We were elated to welcome our first child into the world last month. After a long journey to become pregnant, which I have documented on this blog, it was wonderful to finally meet our baby and transition into the next phase of our lives as a family. Of course, the transition itself wasn’t without issue (seems to be the way of things in my family – rarely do things go smoothly or to plan). I could not have had a more opposite birth experience than what I wanted. We fell victim to the “your baby must be out at 42 weeks” dogma that rules in our state and I had to be induced. This led to every intervention under the sun and in the end I had a pretty harrowing and traumatic birth experience. I include the hospital setting in this. Hospitals are such toxic places, full of both material and psychological stressors. Aside from the constant interruptions, one can expect garbage food and noxious supplies at every turn. I’ll need a year just to detox from the vinyl blood pressure cuffs and IV tubes. I left exhausted and feeling like a pin cushion. Thankfully our baby is healthy and we are both recovering well.
If there is a silver lining from the experience, it’s that I learned a lot and can now share with all of you, particularly how childbirth and breastfeeding can affect or be affected by MTHFR mutations. In particular I want to discuss two major areas where your MTHFR mutations can come into play and affect your childbirth and breastfeeding experience, both of which are interrelated.
The first issue is toxins. While I wanted a completely drug-free, natural childbirth, this was not possible for me with what I had to have for an induction. I received Pitocin, which led to an epidural. Prepared as I was for dealing with labor pain, Pitocin contractions are not “natural” and I struggled with them, especially after the 36 hours I had gone through with Cervidil prior to starting the Pitocin. I had little sleep and no food. It wasn’t happening. So here are several drugs you may encounter should you end up in the hospital for your birth. I would never choose an induction but as I have learned sometimes these things are inevitable despite our best intentions. I have often felt sorry for us in our postpartum days, thinking how did I of all people end up with all this? But I’m not special. And I also realize that many women choose these interventions every day. For those who have this choice, I want to be sure to point out some things to consider, especially if you have MTHFR mutations.
All drugs have to be detoxed by the body. As we know, MTHFR mutations make it more difficult for the body to process substances and eliminate them from the body. This includes not only any pain medications received for labor or C-section, but also the Pitocin. Pitocin is now routinely used in hospitals for preventing hemorrhage as the placenta is removed, so you can expect to receive some even if you weren’t induced. This synthetic form of the “cuddle hormone” oxytocin tends to hang around in your system for a while. For those of us with MTHFR mutations, that’s a problem as it’s even harder to detox. C-sections often require postpartum pain medications, like hydrocodone, which contains Tylenol (another MTHFR no-no because it depletes glutathione). Aside from putting extra stress on your system, these drugs (or having a C-section) can also cause problems with breastfeeding.
As aware as I was about the problems I would have with the interventions discussed so far, I had no idea what a challenge my experience would present to breastfeeding. Despite having a labor that progressed beautifully once it got going, I still ended up with a C-section after two hours of pushing. That’s another story. A C-section is what I most wanted to avoid but I had no idea that one of my reasons should have been the challenges it presents to breastfeeding. Women who have C-sections can experience delays in milk production. Having a lot of Pitocin in your system can also delay your milk coming in. We did not learn about this until the day we were discharged from the hospital when we finally were seen by a good lactation consultant (LC). Luckily this LC was also versed in MTHFR and I ended up learning quite a lot from her.
For milk supply, the first two weeks are crucial. If you have interventions such as Pitocin and/or a C-section, you’ll want to get additional support from a LC and may need to start pumping very soon after the birth. C-section moms can have a delay in their milk coming in of 10 days or more. This happened to me and I needed a lot of help to get back on track. We had to supplement with donor milk the first weekend home and had I not gotten immediate help from my doula and a LC, I don’t know where we would be right now. I think having MTHFR mutations may exacerbate this problem because you have a harder time detoxing substances like Pitocin. And if you had a stressful birth as I did, this can further impair milk production.
The LC at the hospital also talked to us about teas and supplements containing fenugreek that are commonly used to increase milk supply. She mentioned that using fenugreek while breastfeeding can potentially cause peanut allergies in babies when there is a history of food allergy in the family. I had never heard of this before so I want to mention it here for your further research and exploration.
Finally we got onto the subject of tongue and lip ties, which is now an issue I have personal experience with.
Tongue-Tie and Lip-Tie
As a MTHFR-aware person, of course I had heard of tongue-tie. What I didn’t realize is how much they affect my family. I was surprised to learn that I have one, though it is quite flexible and I am able to touch the roof of my mouth with my tongue. I was also breastfed as a baby and didn’t have any issues with that. My husband, on the other hand, has a more significant tie that doesn’t allow him to touch the roof of his mouth, and he did have breastfeeding problems as a baby. During our meeting with the hospital LC, she identified a posterior tongue-tie in our baby as well as a lip-tie. We later met with another LC who referred us to a pediatric dentist to further evaluate the ties.
Tongue-tie, also known as ankyloglossia, is a midline defect that seems to be associated with MTHFR mutations. The tongue-tie is actually a short frenulum that restricts tongue movement. There are four types depending on placement in the mouth. Tongue tie can cause a variety of problems with breastfeeding, including nipple and breast pain, low milk supply, plugged ducts, mastitis, poor latch and suck, poor milk transfer, falling asleep at the breast and early weaning.
Although I thought I was well-supplemented with the right forms of folate and vitamin B12 during pregnancy, our child still had this defect. Knowing exactly how much to supplement is, of course, a common dilemma for those of us with MTHFR. Tongue-tie is also hereditary, which we have noticed within our family. Of course, breastfeeding is a priority for us, so we were anxious to correct this problem as soon as possible – the earlier you address tongue and lip ties the better because the first two weeks are really critical to breastfeeding progress. So we went ahead with water laser surgery, which was a success.
Of course, nothing is a quick fix. In fact, going ahead with the surgery sent us down a bit of a rabbit hole. We had to do some exercises to massage the open cuts created by the laser. This kept the frenum from reattaching but also caused some distress to the baby. Our major issues were gas and baby falling asleep after a very short time on the breast and failing to transfer much milk. These didn’t resolve right away for us, though apparently some people do experience instant dramatic improvements after the frenotomy procedure. We were told that it would likely be four weeks before our child’s sucking improved. Because the baby has been motility impaired since being in the womb, there is muscle memory and a need to relearn how to use the facial muscles to create an optimal suck. Muscles beyond the tongue and lips would have been involved in helping compensate for the prior movement restrictions. It’s like trying to throw a ball when your arm has been in a cast your entire life. The entire fascia must be relaxed and regrouped.
We read about CranioSacral Therapy (CST) as an effective complementary treatment to the frenotomy and began those sessions last week. So far we have noticed quite a bit of improvement as a result but we are still not completely on track with our feedings. I do a lot of pumping and supplementing breast milk by bottle. Of course this is not at all what I thought our breastfeeding experience would be like but we are doing the best we can and I feel fortunate that we received so much fast help with all of these challenges from the local holistic birth and breastfeeding community. My milk supply is ample.
Unfortunately sometimes our plans just don’t work out. That was certainly my experience with birth. But mentally I have been working hard to accept what happened and move on – the health of our child going forward is the top priority. I look forward to sharing our experiences as a family with MTHFR, particularly as these related issues arise.