Today Simone Toomer joins us again to share her second baby’s birth story. Simone is a Black perinatal professional who serves birthing folks and families in a number of capacities, but at this point in time is mostly focusing on supporting nursing parents. In today’s story she shares how she again chose a Black support team and how her decision to give birth at home was a very logical choice following attending many births as a doula in various birth settings after her first baby’s birth. Simone had a quick first birth, and this one is even shorter, lasting only a couple of hours from her noticing the first labor contraction to meeting her son. She then shares being surprised by some of the breastfeeding challenges she experienced with her 2nd, since her first experience had been much easier. She explains how taking her son for bodywork and then getting his tongue tie released made all the difference. Simone also details some of how the challenges she experienced inform the professional lactation support she provides now, and talks again about the nursing support groups she’s doing for nursing parents who identify as Black through Chocolate Milk Cafe as well as for all nursing parents with La Leche League.
Episode Topics:
Choosing homebirth for the 2nd time, largely based on her doula work
Choosing a Black midwife & doula
Takiya homebirth midwife - prenatals in her office as well as in her home
Feeling like an active participant
Tanisha - doula
Anxiety around baby (Malachi) being breech, doing all the Spinning Babies techniques
Anxiety about timing of going into labor while having a 5 year old daughter
4 days past due date - same timing for labor as with Mackenzie
Wednesday got bodywork, feeling loose and feeling some of the same things she felt in her 1st pregnancy just before going into labor the next day
Fri night going to bed and waking up regularly with contractions, 5 min frequency from the very beginning
Spends an hour in the shower coping with contractions
Calls midwife, she says she’s coming immediately
Vomited coming out of shower; not being in the head space, despite her having attended at least 40-50 births by this point, to realize she might be in transition
This is March 3rd, a snowstorm just ended, she’s burning up opening the terrace & windows
Sits on birthing ball
Calls doula Tanisha to come
1:45am things had started, by 3 both doula & midwife have been called
Husband trying to inflate pool while helping her cope, she grabs onto him during contractions
Goes on toilet because she feels like she needs to poop, tapping rhythmically there
Needing hip squeeze from husband (she had intuition leading up to labor she might need that)
Doula Tanisha arrives around 3:50am - she does some oils that balance out the intensity
She bites (or grabs?) her doula’s shoulder to the point that it was bruised
Trying to get in a squat
Everyone in bathroom, baby born there just over 2 hours after the first contraction
Baby cries, wakes up big sister
Moving to the bed
Barely tore (as compared to 2nd degree first time) -- she believes likely because she had the freedom to do instinctive pushing instead of directed pushing
Placenta inside for around 45 min before coming back
Malachi’s first latch was painful - she had been a CLC for 4 yrs at this point, not knowing what was going wrong
Baby losing weight and plateauing, not gaining, pediatrician saying he’s fine but she knows he’s not
IBCLC came over to weigh him
Tried nipple shields, still painful
Plenty of milk, so that’s not the problem
Needed to start pumping around day 4
Getting assessed for tongue tie - Malachi had both lip and tongue tie but they just got tongue tie adjustment
Cranial Sacral therapy - 1 session
Getting oral release/frenectomy with Dr. Siegel out on LI
Recommending bodywork for babies, particularly with tongue or lip tie
Postpartum anxiety all feeding-related, eventually resolved itself gradually
Dr. Brioche (sp) - wonderful Haitian-American pediatrician
Simone’s work as a lactation counselor and leading both Chocolate Milk Cafe & La Leche League nursing support meetings
Resources:
Simone & Lisa chat about nursing support during the pandemic on IGtv
Chocolatemilkcafe.org, @Chocolatemilkcafe, @chocolatemilknynj -- nursing support for folks who identify with the African diaspora (went national in 2020)
Tanisha Evans-Marin, doula, childbirth educator, lactation counselor
Spinning Babies: tips for flipping a breech baby & belly mapping info
Flower of Life Chiropractic (Park Slope & Tribeca)
Earth + Sky Healing Arts - Simone & Lisa recommend for cranial sacral therapy, also does prenatal/postpartum massage, and acupuncture (Long Island City)
Other Black birthing stories on this podcast thus far:
Natal - another podcast that shares Black birthing stories (IG @natalstories)
Sponsor links:
Interview Transcript
Lisa: Today I have with me again Simone Toomer. Welcome, Simone.
[00:00:04] Simone: Yes, I'm excited. This is -- not that anything [was] wrong with my first birth story, but I'm really excited about this one.
[00:00:11] Lisa: Well, I'm excited to hear it.
[00:00:13] [insert post-recorded intro]
[00:00:13] You do so many things. What have I forgotten?
[00:00:15] Simone: And I'm a mom of two.
[00:00:17] Lisa: Mom of two. And remind us how old your two are?
[00:00:21] Simone: McKenzie is eight and Malakie's two and a half.
[00:00:24] Lisa: Oh, I love that you did the matching initials. We did that in our household too with our two kids, although no one knows it because our Gabriela and Grayson, but Gabriella goes by Ella. So no one ever realizes. I don't I like to be cheesy that way.
[00:00:40] Simone: That's funny. My husband's is Mark. So I was like, maybe the next one, if there's a next one we should do S, so I could get some on my side.
[00:00:48] Lisa: Sounds good. Can you tell us a little bit about, in the years between number one and number two, what was that like? How did you decide or did you decide to get pregnant again or did it just happen? Tell us a little about.
[00:01:04] Simone: So definitely like I've come from a big family. So I knew it wasn't like one and done for sure, but it was just like when would it happen.
[00:01:12] It was funny, the month before we got pregnant, I was like, like something just kind of was like, maybe I should check out the midwife scene. I knew from a birth perspective as a doula who was out there. And I remember Grace, a doula, she was like, "Why don't you check out Takiya?"
[00:01:30] And Takiya was actually a midwife I had never heard of. She was here in New York for a bit. And then she practiced in Lancaster, Pennsylvania for most of her career and then she came back to New York. So I think when I reached out to her, even before pregnancy, I was like, "We're gonna try to get pregnant soon and I think I'm going to want to interview [you]." And she was like, "Sure, yeah." And then the next month we got pregnant and I hit her up. And I remember it's so funny because it was one of those things where I was like, I should interview people just to know options, but it also felt like I knew she would be my midwife.
[00:02:02] Like I reached out to different people, but I still somehow just so felt like she was going to be the one. And so I hit her up for an interview and she was like, "Come on down to my office." And it was like an hour, you know, consult with her to really just feel her energy, feel her vibe. And I just loved that personable kind of approach to like, this is someone you're welcoming into your precious space.
[00:02:25] And so I chose a home birth with my second. So I had my first in the hospital. By the time I had my second, I had definitely attended well over like 50 or 60 births in all these New York City hospitals, birthing center and home. And I just felt by that time, I was like, there's no need for me to be in the hospital.
[00:02:45] I'm confident in my body. And there is power in having a supportive birth team, as well as your family involved. And I knew that what I wanted for myself. I did personally want a Black provider and a Black doula. As a doula, I did go back and forth with, did the doula need a doula? You know, so I did not hire a doula right away, but eventually I did.
[00:03:08]But Takiya, she literally just felt like home right away, you know? And I remember my daughter in her office coloring and asking her questions. You know, it just felt natural. So, because I was a low-risk woman, I hired her, but we didn't necessarily like get into prenatal care straight away.
[00:03:27] It kind of was like, "Oh, we can wait a little bit." So maybe I saw her in June, just email communication on how I was feeling. And then our first like, real visit, it was like probably August or so when I was like 12 weeks for like blood work and, you know, all of the initial things.
[00:03:43] Lisa: Yeah, I love that. Yeah. Big difference in how your prenatals feel, right?
[00:03:49] Simone: Definitely. It's a very huge difference. Like I remember with my first prenatals -- one, you're sitting in the office for however long waiting, right. You are then like most of the time putting on a gown, right? They're taking your vitals, they're measuring your belly.
[00:04:06] And you're done within like probably 10 to 15 minutes. With Takiya, and there's a lot of midwives that will also come into your home and do prenatal care. So that's beautiful. Also, with Takiya, it was split between an office in some of the later appointments were in my house. But they would easily be an hour, maybe an hour and 15, just really, like, I felt like talking to a girlfriend, you know?
[00:04:29] And so the clinical side of it was like 10, 15 minutes. The beauty also of the clinical side of it was I was an active participant. You know, I was taking whatever urine to get tested and dipping, whatever sticks for whatever test was needed. But the bulk of the prenatal was really like, "How are you feeling? How are you sleeping? How's work going?" You know, "Do you have any concerns about your birth?" Because birth is so much more than just the physical, it was really just getting down to just like how I felt in my body and with my progress. And I loved that.
[00:05:06] Lisa: Yeah, much more holistic care, right? Because usually with a hospital care provider, especially OBs, but not limited to that, I mean, just due to the insurance system alone, they're so rushed. They have to pack so many patients back-to-back that there's just not much time, plus there's not a lot of training for them, I feel like in holistic care, in, you know, really the value and importance of nutrition and lifestyle and like emotions and the mind-body connection and all those things that so, so much matter.
[00:05:41] Simone: Yes, for sure. I remember I had like some anxiety, but that presented itself when I was like seven months. I was aware of it, but I didn't really call it anxiety, but I knew it was there and Takiya and I spoke about it and it really manifested in my postpartum, but it was also nice for her as my provider to already see those red flags, too, you know? And as myself, the patient, but also for me to be in my body and honor what I was feeling too and how that was impacting my mental health and my wellness.
[00:06:15] Lisa: Do you mind my asking, did you ever get to the bottom of the source or the root of the anxiety?
[00:06:20] Simone: Yes, definitely. I think, you know, it's funny being a doula. It sometimes feels like knowing too much can kind of kick you in the butt, right? So Malakie was breech for a little bit. And I was like, "Oh my gosh, what if he doesn't turn?" Oh my goodness. But also I know for a fact the reason I picked Takiya is I felt safe with her and I felt secure in her skill that a breech baby, like I felt like my baby was going to be delivered safely regardless of breech or not. I trusted her skillset. She had worked with the Amish community. She had worked in a birthing center. She worked in the hospital. Then she went on to her own home birth practice. She recently retired this year, which has been very, very sad.
[00:07:03] Lisa: I thought so; I was going to just double check with you. Yeah, that's what I thought I heard, but she's mentoring some younger midwives, right?
[00:07:09] Simone: She's mentoring and she's actually mentoring me regarding my IBCLC. She's an IBCLC so it's, you know, like full circle. And just being a Black woman being mentored by another Black woman. And it's just nice to just have, you know, I have a few Black IBCLCs that are mentoring me from the birth community that before my journey and becoming a lactation consultant were doulas.
[00:07:30] And, you know, we kind of like ran cases and clients with each other and it's just like the village. Which I think is so, so important.
[00:07:37] Lisa: That is beautiful.
[00:07:39] Simone: Yeah. So, yeah, so my anxiety I knew came from initially, just like, what if my birth does not go the way I want it to go? And then his position and Takiya had recommended Spinning Babies for me. So I was like upside down three times a day.
[00:07:55] All of these--yes, inversions and side-lie with my leg hanging over my bed every night. And I was like, "I'm going to give this a thousand percent, right?" And he eventually turned. And another empowering part of this journey is I remember towards the latter part of my pregnancy being like, "Oh, like feeling the baby and knowing for sure, like, here's the butt, here's the legs, here's the kicks, you know, and Takiya would just be like, "Yep, you're right," right? And there's so many times I hear clients go, "Oh, I have to get a sonogram to confirm my baby's position." And I'm like, "No, you don't." Like, let's get into our body and feel our baby, right? Because there is a communication happening between the two of those, even though they are inside. And so every night I would just like lay down and just try to feel, you know, before the appointment, like what's going on and then go in and be like, "I think this is happening." And it was really cool to always be right about what I was feeling.
[00:08:54] Lisa: Yes. Yes! I'm so excited that you're talking about this because when I'm teaching birth class, I always bring up Spinning Babies. I always talk about it can be so confidence-building, so empowering to realize you don't have to always ask your care provider in the 30s weeks, once the baby's big enough to be able to identify those parts of the baby.
[00:09:13] And then I direct them to the website and say, look at this little belly mapping area that guides you in learning how to connect with that and figure that out for yourself. And, yeah, that's so cool.
[00:09:24] Simone: Yeah, it's a big deal. And I know for sure once I started implementing that in my prenatals that has changed labor for many of my clients in regards to intensity, prodromal labor, the length of labor, hands-down.
[00:09:38] Lisa: Oh yeah. Yeah. And I really, I so wish that, well, I wish a lot of things about our hospital births. But one of the specific things -- I was just talking about this last night in birth class, actually. I really wish that when people arrive at triage, that part of the standard protocol would be paying more attention to the nuanced position of the baby. Rather than just, "Yeah, baby's head-down. You're good." That's a great way to reduce interventions, right?
[00:10:06] Simone: Yeah. I have a doula I'm mentoring now. And I remember her telling me something, you know, while in labor. And I said, "That baby's posterior." I said, "Can you ask the doctor for a little bit of insight?" And then doctor confirmed, and so we got Mom moving and doing some things to help.
[00:10:22]But yeah, it's just so interesting to look at the signs of labor or the signs as one nears their due date that could give you some insight to baby's position and somewhat of how labor might unfold.
[00:10:35] Lisa: Do you happen to remember, in your second pregnancy, how many weeks you were -ish, where you determined that baby was breech and then around when baby flipped?
[00:10:44] Simone: Oh, I don't remember. I remember being nervous around my seventh a month, even though in my head, I was like, I know there's time. But that was just like the anxiety. But I feel like he definitely flipped much later. Like I was already like, 30 something or so, and then I know with second-time babies, they kind of do their own thing and there's more space and, you know so I would say like he definitely flipped head down later on.
[00:11:08] And then once he was head-down, the goal was to keep him anterior. Cause he was like flipping back and forth and rotating. And so that's where the side lying came in to keep him on one side of my uterus.
[00:11:21] Lisa: Any other things you wanted to share about your pregnancy or ways that you prepared for giving birth before you go into actual labor?
[00:11:28] Simone: Yeah, no. Takiya, like I said, I felt equipped with her for support. Like I said, also I debated with like hiring a doula, so I did end up hiring a doula friend. We have a really close doula community. So Tanisha was my doula who I call her mama T. She's a mom of three and she's just so nurturing.
[00:11:49] And I just was like, "This is going to be my birth, we're going to rock this birth." This is going to be like an awesome birth. And there was some logistics, of course at the time McKenzie was five. So it was like, "What if labor starts while she's at school? What if labor starts..." you know, all of these questions about who's going to go get her or are we gonna like keep her home or, you know, stuff like that.
[00:12:10] So it's funny, but my labor actually started the same exact time as my first. So the only differences with Malakie I went four days past my due date. And I remember getting body work on like Wednesday. And immediately the day after, like my hip started to really hurt and things started to feel really loosey-goosey.
[00:12:38] And Friday night I went to bed and kind of exactly the same thing. I was waking up every five minutes. So as opposed to my first real contractions started like 20 minutes apart, then got to 10. Then to five, you started right away, five minutes apart. 2 o'clock in the morning, McKenzie's already asleep.
[00:12:58] My husband's a night owl. So he was like in the living room doing his thing. I'm like, I'm tired, but after like five or six of them where they're waking me up out of my sleep, I'm like, "Oh okay." At that point I had gone to the bathroom and after the fact, my husband said he noticed the blood in the toilet.
[00:13:13] So I had already started spotting, you know, signs of cervical changes. So I said, you know, "I'm going to go in the shower and see if this stops and let you know." Spent like an hour in the shower. Every time the contraction would come I would face the shower so the shower would hit on my stomach and distract me.
[00:13:34] And then when they were done, I was in there, just swaying. It was really calming. And then after an hour, I was like, "We probably should call Takiya, let her know something has started." So Mark called her and she was like, "I'm coming." And I was like, "I don't need you. I'm good. You're going to just be on my couch, but if you want to come, no problem."
[00:13:57] But immediately coming out of the shower, I vomited. And so it's funny 'cause my doula brain obviously was not in full gear here, right? So I vomit, okay, but I'm good. I remember getting my birthing ball immediately, I didn't have my robe on, walking into the living room. And I'm hot, like it's March. So he was born March 3rd. So a storm actually had just ended-- like a snowstorm, I think, had just ended. It is hot and I'm like opening the terrace door. 'Cause I am on fire. I'm like, turn off the lights, turn off the TV. I don't want to hear anything. I don't want to see anything.
[00:14:38] And I just get on my birthing ball and I'm just like rocking back and forth. And then I'm like, "I should call Tanisha now." So everything started around like 1:45, 2:00. By 3:00, Takiya and Tanisha are called. And I'm still like, "I'm good guys," but Tanisha's like, "I'm heading there now."
[00:14:58] Takiya's like, "I'm heading there now," and I'm on the phone and I'm like, "I gotta go to the bathroom." But I'm literally just like, I need to poop, that's all. Like, I just have this, like in my head I'm... it's so funny. Every time I tell this story, I'm like-- and like Tanisha is scaring me on the phone. And she was like, "Simone--" because at this point during contractions, I can't speak.
[00:15:21] So I'm like, I'm closing my eyes and through the contractions, she hears me take breaths. So they were always five minutes apart from the very beginning. But at this point they're probably like two-ish minutes apart. Also, my birth tub isn't blown up. So my husband is trying to blow up the birth tub in between helping me with contractions.
[00:15:42] And I'm like, "I just want to get on the toilet. I just need to poop." So as I sit on the toilet, my husband said I was literally trying to attack him. Every time a contraction came I was going to pull him into me and like grab on his shirt or something. So I'm on the toilet now, the contraction comes and I pull him and it peaks and every time that peaks I'm tapping the toilet and I'm like, "It's coming down, coming down, coming down," and he'll go blow up the birthing tub some more. Then I feel another one, "I'm like Mark, Mark, it's coming. It's coming. It's coming, so come." So there's an intuition about me that two days before labor started, I told him, "I think I'm going to need you to do a hip squeezes on me."
[00:16:30] I didn't need his support in any way -- let me not say I didn't need to support anywhere the first time -- the first time I didn't need physical support. Like I was fine without any touch. So the hip squeeze is the only thing that got me through this birth. So every contraction he was going in there really squeezing my hip as I maybe bit his t-shirt or like grabbed something.
[00:16:53] And then I would say Tanisha arrived around 3:50. And they swapped out where he was like, "Okay, I'm going to focus on this birth tub, which never got blown up, basically filled with water. And Tanisha comes in and she likes, she gets some cinnamon and she gets some hot oils on her. And the hot oils she like rubs down my back, along my lower back. She's doing these hip squeezes and the heat of the hot oil is just really, it's like they counterbalanced the contraction. It felt so good. I feel so bad every time I say this out loud. I either grabbed her shoulder or bit her shoulder.
[00:17:37] And she had like black & blue there. And I remember the toilet roll next to me, like my hand kind of like knocking it out the wall just from pushing down so I'd keep my balance while a contraction was coming because as the contraction's coming on, like arching up and trying to just open my hips up and like get into this really perfect squat to give space for what I'm feeling needs to be done.
[00:18:04] I'm pooping, bearing down. Takiya comes maybe like 4:10-ish or so, and right away, she goes, "Simone, I think you're bearing down," and I'm like, yeah, 'cause I'm pooping.
[00:18:18] Takiya just goes, "I'm just going to check you really quick to see when you are. Oh, you're 10cm. The head is right there." And then it's as if like the minute she said that, all things ramped up and I don't even know how everyone got into the bathroom, like Mark was in the bathtub, Tanisha was next to me doing hip squeezes, Takiya's on the right of me and Takiya's like now just like rushing to get her gloves on because as she says, I'm 10. I feel this like burning fire and I'm like, "My vagina!" And I just like scream that and like the head is there basically. And she's having Tanisha like help her, kind of get things together.
[00:19:04] And she's just like, so she goes, "Blow out his first birthday candles, slow down your breathing, blow out his first birthday candle." To allow me to start slowing down my push. Because now I'm on the toilet. I remember them asking me, "Do you think you can make it to the bedroom?" And I was just like, "No, I can't move from this position."
[00:19:24] And he comes out and she just says, "Arch your hips forward so he doesn't of course hit the toilet bowl," and she just scooped him up onto my chest and he gives his first cry. And my daughter comes out real foggy eyed and groggy, and we're like, "You have a brother!" And he was born.
[00:19:47] Lisa: Was there enough sound and stuff that she woke up or did somebody wake her up?
[00:19:51] Simone: She woke up just from his cry, which is weird because all the cursing and yelling, I was doing before did not wake her up, but I was saying some nice commentary.
[00:20:04] So he's on my chest and Takiya and Tanisha are like, "Okay, now let's move into the bedroom." We had laid chux down and everything, and I just laid down with him and I'm like crying and he's just on my chest. And Kenzie's next to me in the bed, like looking wide-eyed, just really excited. And I'm just lying in bed like oxytocin high, right? Like this was really took two hours. On my toilet like, "Oh my gosh." And Takiya just goes on to do like my exam. I barely tore. I had a second degree with my first. This one, barely tore, which I think comes more so from like my own pushing as opposed to guided pushing.
[00:20:45] And Takiya does everything. The placenta at this point is still inside me. And so at this point I'm just holding him and she's just kinda like, "You can nurse him if you want." And I believe the placenta was in probably like 45 minutes before I started to feel cramping again.
[00:21:01] And then once it came out on its own, we just put it in a bowl to the side of me. Kept that attached to him until it was really like white and limp. And then Takiya did all of his exam, we latched, and they helped me get into the bath and made sure I was eating and hydrating, monitoring my blood and all of those things. And Kenzie put on gloves and actually like touched the umbilical cord and that type of stuff.
[00:21:27]But it was really a beautiful, beautiful experience. Like no other, every time I think of it, I'm like, Birth is beautiful and empowering, but I think it's like, it kind of feels like you're tripping. Like your hormones are so high and it's like, I just pushed a human out, you know?
[00:21:46] And then I latched and just to get into a little bit postpartum,
[00:21:50] Lisa: Before you go into postpartum, can I just ask a quick question? Because a lot of people, as I'm sure you know, are really afraid of pooping in front of everyone in labor. And it's so common as you and I both know. And you mentioned pooping. Did you care?
[00:22:07] Simone: I did not care at all.
[00:22:09] Lisa: Right, because you lose all inhibition. And the vast majority of people are like, "What was I so afraid of?" on the other side of it.
[00:22:17] Simone: And honestly we see poop and we know something's going right, right? 'Cause it's like those are the muscles you need.
[00:22:22] Lisa: Exactly. you're pushing beautifully. Totally.
[00:22:26] Simone: Yeah, so I was not concerned at all.
[00:22:29] Lisa: That's what I figured, but, and all the less embarrassing when you're in your own home, in the comfort of your own home, rather than in someone else's building.
[00:22:38] I just find
[00:22:39] Simone: it funny. The things that I really thought I needed to poop and it never ever came up, like, maybe the baby is right there.
[00:22:49] Lisa: Even with all the births you attended.
[00:22:52] Simone: I was like, "I'll feel better."
[00:22:53] Lisa: Thank you for clarifying. So postpartum...
[00:22:56] Simone: So postpartum, Malakie latched and the first latch was horrible and I was like, this doesn't feel right, but you know, sometimes your nipples are a little sore or something's going on. And despite latching repeatedly -- he was born like early Saturday morning -- by Sunday, my nipples were like raw and this did not happen with McKenzie. And from a professional standpoint, I was like, "What's going on. Like, I don't see anything. I'm sandwiching the breast. He has the areola. From the outside it actually looks really good. But from the inside it felt like glass in my nipples. That's the way I could describe it.
[00:23:38] Lisa: And so I know you were a doula at this point. Were you also a lactation counselor at this point?
[00:23:42] Simone: I was, I was, yeah. So I actually, doula and CLC were the same year. At that point I had been practicing for already like four years. But it just felt like, "What's going on? Like I'm doing all the right things."
[00:23:55] And at this point I heard of tongue tie, but I didn't have much experience with it. And I remember just thinking, like my nipples shouldn't be banged up. Takiya saw me by Monday, my milk definitely came in within like two days. I feel like with every baby, your milk probably comes in a little bit sooner, a little bit more robust.
[00:24:15] So it's hard to say, but at some point I was in so much pain that I didn't want to breastfeed him. And it was to the point where he wasn't actually gaining, like he had plateaued. So he was born like seven one, seven two. He had went down to about six 11 and just kind of stayed there. And in my head, I was like, "Everyone was telling me this is okay. And I know it's not okay."
[00:24:42] At one point he went like a day without pooping or two days without pooping. And I was like, "This is not right." And the pediatrician was like, "It's okay. He'll, he'll be fine." I was like, "Oh, like, what's going on here?" I had so many of my friends come over to kind of help me and do weighted feeds.
[00:24:56] There's an IBCLC who came over to weigh him. And we could tell like his weight just wasn't enough. Like his gain, his transfer. And just being a second time mom, the supply was definitely not a question; my milk was definitely in. So I was like, what is going on? I tried the nipple shield and I still felt pain through the nipple shields.
[00:25:17] And so by day four, I actually had to start pumping and giving bottles, which was really, really hard for me just given like exclusively nursing McKenzie. And so I had to go back to work and now, you know, day four, being like either I don't want to nurse him at all because I'm in so much pain, but we gotta figure something out because I don't want to do formula.
[00:25:38] So I would literally be like nursing on one breast because I wanted him at the breast and pumping the other side for that bottle I knew he would need. And then Takiya, like fast tracking an order, a Spectra for me. 'Cause I didn't even anticipate needing a pump so soon. And then actually doing like breast and bottle for about a week or two before going to get him assessed for a tongue tie.
[00:26:04] Lisa: Did you like the Spectra by the way?
[00:26:06] Simone: I do.
[00:26:07] Lisa: If anybody likes a pump; I don't know if anybody really likes a pump. In terms of, I don't know if you had anything to compare it to like a different model or anything.
[00:26:16] Simone: Actually, with my first, all I ever used was the Medela manual, I didn't even use one much with my first. And the Medela manual was enough.
[00:26:23] I didn't really like do a lot of bottles with her. So if I did the manual, it was just because I needed like three or four ounces to have there if she needed it, as opposed to Malakie, I was always trying to like stay above what he needed in case he needed to be supplemented.
[00:26:39] Lisa: So being assessed for tongue tie. Can you talk us through that a little bit?
[00:26:43] Simone: Yeah, I mean, so it's interesting because I had a fast birth. And so a lot of my lactation friends who came in to support me and I have to like shout out to every doula in New York City. Because I was blessed and showered with so much love from like, you know, different chilis and stews and like the amount of -- to this day I'm like I could not have done it without my community, hands down. And I had already like the anxiety just kind of amped itself up after. So I would have been a hot mess, you know, if it wasn't for that. And I was trying to figure out like, adequate dinner or something.
[00:27:21] Lisa: Yay for meal trains. Those are so wonderful.
[00:27:24] Simone: Yes, that's exactly what, yeah. Yeah. So me being nourished and then just people stopping by to say hey, to just like talk to me. I was in my room, either sleeping or nursing for the first like six weeks. Just because I was so exhausted. But when it came to his tongue tie, from my knowledge then it was like, "Oh, I don't see anything, so there is nothing there." And from colleagues it was like, "Something's going on. We don't see a tie, but sometimes there is a tie that is, you know, something considered a posterior tie, which is more underneath. It may not be felt, but it definitely manifests with issues like supply and weight gain.
[00:28:01] I did get one session of craniosacral therapy done with Malakie beforehand. The way that it was described to me and now the way I even described the clients with like, especially with a fast birth, everything's kind of just condensed and tightened, right? So there's tension in the body and needs to be loosened up.
[00:28:20] So we did that. And then we went to Scott Siegel for a tongue tie release which... It's interesting. Because I was so desperate, we actually went to the Long Island office. Because he didn't have any appointments in his Manhattan office. And I was like, "We need to get this done. Like right now, I'm just tired of waiting."
[00:28:39] And it was a posterior tie. He has a lip tie, which we didn't do anything about. And immediately like the pain went away. I remember that first -- we took the Long Island Railroad with a two-week-old baby and I packed the bottle cause he wouldn't latch on the train and we so happened to have a fire on the track and get caught out in the middle of Suffolk County on the way back home with a two-week newborn crying who just had a tongue tie release. I was like, "You've got to be kidding me."
[00:29:13] Immediately that week, I remember going to a support group on a Sunday and the support group the following Sunday. He gained like a pound in a week. So obviously it was like, "Oh yeah, okay. Now he's gaining weight.
[00:29:24] Lisa: Huge difference. Oh my goodness.
[00:29:27] Simone: So yeah, so. It was interesting to see that difference from the tongue tie release.
[00:29:31] We also did like a few sessions with Flower of Life in Park Slope after. And so I vouch for body work all around for pregnant people, postpartum people, new babies. I think it's also a nice approach if you don't want to rush to a tongue tie release to see what it can do.
[00:29:47] And I'll be honest, like things weren't a hundred percent until about six to eight weeks, like he was gaining well, but my nipples still looked smushed and weird and he was cluster feeding a lot. I used to joke like five o'clock I need to be on my couch ready to feed until about nine.
[00:30:01] And that was just the way my first month and a half went as he figured it out. And now at two and a half, you know, you would never think that there was nursing issues.
[00:30:13] Lisa: That's amazing. For people who have not heard of tongue tie or lip tie. Can you explain a little bit about that as well as what a frenectomy is like?
[00:30:23] Yes, for sure. So, you know, we all have a frenulum underneath our tongue, that tissue that we see when we lift our tongue. It's not a matter of if we see it or not. It is not a matter of how short it looks or how stretchy it looks. It's really a matter of how it functions. So many times I see babies who are not efficient feeders or they can't latch, they're slipping off the breast constantly.
[00:30:46] And unfortunately they've heard, "Oh, it's a mild tie. It doesn't look like a tie," but it really is a matter of that frenulum and how much tension is there? How much can you really move the tongue? How efficient is it in removing the milk from the breast?
[00:31:02] Because those first six weeks is what establishes your milk supply. So whether you're nursing on demand or pumping, you know, every two to three hours, that body getting the signal to remove milk and build that supply, it's going to happen in those first six weeks. So we want to make sure that baby's draining really well.
[00:31:20] Back to birth weight in two weeks and that supply's good for however long you decide to provide your milk for your baby for. I think the issue is -- they say that it's over-diagnosed now, but I think we're just in a very pro-breastfeeding community now, and we're catching it more and more, you know, the education is there, the resources are there, I think many of us have it --had it, still have it, worked through it, right?
[00:31:44] Like there's so many things down the line that whether with solids or speech or orthodontic work that comes up.
[00:31:53] I was just going to say I learned even it can affect your sleep and it has so many ramifications in our long-term health and life.
[00:32:02] Simone: Yeah, so when I educate parents, of course, I look at them immediate nursing situation -- is the baby gaining well, how much is baby transferring per feed, ideally how's moms supply? I look at goals around feeding. Does the parent want to exclusively nurse, can they do bottles for two weeks to see if this improves and then we reassess. I rule out any medical concerns with the nursing parent that could kind of mess with hormones, which will then impact breastfeeding. So we could say, okay, it's not a parent issue. It's the baby issue. And so how can we support you guys through that. As well as I never want to be in a rush to have an intervention done.
[00:32:37] So it's like do body work, do [self?] exercises. There's many things we could try to do to improve things. And at a later date, reassess if needed.
[00:32:46] Lisa: Yeah. And does Dr. Siegel -- I actually just heard from his assistant the other day because I refer people to his practice. Is it a laser for the procedure?
[00:32:55] Simone: It is a laser.
[00:32:57] Lisa: That's what I thought they use.
[00:33:00] Simone: So in New York I find a lot of pediatricians refer to ENTs. An ENT's an ear, nose, throat doctors, and they all do scissors. Siegel does laser. And there's been, you know, debate about which is better. Which one is more efficient. And it's interesting too, to like which doctors to go to what for, and I have seen like, depending on the tie, scissors be totally fine. Like what level of height is.
[00:33:24] Also, I think the amount of the skill of the provider. Also laser's out-of-pocket versus an ENT and insurance. So I've had some people do an ENT initially to see if it's hit or miss. And then if needed they're go to Siegel and he might correct the tie. But I do think a lot of people, they're not in a rush to do an intervention, as well as when perhaps pediatricians or other specialists, aren't identifying it. It's a debate of like, "Is it something we should do?" And I think it's something to note, not all care providers are trained in lactation. So there's not equal education in lactation. So we can't necessarily think that like one provider is the end- all-be-all.
[00:34:09] Lisa: Yeah, that's a great point. Excellent. Yeah. Pediatricians and also postpartum nurses don't always have the level of lactation expertise that we would think; that many of us would just go into it thinking that they have; that's just not a thorough part of their training. In most cases, anyway.
[00:34:26] So with seeing Dr. Siegel then were you working with your IBCLC for aftercare for like some basic PT, some massage? What did that look like?
[00:34:36] Simone: I was actually going to the support groups to make sure he was gaining well, and doing the stretches. So there's a bunch of stretches you're supposed to do underneath the tongue and lifting the tongue for about two weeks after. And I will say I was fortunate where it did seemed like Malakie's recovery was a little bit faster than what I've seen.
[00:34:52] You know, I've seen various levels of recovery. With some people I'm like, this might just be what you need and others, they might need the continuous body work or the continuous stuff training, you know? So it is something of patience where even though Malakie gained well immediately, I don't think that the latch kind of perfected until maybe a month or so after the fact.
[00:35:12]The comfort wasn't a hundred percent right away, but that was just something that in my head, I was like, "We're just going to have to work through it. It's improving, you know, progress is progress." I think what gets hard is when a parent believes or has heard, like they need to be on a schedule or babies should be sleeping through the night at a certain time or a certain amount of hours by certain age. Because when you have a baby who is not efficient at the breast, and you're supplementing with bottles, bottles will always mask weight concerns.
[00:35:42] And then if you have a baby sleeping through the night, that's how many hours without feeding. And is that nursing parent pumping? You usually see those issues re-arrive after, you know, clinical sleep training. So in my head, I was just like, I just have to dedicate my evening to nursing more, offering him more feeds.
[00:36:02] And yeah, his weight was always fine after, and I think he just helped my supply and became more efficient over that next month.
[00:36:12] Lisa: Did you want to talk at all about you mentioned having some postpartum anxiety. Do you want to touch on that?
[00:36:20] Simone: All breastfeeding-related.
[00:36:21] Lisa: I had a feeling it was breastfeeding-related, but I wasn't sure, just wanted to check.
[00:36:27] Simone: Yeah. So, you know, as a mom who exclusively breastfed her first, when I realized I had to do bottles, I'm like, "I have to pump. What if he gets nipple confusion? What if he never gets back to the breast?" I was like down my husband -- so don't tilt that bottle too high, you don't want that flow too fast." And you know, so here I'm like trying to pump and get my milk and also micromanaging the bottles. And you know, "what if my supply goes down," -- Thinking kind of the worst of what breastfeeding could come.
[00:36:58] Lisa: Because you know too much?
[00:37:00] Simone: Of course, of course. I was just like, all the situations in my head, like planning out.
[00:37:05] And then it was like, and then it was interesting because the pediatricians are saying everything's okay. And then my intuition was like, "No, it's not." So that was a little bit of anxiety, too. And then also I knew I didn't want to pump long-term. So the goal was always to like do bottles to get his weight good and then take away bottles and pumping so I could nurse exclusively. Then I'm thinking about, "Oh my gosh, what if I have to carry a bottle everywhere I go? And what if I, you know, like I can never nurse in public and it's so much easier to just have a baby in a carrier and just pop them on it."
[00:37:35] And so it was just really like this rumination about like the worst-case scenarios to happen around breastfeeding. Feeling really overwhelmed; really exhausted and really overwhelmed.
[00:37:47] Lisa: And what about now that you have two little ones, a newborn and a five-year-old I think you said. Was that playing into the anxiety at all?
[00:37:57] Simone: It was more like, I was just so exhausted. I literally was in bed, like 90% of the day. And that wasn't my vision. Anyone who knows me I'm like out and about. Like, I remember with Kenzie just putting her in the carrier, just walking outside. One, he was a smaller baby. And because he lost weight, he got even smaller. And so I remember the first time we took McKenzie to the park, he had to be like maybe three or four weeks. And I had him in like a carrier in my coat and it was just like 15 minutes outside. And I felt so accomplished to even able to venture out and do 15 minutes.
[00:38:31] 'Cause it felt like all I was doing was like trying to catch up on sleep and nurse the baby.
[00:38:37] Lisa: Just to try to help things improve. Took a concerted effort.
[00:38:41] Simone: Yeah. And then with Kenzie, she would just like come into the room and just so every, any interaction with her was just like me from the bed, which was also weird.
[00:38:50] So then did that anxiety just eventually work itself out or as you introduced solids down the road. Was there still some anxiety there? I'm asking this because I had an interview recently with someone who really had a lot of anxiety surrounding every aspect of feeding going into solids. So I'm just curious if there was any similarity.
[00:39:10] The anxiety worked out on his own. Like, I joke and say, I didn't need a therapist to tell me I had some level of like, PPD, right? And anxiety is on the spectrum of PMADs. I personally started taking CBD for my anxiety, which is like, you know, no THC.
[00:39:28] That worked wonders for me. It really, I noticed an immediate difference. And just talking things through and like the interesting thing about my anxiety, and I'm not sure if it's the same with others, I could tell like, my, my thoughts were so illogical. Like, it didn't make sense. But they're still there and you're still concerned about them. And over time, I just felt like the clouds over my head just kept floating farther and farther away until it was like, "Oh, we're good." And then at six months we introduced solids. He wasn't really ready at six months. Like it wasn't like eating-- and many babies aren't. So I think for me already being a mom, I wasn't like stressing about solids and being like he had to eat. So I was just really following his cues. Gave him some avocado, but I would say he didn't really eat solids until probably eight or nine months. Yeah.
[00:40:14] Lisa: I also wanted to ask you: in terms of choosing your pediatrician, did you just stick with whoever you went with with your first or not?
[00:40:26] Simone: I changed pediatricians, and after feeling unheard, I changed again.
[00:40:32] Lisa: Good for you.
[00:40:33] Simone: Yeah. And we actually have a pediatrician now Dr. Brioche, which I joke she's every Black, Brooklyn family's pediatrician, basically. Yeah. Like she's really, she just listens and she honors your decision and parenting, and really just gives all the choices, which I really, really love. So yeah, so we go to her now and she is she's awesome.
[00:40:56] Lisa: And is she a Black pediatrician or not?
[00:40:58] Simone: She is a Black, she's a Haitian American
[00:41:00] Lisa: Haitian American. Nice. I'll have to get her name so I can include that in the show notes.
[00:41:04] Simone: She's actually with Tribeca Pediatrics, which is interesting. And so I tell parents all the time, like you find what resonates with you. Just because a practice is presenting X, Y, and Z, every doctor kind of works differently, has a different approach and you have to find which feels good to you. So I personally, when I booked for her, I'm only booking her because I know I want [her].
[00:41:31] Lisa: Yes. I know what you're talking about. Ah, great. Well, I'm glad I asked that question because it just, again, it goes back to finding the right care provider for you in every aspect of your health care, not just giving birth, but like for your little ones, you want to find a good fit. And normally, I don't know what it was like for you; feel free to share on this. But I recommend that people for the first year of a baby's life, just choose mostly by proximity, just because you're exhausted, you're having to go all the time. You don't want to have to travel. It's easy to switch later on to your more like ideal pediatrician, you know, that might be worth the trek later when you have the energy and you're not having to go as frequently. But did you choose initially somebody really close, or?
[00:42:16] Simone: I don't even know. Now that I think about, I don't even remember how I made the first two decisions I did. Because Mali was a home birth, we had to then go in for him to get checked. But I just went Methodist at the time. And then, like I said, after just feeling unheard, I just decided to not continue there. And then I don't even remember -- you know what? Takiya, I think, told me about Dr. Brioche, because she had had previous clients who went to her and loved her. Yeah. And so, yeah, and I think Dr. Brioche has done like a podcast with her already with Takiya. So yeah, just once again, going back to that village and that community.
[00:43:01] Lisa: That's great. Yay for finding wonderful care providers.
[00:43:05] As you were talking about getting body work. If there's a suspected tongue tie or a lip tie or even if there's not, the recommendation of bodywork. It just occurred to me, I wondered if you had any thoughts for if someone is like, they just don't have the financial resources for that kind of thing.
[00:43:23] 'Cause most of that stuff is not covered by most people's insurance. What would you say to someone who has that argument but still really would love to do those things. Are there any resources here in New York for different kinds of body work on a lower cost or sliding scale basis?
[00:43:41] Simone: Yeah. So I will say the two places that I knew pre-COVID no longer exist. And I think that's because of COVID right. Which is horrible. I personally am the type of provider that I will personally email other providers. Like, "Hey, I have a client. I would love to refer to you, but this is their situation." You know, and aside from body work I talk about tummy time a lot. I educate on tummy time a lot. Because that's its own body work. So I educate on that, too. And I mean bodywork isn't a must, but it definitely is beneficial. So it's also one of those things that, is it something we do body work or should they go to a skilled provider and do the tongue tie release also. And I've heard that, I've definitely heard parents kind of be like, "It's just adding up," you know, and that's definitely a concern for them.
[00:44:32] Lisa: Okay. Great. Thanks for speaking to that.
[00:44:36] So you mentioned the struggles you had with -- I think before we started recording, you mentioned that this breastfeeding journey and some of the struggles that you experienced really informed the work that you do with nursing support groups. Do you want to speak at all to that?
[00:44:52] Simone: Yeah, for sure. So even though I was already a mom and a La Leche League leader and all these different hats in the birth community, like I had said my knowledge of like tongue ties and different issues that come up with breastfeeding didn't really like my own personal journey kind of catapulted me into researching and really understanding how tongue ties, lip ties, supply, all of that can unfold.
[00:45:17] So I will say like 85% of the babies I see postpartum. There's a level of a tie there. And baby may not be transferring well, and mom's supply might be questionable, but I think it's beautiful to see like -- Let's do body work. Let's do some suck training. See if baby can get stronger, you're pumping to help, you know, your supply be maintained and let's ensure, hopefully, that the supply continues to stay up.
[00:45:44] I tell parents all the red flags to look out for, for long-term, especially if things are on track. But sometimes, unfortunately, tongue ties, like let's say, mom has an oversupply in the beginning. That can mask a tongue tie.
[00:45:54] Or I've seen parents where baby was gaining well initially, because mom was nursing on demand, but they're sleep training now. They're sleeping 12 hours at night and now supply and weight gain is not good. So I talk to them about all these realistic different approaches to sleep and life and feeding around the tongue tie and anything else from like, you know, if your thyroid is messed up, that can impact supply. Anything with hormones can impact supply.
[00:46:19] It's so interesting, all I've learned over the years from like your cycle being irregular and estrogen levels and all of that. So it's more than just let's get a perfect latch. Let's just change that position. And really allowing you to dig in deep and really look at the big picture.
[00:46:34] I feel like in my head, I always felt like, okay, I want to become an IBCLC. And I was definitely working on it already when I had Malakie, but it just kind of pushed me even more to be like, okay, I gotta do this.
[00:46:49] Lisa: Great. So is there anything else that you wanted to share before you share a little bit more about the work you do just in case anyone didn't hear your first story or see our IGtv chat. I'd love for you to talk about that again, but any other insights you wanted to share?
[00:47:03] Simone: I think I kind of said it on the first one. Like just the idea of "you can hire and fire any of your providers." If you don't like someone, if you don't feel heard by someone, you don't feel respected, honored, and listened you can go to someone else. There are always other options.
[00:47:24] You don't have to tolerate something because they're your aunt's or your best friend's provider or everyone in your family birthed at this hospital, or like just common things you tend to hear in the community about why someone sticks with someone, even though they're also saying, "I didn't like this when this happened, or, you know, I don't like this hospital and it's just like really be an active participant in your birthing journey.
[00:47:48] Lisa: Well, as we wrap things up, could you please just tell us one more time about the nursing support work that you're doing and any other work that I would love to just amplify?
[00:47:58] Simone: Yes. So I am currently leading Chocolate Milk Cafe meetings. We have a handful of other lactation specialists for the Brooklyn location. This is a breastfeeding support group specific for those identify as Black. And we've been active for two years now. There's a Harlem location, there's a Newark location.
[00:48:18] We are expanding. We've just become national in the last couple of months. And I'd also do La Leche League. They're both once a month meetings depending on the location, but because there's so many locations you can usually find something at some point. And then I'm doing in-home visits when absolutely needed because of COVID.
[00:48:37] It's just unfortunate virtual doesn't give you all you can do depending on the situation and in the new year, just plan to put up my new schedule for everything once I know what's going on.
[00:48:47] Lisa: Sure. And right now I assume your nursing support groups are virtual.
[00:48:52] Simone: They are virtual. Yeah. So on the websites are the links.
[00:48:57] Lisa: Great. Yeah. So anybody anywhere potentially could join, but ideally find your local chapter so that you're developing those relationships so that eventually we'll be able to be in person again and really have the face-to-face support and connections. Yeah. I'm really excited about the work that you're doing and that Chocolate Milk Cafe is doing. And again, I'll be sure to link all of that stuff in the show notes. Great. Well, anything else?
[00:49:24] Simone: That is all. I was working at Methodist this year and I'm actually starting again in January. So that's why I have to like rethink the schedule, you know, but on average, that Chocolate Milk is the first Friday of every month, 5:30 to 7. And La Leche League is the first Tuesday of every month.
[00:49:43] Lisa: First Tuesday of every month; great. Well, thank you so much, Simone. It's been wonderful to hear this beautiful second birth story
[00:49:49] Simone: Thank you for allowing me to share.