My granddaughter is now 12 days old. She's growing like crazy and sleeps for 6 hours or more at a time during the night. The only problem that my daughter has with her is that she refuses to nurse without the nipple shield. My daughter has a pretty large chest and relatively flat nipples. Is there anything she can do to get the baby to nurse without the shield. It's fine while she's home with her but she doesn't want to try to feed her in public. It takes too long to put on the shield and get the baby latched on. Any advice. Kathi
I used one because of really bad nipple pain while working to correct Jenny's latch. I worked real hard to only use it to get baby latched on, once she was latched and the letdown started, I'd pop her off and remove the shield and latch her back on as fast as possible. If she absolutely refused to latch back on, I'd try the shield again, and repeat the removal process. It only took one weekend to break the habit. I already had low supply, and she already had a bad latch, I didn't need the shield making it worse. I had been advised to gradually trim away the edges of the shield, but that doesn't work with the clear silicone ones like I was using, it made the edges too sharp and I was afraid it would cut baby's mouth. edit - is it possible your daughter has overactive letdown, and baby has decided to prefer the shield because it slows down the milk delivery? There are lots of things she can do about that if that's the case.
Some mamas do better with the sheild. Eventually, they nurse one time without it, without realizing it, (usually in the middle of the night) and then don't need so much anymore. Some babies and mamas use the sheild for months, I have seen a few dyads use them for more than a year. With the newer, silicone, thin sheilds, the nipple is still stimulated, and it doesn't reduce production like the old rubber ones used to. She is going to have to learn that she CAN nurse in public, but it will take some time. Also, the sheild is OK, as long as she is keeping it clean (DON'T USE antibacterial soap on it, it is a major cause of yeast infections, plain soap, or a run through the "clean bag" from Medela in the microwave is the best way to clean it, and they do need to be cleaned several times a day. Most mamas get a few of them as they can get lost ect.) she can continue to use it, as long as the baby is being weighed by an LC, and they are otherwise nursing well. Some mamas nipples tend to take longer to enlongate. She'll be OK with the shield for now.
Where can you get a nipple shield. I have a 10 month old nurseling and he is occasionally biting. Would this help with that? Or is he a little to old?
He's too old. Nipple sheild at his age would only confuse him, cause MORE biting and are not thick enough to prevent you from feeling it. Nipple sheilds are meant for severe latch difficulties and for premies who cannot get the nipple and areola far enough into the mouth to sucke. They are not meant to "protect" the nipple. A biting baby does this for many reason. Teething, nipple confusion, frustration at being not given the breast often enough or quickly enough, or simply falling asleep and "clamping" on you, so he doesn't fall off. Teething: Treat the teething, let him chew on teething toys and use Motrin or Hylands Homeopathic teething tablets. Take him off the breast if he bites, for a few seconds. DO NOT yell. Also, rubbing the gums BEFORE you nurse can help with the tingling that babies feel when they have suction on irrtated gums. Don't use a "numbing" agent close to a breastfeeding time, it may prevent him from feeling your areola and cause more biting. Numbing agents should only be used with caution, and AFTER a feeding, if you know the baby will not be asking to nurse in the next hour or so. Most babies, however, hate this stuff. Nipple Confusion: this occurs in an older baby when they assume the bottle or pacifier is the same as the breast. They are often biting on the bottle nipple or the paci and no one says anything, so they think it is OK to bite the breast. Soluition: Eliminate the bottle, unless it is an absolute neccesity. Reduce paci use, for time when you absolutely cannot be there, like in the car. Don't let babies sleep with pacis, Use your breast. If the bottle is neccesary (say you are working or schooling outside your home and can't bring him) tell the person who takes care of him to gently say "Ouch, that hurts." If he bites the bottle or paci. Then remove it from his mouth, using the finger tecnique for breastfeeding babies. This usually helps. Frustration: Attempts to wean a baby before the baby is ready can cause frustration. Some babies will bite out of frustration, or becaues they don't want to be taken off the breast. Solution:Nurse on Demand. Don't "wean" the baby. Let him decide when to wean on his own. Sleep "sliding": Some babies will clamp down on the breast, as they slide down, as they fall asleep. They wait until they get right to the bulb of the nipple then BAM, BITE. Solution: Babies cannot nurse and bite at the same time. Your baby HAS TO pull his tongue in before biting. Make sure you know when he does this, and get your finger in his mouth, so he can't bite. I used to put my finger RIGHT between the back gums, so I would stop the biting. Fun: Some babies think it is funny to bite, once they get a scream out of you (other babies actually will go on a strike because the scream scares them) I had one baby who did this. I would put her on the floor for just a minute, say, "Moon, no biting mama, that HURTS." And them pick her up and let her nurse again. I also learned to put my finger in before the biting, like in the Sleep Biting. Never yell at a baby for biting (although something screaming is beyond your control.) It is a fallacy that you need to wean a biting baby. I have worked with hundreds, may be thousands of biting nursing babies, in all situations, we could figure out why the baby was biting and stop it. Weaning is NEVER neccesary.
Ciencia was very tiny, only 6 pounds and she just couldn't get her mama's larger nipple in her mouth. So she wouldn't nurse much at all. And my daughter got extremely sore and cracked nipples. The day she was bleeding very badly is the day she bought the shield. With the shield she nurses great. My daughter is just worried that she'll never get her to nurse without the shield. I'll let her know what you and Maggie said. Thanks, kathi
It sounds like a reasonable reason to use the sheild, for sure. The baby and she will outgrow it, when they are both ready. When I first started practicing, I NEVER used sheilds with my clients. There were too many bad stories and even studies on the damage they did. BUT, the newer ones are SO different. I probably use them with about every 10 clients, now. Let her know she can use it as long as neccesary. And, if it IS Over Active Let Down (or over active ejection reflex) there are also other ways to manage it, but we do use sheilds with really tiny or preterm babies, as not only can they not get large nipples into their mouths, but they can't pull them far enough back to "milk the breast" properly and the sheild can stem the really strong flow, that can often turn a tiny baby, who isn't ready for a huge bolus of milk with OER, off of the breast. She should be OK. Just so she keeps in contact with her LC.
Here's an article I wrote about OER. http://www.hipforums.com/forums/showpost.php?p=2572058&postcount=2
Maggie, do you think that a sheild would help when I try to nurse my next baby? The LC showed me one, but wouldn't let me take it home. Leane had a PAINFUL latch...my nipples turned white and were cracked with blood at the ends. I'm trying to remember what the LC called it....i think that it was "road rash." But yeah, do you think that it's worth looking into with the next one if the same problems continue?
Jenny was really tiny too. 4lb2oz at her smallest. I could only nurse her in the football hold at first. besides the tongue-tie and tiny mouth, she hated when my milk started squirting in all directions. time fixed the tongue-tie (I couldn't find a doc to clip it), she outgrew the tiny mouth eventually, my nipple pain from having Raynaud's quit bothering me when I fixed my supply and thrush problems. ...and the squirting thing I helped by pointing my nipple at the roof of her mouth or latch her on a little crooked, so the milk wouldn't squirt down her throat. All of those issues (except the low supply) were helped by using the shield, but I was terrified by the stories of problems they cause and tried really hard to not use them except as a last resort. about nursing in public, suggest to her that she practice nursing in front of a mirror. I was really suprised by the fact that even my tiny baby covered most of the skin that I thought was exposed. I was very uncomfortable nursing away from home until I went out of town to visit relatives and had no choice. Boy was I suprised when nobody cared, not even at a crowded restaurant!
Kirsten, you don't want to use a sheild, unless you have been evaluated by an LC with your next baby. Without actually seeing the latch (on a baby who isn't born yet) I can't tell. But, often, problems that occur with the first baby don't happen with the second. Plan on seeing a GOOD private Practice IBCLC, RLC as soon as the baby is born. The hospital LCs are not always trained well enough, nor do have enough time for a full evaluation of a real problem. Most of them just grab the baby, grab your breast and mash the two of them together, and if the baby doesn't fall off, they put "latch successful" on theri chart. Some are quite good, but many are just overworked. I've seen them look at a baby and mama from the door of a hospital room, and yell "The baby's suck looks good." and then leave. *sigh* Obviously, this person cannot help you. Line up a private practice IBCLC while you are pregnant. Have her come and do a complete evaluation and training session (make sure she uses digital.oral exams, she has lots of expereince and she uses a good, electronic scale, as well as asks lots of questions about you, the birth, the problems you had the first time and the baby she is seeing) and most likely a Nipple Sheild won't be neccesary. But, there is usually no way we can know, ahead of time, who will need them and who won't. With the exception of preterm babies, (most of whome do need sheilds because their mouths are so small they can't compress the areolar tissue to obtain enough milk) you need to be seen by and LC to know if a sheild is something that will help. In many cases, a sheild can do more harm than good. So, wait until your next baby is born and do what needs to be done at that time.
Thanks maggie. As I have said many times before, that hospital LC I saw when Leane was born confirms everything you've said. When you mentioned the scale, I remembered something else....she wanted me to rent out the hospital scale for $100/week an a breast punmp for $50/week. I tried finding a way to get the fees waived, but guess what I was told? If the financial buren is that bad then just use formula. No fucking wonder I never figured it out. I found out that there are a few private LCs who work out of the birthing center here in the small town that I live in, which is where I'm planning on having the next baby. No more city hospitals, thankyou very much!
A lot of private practice LCs and even WIC can get you grant pumps. A scale for your home is rarely neccesary. Only in very unusual situation would you need the scale. The LC should have one, so pre and post feed weighs can be done at the Consultation, but there is hardly ever a reason a mama would need one herself. If your problem was over active letdown, a pump wouldn't be all that useful, as it would just increase an already strong letdown. Taming the letdown (as in the page I stickeyed above) is better than pumping. My guess is you had enough milk, or the ability to make enough, but Leanne got freaked out by your letdown and couldn't nurse properly. A pump isn't needed in this situation, but good lactation managment, by your LC, (setting up a good plan) and by you, by keeping an eye on your letdown and doing what you can to help the baby not get overwelmed, is the best bet. Most good LCs will let you come in and weigh the baby as much as she feels neccesary. Once we know the baby is getting enough, the weighings are not that important. You can tell how much the baby is getting by what is in the diaper. Good luck next time. Usually things go easier with the second baby. That is a hell of a lot of money. My pumps, in the USA, rent for between $55.00 per month, for the Lactina Select to $75.00 a month for the Symphony. 50 a week is ridiculous!
A while after she was born I learned about the birthing center here and all the breastfeeding support groups, classes, etc and weighing them and all that jazz is totally free. The reason why I was looking into the pump was because I never knew over active let down was the problem until you told me. The LC I saw told me I didn't have enough milk.
