Paci to Soothe
I have a 2 week old infant girl, who was born with an ASD and a VSD (heart murmurs), but she feeds like a champ. Recently, she spends about 30/45 minutes on each breast as a feeding session, but towards the end of the 2nd breast - she literally knocks out. The minute I break her latch, all hell breaks loose. I put her back on, she falls immediately back to sleep - to the point where milk is just sitting in her mouth, even at time coming out of her nose. I've tried skin to skin to calm her and it doesn't work, it's like she needs something in her mouth in order to calm her.
The NICU nurse gave us a soothie paci and mentioned that she had noticed that even taking almost 4 ounces (at 5 days old) that she was still needing something in her mouth. And asked if she could use the paci, because even when she gave her expressed breastmilk, she wouldn't drink it, and just let it sit in her mouth.
I started using the paci yesterday to comfort her during these times, she'll suckle on the paci for a few seconds and just leave it in her mouth, but the minute it falls or leaves her mouth, she wigs out. There is no nipple confusion, but I want to know if I'm doing the right thing? I've tried different methods to soothe her, but unless there's something in her mouth, she won't be happy. Two days ago she was on both my breast for 3hrs straight, and she almost choked on the milk just sitting in her mouth.
Any suggestions would be helpful!
Re: Paci to Soothe
Most guidelines say to wait at least 3-4 weeks before introducing a pacifier. Babies suck differently on pacis than they do on the breast, and sometimes that can mess up their willingness or ability to latch. Another potential problem is that if a baby gets her sucking needs met by a paci, she may not nurse as often as she should. That's not to say you must not use a paci- it's just to point out the potential drawbacks.
Is baby ever content to be on you, but not nursing? Like if you wore her in a sling or wrap or something? A lot of babies just hate being put down.
Re: Paci to Soothe
She turns 3 weeks this Thursday, and she shows no signs of nipple confusion, she knows her mommas boobs! Lol I've tried wearing her in the sling, and still she needs something to suckle on. She even has little tiny hickies on her wrist.... Someone suggested to me to teach her to use her thumb, and she puts her whole fist in her mouth, she won't suck on it, but just leaves it in her mouth.
Re: Paci to Soothe
Wow, sounds like she has an extra strong desire to suck! Since she's already almost 3 weeks, and isn't showing signs of nipple confusion, and is getting plenty to eat, I would keep on using the paci. Just be a little extra careful with it. Make sure she doesn't go more than 2-3 hours during the day without nursing, and keep a more careful eye on diaper output. Just for the next could of weeks.
Don't worry about "teaching" your LO to suck her thumb- she'll doubtless figure that out on her own, around the time she discovers how to control her own hands and feet. For my kids that happened in the 3-5 month window. It was like "Hey, what the heck is this amazing thing at the end on my arm? OMG, did you know I can put it in my MOUTH?!!!"
Re: Paci to Soothe
I assume weight gain is on track? Sometimes babies with heart issues have slow gain.
Also does baby receive any bottles at this point? Have you seen a lactation consultant to be sure baby is able to nurse well and transfer milk effectively? The not swallowing sounds a bit odd to me. Sometimes constant nursing signals an issue with milk transfer. Sometimes a baby is nursing more than 'typical' becasue that is how that baby gets enough milk.
It is normal for a very young baby to want to nurse/suckle pretty much all the time. This need to suckle does not have much to do with how full baby's tummy is, as far as the most recent research/theorizing indicates, it is a hormone based command that has a clear species survival purpose-a baby who asks to be suckled pretty much constantly will be held by her mother pretty much constantly, and will stimulate her mommas milk production very well. A baby who is held by her mother pretty much constantly and brings in a great milk production is the baby who is going to survive even in harxsh conditions. (Because biologically, today's baby is no different than a cave baby who would die vey quickly if left alone by mom.) If you take that theory out to your situation, doesn’t it make sense that your baby, born with health issues, and probably NOT allowed to nurse as much as baby 'wanted' while baby was in the NICU, would feel compelled to nurse even more than the typical newborn? This part is just musing...but I know both my babies who were born a few weeks preterm needed to suckle more often in the early weeks than my bigger, full term baby.
She is still very young. This intense need to suckle will almost surely ease up as time goes on. Assuming weight gain is on track, nursing her as much as she likes is not really a problem for HER. I understand it may be a problem for you but I am not sure which you are concerned about.
Nipple confusion: Some babies go back and forth from bottle to breast to paci no problem. Others do not. There are two types of nipple confusion as the term is generally used. 1) is that the baby develops poor nursing habits when given anything besides the breast to suckle...poor latch, clamping, weak suck, etc. This can be watched for and if latch or milk intake becomes an issue, the pacifier use can be curtailed. The other is baby begins to refuse the breast or seem to "prefer" the bottle or pacifier. This is a more insidious but possibly even more problematic issue. Both can be a big problem, which is why there are so many warnings about this.
When it does occur, nipple confusion is not usually something that happens overnight. Many a two week old baby shows “no sign of nipple confusion” and then is not nursing at all by two months. It is something that builds over time. Comfort nursing is entirely normal and an important part of breastfeeding. So a baby who is trained away from comforting at the breast via pacifier use may well develop so called "nipple confusion" over time.
This is why I do not really hold with the "One month” rule or “6 week” rule for introducing pacifiers (or bottles.) Although I would never recommend it,the fact is, some babies do fine getting a pacifier from day one. With others, the pacifier can be introduced months down the line and still cause lots of mischief.
Instead, I basically agree with mommal-if you are going to introduce/keep using the pacifier, know your baby. Know what is normal and healthy in terms of breastfeeding frequency and duration of feeds, and know why you are using the pacifier and do so judiciously. Using a pacifier as a PACIFIER (rather than as a suck training aid, for example) in a breastfed baby is (almost) always for the parents benefit, not the babies. There is nothing wrong with using a pacifier for the moms benefit, in fact, it can really help in some situations. But it is important to remember why a pacifier is being used, so it is not over used.
In your case, assuming growth is normal and baby is getting plenty of milk, giving yourself an occasional break with a pacifier even early on is probably less likely to be a problem because overall, you are welcoming your baby to the breast and letting her nurse as much as she likes. You are not discouraging comfort nursing and you are making sure your baby gets enough milk and your breasts get the stimulation they need to make enough milk for your baby. On the other hand, someone who is told to use pacifier because baby 'just ate and can't be hungry again" or should 'only eat for such and such a time" and consequently, baby does not comfort nurse (or nurse overall) enough, may well run into problems.