at this point seeing a Speech Language Therapist (SLP) to assess Levi's mouth muscles, which of course I was all for.

At this point, wanting to try every avenue possible, we also began bringing Levi for chiropractic adjustments to a Chiropractor that Asher saw who specializes in babies and children. I believe the idea behind chiropractic care that says if the vertebrae that house a specific set of nerves are subluxated, that body part or bodily function could be effected. Levi has since had numerous adjustments in an area of his spine that houses the nerves of the face and head. (It's painless, I swear, he doesn't even flinch during the treatment).

So off we went to continue with the Zantac and allow it to fully take effect on Levi and wait for this appointment with the SLP. During the course of the week between these appointments I did noticed that nursing sessions with Levi seemed to go somewhat better. He still had fussing fits, but not every time and not as bad. I was encouraged by this. I had hoped the Zantac would be the miracle cure for him, and while it didn't fully seem to fix the problem, it did make a noticeable improvement.

When we went back to the Breastfeeding Clinic this week, Levi had gained 8.3 ounces, a great improvement from last weeks 4 ounces. I credit the Zantac having some effect. When the SLP did her assessment she did discover that Levi does have a small issue. When he nurses, he is using his tongue to do the work, which is supposed to happen. Levi, however, is not engaging his lips like he should. There is no problem with his lip muscles, but he is certainly not using them during nursing to latch on and help maintain suction and draw the milk out of the breast. This is a problem. Combined with the fact that he has a bit of an overbite (we are already saving for his braces!), this means that he struggles to maintain his latch and his tongue is not always enough to grasp onto my nipple. This also means that Levi takes in excess air when he's nursing since his lips do not form a proper seal on my breast, which leads to gas. Awesome. Surprisingly this issue is not fixed when Levi takes a bottle. This past week he has had 3 or 4 bottles of pumped breast milk and he makes a very funny sound while drinking this way - obviously not making a firm seal on the bottle nipple either.

So we are now doing lip exercises to strengthen those muscles. We do one set of exercises to engage the muscles that allow him to open his mouth and one set of exercises to engage the muscles that allow him to close his mouth and make a proper seal. We do these 3 times a day and should see improvement within a week or two once he starts using those muscles more. Many of you have been asking what the exercises are, so here's a copy the SLP wrote out for me:

Pretty interesting stuff huh? I'm hopeful that this will fix up our issue once and for all. So far Levi doesn't really seem to mind the exercises and I find they help me to keep him awake when he starts to get sleepy during nursing.

So that's the scoop. A pretty intense trip so far, and further proof of my feeling that breastfeeding is one of the biggest commitments I've ever made. It would have been so easy to give up by now, but the experience and benefits for both I and Levi will be worth it in the end!