Weaning off nipple shield
Hi, I'm on Day 2 of trying to wean my 8-week-old off the nipple shield. Two problems...
PROBLEM 1: I am getting very sore! I think his latch is wide/deep enough, but it almost feels like he's "biting" me with his gums rather than just sucking. The soreness seems as much, if not more, in the area around my nipples, as opposed to the nipples themselves being sore. I still have to compress the breast that he's eating from so he doesn't slide off and end up biting on the nipple itself... by the end of 15 minutes on a side my hand gets pretty numb... It's also hard for me to distinguish pain from our breastfeeding sessions from pain that I think is being caused by my nipples chafing on the sides of the breast pump shields.
PROBLEM 2 (not nec. related to weaning from nipple shield): The amount of milk I'm able to pump seems to have gone down, and I've had to rush home from work three days in a row b/c he drank all the milk I'd left for him. Now I can't even seem to get enough stored up to fill a bottle so I can go back to work. I used to be able to pump 4-6 ounces in a session. My breasts were huge and hard, which was a big part of his latch problem. Now they are very soft, which is the reason he can latch without the shield.
BACKGROUND: I have flat/inverted nipples, and my baby was small at birth. It took us 5 weeks to work out latch issues and get him breastfeeding with a nipple shield (did pump-and-feed with short nipple shield sessions for the first 5 weeks). Then we had 2-3 good weeks of breastfeeding with the nipple shield, and now I'm trying to wean him off of it. In general it's going well - he feeds for about 30 minutes with about an hour-and-a-half break between feedings and doesn't fuss. Scale (weigh-feed-weigh) says he's getting about 2 oz per feeding.
Re: Weaning off nipple shield
Problem 1: No ideas on how to fix this now, but I hope someone else will come up with some! At the very least, the situation should improve as baby gets bigger and stronger, and has less of an issue holding onto the breast without you having to compress it throughout the session.
Problem 2: 4-6 oz is a greater than average amount to be pumping at one time. It's not reasonable to expect production to continue at that level for a significant amount of time. If you're having trouble filling your baby's bottles, here's what to do:
1. Make sure you're leaving a reasonable amount of milk- about 1.5 oz per hour of separation.
2. Make sure your caregivers aren't overfeeding the baby. If they are significantly exceeding that 1.5 oz per hour standard on a regular basis, it's time to have a talk with them about things like paced feeding, using comfort measures other than a bottle to meet baby's needs, bottle size, the difference between breastmilk and formula, etc.
3. Make sure your pump is in proper working order and that your shields are properly fitted. You may have gone up/down a size since the engorgement went away.
4. Pump more often, and/or for longer time periods. (Pumping more frequently is usually better than pumping for longer.). If you aren't able to pump often enough at work, add in post-nursing sessions at home.
5. Consider using a better pump. If you're using a manual or single electric pump, get a double electric, preferably a good one.
6. Encourage baby to nurse more often when he's with you. More nursing often translates into better pump output.