Nipple shields question

[houseof3boys]

I am frustrated with my breastfeeding situation but after reading through some posts from the last few months I know you guys can give me some help. Little Ryan was born 5 days ago and we had lots of difficulty with his latching on in the hospital. Saw 4 different LC's in the 48 hour stay and got a lot of help with nipple shields, then weaning from the nipple shield, then with how to wake our extremely sleep slighlty jaundiced baby. The morning of discharge the pediatrician came in and started giving pressure to supplement as Ryan's weight had dropped almost 10%. The LC was there at the time and tried to help us by observing his latch and giving her opinion on how successful he would be to avoid the supplementation. I was firm in my stance and said that I was devoted to the cause and that I would do whatever it took to continue the breastfeeding relationship I had busted my you-know-what over for the past 48 hours. Well, when we got home it got worse and since it was the weekend was difficult to get a LC on the phone for consult. I broke out the PIS (thank goodness I had just gotten it Fed Ex the day before I went into labor) and started pumping and crying because we knew Ryan had to eat. My husband gave him a bottle and we continued this for the last 12 (something like that) feedings. Well when I talked to the LC today and explained she said that I needed to get him back on the breast because he was obviously feeding well from the bottle and she was sure his weight "problem" was remedied enough to satisfy the pediatrician. Now he has huge nipple confusion and my breasts are painfully engorged (perhaps to dilligent with the Mother's Milk tea for those days in the hospital). It has been 2 feedings so far and lots of screaming at the top of his lungs. He wants that perfect and easy bottle nipple! We got the shield out and finally got that to work. I have tried to get him to latch on directly to the breast but he is being lazy and won't give it the old college try despite my patience and praise in my happiest voice. My nipples are killing me with that darn shield. I will endure the pain of course but until we can successfully get him latched without the shield I need help! He weaned once in the hospital off of the shield so I can only be confident that he will persevere and do it again but I can't get him to open wide enough over that shield so that the excrutiating pain eases up.

I cried while reading some of the posts from March and April so I know you guys are experts and the consoling for the other people consoled me and gave me hope. Momof3labs you seem to be the nipple shield queen...any thoughts? Anyone?

[jd11365]

Hang in there! It is very normal for them to lose weight in the beginning...My DD lost a half pound when she left the hospital. I personally never had pain from the nipple shields, but the pump seems to bother me...could you be sore from the pump? Also, I don't know if you've got any Lansinoh cream for your nipples, but that was a help for me in the beginning. You're going to get there...he's done it before, and he'll do it again...you're a champ...your son is lucky to have a mommy who is making such effort...good luck!

[heytootsy]

I went throught the same thing, and I know how frustrating it is, but DO NOT give up!!! DD was born 3 weeks early and weighed 6 pounds 3 ounces. She was a lazy little lady, and would just not latch on. I also opted for the nipple shield, which made a world of difference. When we took her back to the doctor 5 days after birth, she weighed 5 pounds 10 ounces and also had jaundice. She was still having problems latching on, but would take the bottle and use the nipple shield. I was so encourged, it hurt like crazy. I was so frustrated and ready to give up. I was even going to order the most expensive pump I could and overnight just so I could relieve myself. Then I shook my head and came to my senses. I gave up the bottle because that was something I did not want to continue, and for the next week tried to nurse. Once she got plenty using the shield, I pulled it off and tried to get her to nurse naturally. At first, it hardly ever worked, but I wanted her to get the feel of my natural nipple. After a few days, she was getting the hang of it. By the time she was 2 weeks old, she was a pro!!! If you have to use the shield for a while, don't feel bad, and don't feel like you have to give it up just yet. It's hard for them to latch on when you are so engorged. Try to stay away from the bottle if you can, as not to confuse her too much. It will work - I am convinced the first week of breastfeeding was harder than my labor and delivery, but it gets better. I should also note that at her 6 week check-up, she weighed 11 pounds!!! And she lost more than 10% of her weight. She is now 3 months and 14 pounds, so don't get too hung up on that, she will gain, jaundice will go away, and you both will love breastfeeding!!! Good luck

Christine

[C99]

I agree -- don't worry about using the shield for awhile -- you can always wean him from it later. Remember that the little guy has had a lot to learn in the past few days...

Also, using the shiels shouldn't hurt -- you may have a clogged duct or thrush.

[Momof3Labs]

Uh oh - the nipple shield queen? Probably. But I'm definitely not the queen of weaning from nipple shields!

First, let me say, believe it or not, that the worst is likely behind you.

Second, I'll tell you my story but wanted to start it by saying that we are still exclusively bf'ing (plus solids, since 6 months) and Colin hasn't had a drop of formula since he was 3 days old. So even though our start was VERY rough and we have used the nipple shield this whole time, nursing has been a success for us - and will be for you, too.

Colin was born in the wee hours of a Saturday morning to an overflowing maternity ward. He latched on early, but wouldn't suck. The nurses said that he was just tired from delivery - wait and try again. The same thing kept on happening. I finally got the attention of the *one* lactation consultant early Saturday afternoon for a few minutes, and wouldn't you know it, Colin nursed fine when she was there. He fought it a bit, but did his best. Things went downhill from there - he wouldn't suck, and did a lot of screaming. The night nurse said that we needed to start him on formula via a SNS, so we did. He was much happier, but feeding became a huge ordeal. The nurses didn't help me - all they did was yell at me for not feeding him every two hours, but they did nothing when I showed them that he wouldn't suck. The lactation consultant wouldn't be back until Monday - the day we were discharged.

So, we had a very rough time in the hospital. Lots of screaming (Colin) and crying (me), although he would occasionally nurse fine. When we finally saw the LC on Monday, go figure, Colin nursed okay in front of her - still fighting it, but okay. And she completely disregarded what I told her about his nursing over the weekend.

We went home to more of the same, except my milk had come in, so I pumped (thank goodness I had ordered my PIS early) and we gave him EBM via the SNS. Finally he refused that, too, so we went to finger feeding. We did break down in the wee hours one morning and give him a bottle, but tried hard to stick to the finger feeding.

All this time we were talking to two different lactation consultants who gave us lots of advice, none of it worked though. By day 5, Colin had dropped 9% of his birthweight, so our ped wanted us back on day 7 for a weight check.

By day 5, I was such a mess that I had decided to pump and bottle feed. The hospital LC talked me out of it - she asked me to come in for one last try. I agreed only because it would either work or not, right there, so Colin didn't have to go through another day of hunger trying to make something work.

So, we went in and tried the nipple shield. Colin latched right on and nursed like a champ - and he has done so ever since. By day 7, his weight was up 3oz from day 5.

I was warned about supply issues from using a nipple shield, but have not had any problems at all.

Now, my thoughts for you:

It is important to position it properly, with your nipple in the dead center of the shield. Nipple shields should NOT hurt. But latching problems will hurt, with or without a nipple shield. If I were you, I would focus on getting Ryan nursing properly on the shield for now, and worry about weaning in a few weeks, when he is less sleepy and less at risk for weight and jaundice problems.

To get him to open wide enough, you need to do more than talk to him - use your finger (or DH's, since you already have your hands full) to pull his lower jaw down when he latches on. If he slips to the end of the shield, break the latch and put him on again. He should get the hang of this pretty quickly - a LC can help you with his latch, too. You might try nursing in a different position, too. Football hold and cross-cradle hold are my two favorites.

In the meantime, use Lansinoh and Soothies (little frozen pads that you can get at BRU and put on your breasts to ease the pain).

I'm attaching a link from Medela's site on nipple shield use - pay attention to the pictures showing the positioning of it.

http://www.medela.com/NewFiles/nipshield.html

Good luck, and hang in there - if you want to talk, e-mail me at [email protected] and I'll send you my phone number. The first days of nursing can be VERY VERY tough, but it sounds like you are through the worst and WILL be successful nursing Ryan!

Congratulations, too, mommy!!

[Karenn]

It will come together! Hang in there! It does get better, and when it does, you'll most likely love it! I don't have much advice, but just wanted to mention a couple of things from my experience when I was having trouble in the beginning. My hospital had the same system where you could call the lactation office for a phone consultation. In retrospect, I wish I would have shelled out whatever money was necessary to see a LC in person. That way she could have looked at Colin's latch and figured out right away what the issue was. The phone is good for some things, but not for helping a baby latch on. Also, while it was great to have a lot of LCs available, I found that they all gave slightly different advice and I had to start from scratch with each one of them. I finally had to pick one that sounded the most on target and ask to speak with her each time.

Sorry, I know nothing about nipple shields- but I did want to offer my support! Good luck.

[stillplayswithbarbies]

First I want to say congrats on standing your ground and not allowing the doctor to talk you into supplementing! That is something you should be very proud of.

My daughter was very lazy about breastfeeding at first. Part of the problem was that her mouth was very small and my nipples are large and we just didn't seem to fit together very well. Be assured that it will get easier as he gets bigger! I think it also was that she was such a sleepy baby and nursing is such hard work.

I can't add anything to the excellent advice momof3labs gave you, but I did want to say that you are not alone and that you are doing a great job as a mom, and please keep working at it, it gets easier!

You might find this site useful:

http://www.kellymom.com/bf/concerns/back-to-breast.html

...Karen
Jacob Nathaniel 2/27/91
Logan Elizabeth 3/25/03

[houseof3boys]

Thank you so much for everyone's posts. Well the dr. visit this morning shows no weight loss or gain from my hospital discharge so we go back in 2 days for another weigh in. I am still trying my breast first then the shield after about 3-5 minutes depending on the severity of the screaming he does after trying the breast. I think I may have been sore from all of the pumping. I have been dilligent about putting on the Lansinoh cream (even when pumping) so that should be working soon. I am also starting to leak like crazy now so he doesn't have to work that hard to get the milk through the shield. By tomorrow he and I should have some of the challenges of the engorgement down as well. I was pumping way more than he was eating so I think the milk supply was adjusting accordingly and now I just keep changing breast pads every hour as they fill up. He is great on the shields and vigorously sucks for 10 minutes each breast. After the doctor left the room this morning, he even did the left one twice. I find football and cross cradle are the best holds as well. I am so much more relaxed about the nipple shields now too. The LC's just kept warning me about not using for more than a day or two but I think we will be just fine. You know how panicky things can be at 4:00 in the morning when things get challenging and everything runs through your head about the "right" thing for your baby. I am packing up the PIS (for use at a later date) and we have already packed up the empty bottles !

Ryan and I both thank everyone for their encouragement. I won't be such a lurker on these boards now!

[sparkeze]

You may want to continue to pump after nursing sessions to make sure your supply doesn't go down. If after a month or so he's still gaining like a pro you probably don't have to worry about your supply. He should be weighed weekly during the first month too.

My schedule during the first month went like this: nurse w/shield for 15-20 minutes, pump for 10 minutes on each side. I just saved all the milk I was pumping in the freezer. I was also squirting some EBM into the shield with a syringe so that DS would have something to eat and entice him to continue sucking until letdown. Does he suck on a dry nipple shield until the milk lets down? How is he with that?

I also agree that using a nipple shield is not a bad thing. I wouldn't have been able to continue BF without it. In my own experience and from what I've heard form some other moms, babies seem to outgrow the need for it - then it's a matter of breaking the habit, but it gets easier to latch babies on to the breast when their mouths get a little bigger. Is it easier to nurse w/o a shield? YES! Way more convenient and simple! But babies do wean off them - mine did when he was 5 mo and I have no regrets whatsoever that I used a shield.

And you shouldn't be having pain while nursing with a shield. With me, I had bleeding, cracked nipples and when I started using the shield it wasn't painful to nurse on them at all. If it's the pumping that's causing sore nipples - do you have the suction turned all the way down on the pump? Pumping shouldn't be painful either.

I think the best thing you can do is get good at nursing with a shield. Once you have the hang of it you can start trying to wean off it. You have enough stuff to worry about this early in the game!

HTH!

[houseof3boys]

The update:

Have been able to nurse twice on the left side without the shield! I just keep trying everytime I nurse to see if he will latch without it and we are encouraged about the whole thing now that we know he can do it. My milk is now leaking profusely so it is very easy for him to latch on with the shields since milk is collecting in that minute that it takes me to get him on after I put the shield in place. The nipple pain seems to be getting better and the bleeding and cracking is healing up nicely. Gotta love that Lansinoh! He gets weighed again tomorrow morning at the doctor so we shall see where we are with that.

Thank you again everyone for your encouragement with everything. I don't feel the slightest bit bad about using the shields anymore since so many people have experienced this.

[jubilee]

as you probably know, I have had this problem too. I am praying for your breastfeeding success!!

[Rachels]

Nope, good for you for doing whatever helps you nurse! I used shields for 4-6 weeks, on the advice of my amazing LC. We would never have been able to nurse otherwise, and I was SO grateful. I am still breastfeeding almost 13 months later and am just so glad that I found a way to do it.

One other thing that can help is to use the shield for two minutes or so, then slip it off. Often the baby will latch back on to the breast nicely, because he's used to nursing and your nipple has been pulled out well. Worth trying. But be patient. As he grows and gets more coordinated, he'll be able to do it on his own.

-Rachel
Mom to Abigail Rose
5/18/02