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Thread: Nipple Shield/Latch Problems

  1. #1
    Join Date
    Sep 2011
    Posts
    13

    Default Nipple Shield/Latch Problems

    My baby is having problems latching on and has had these issues since she was born. She was born at 6 lbs 10 oz, but by her first pediatrician visit the day after we left the hopsital, she was at 5 lb 14 oz. The nurse at the hospital suggested a nipple shield by medela which I tried again once I got home and it seemed to help. My baby is wetting more than 6 diapers a day and having at least 5 bowel movements, but she is not gaining weight at a normal rate. She will be two weeks old tomorrow but is only at 6 lb. 4 oz. as of today. My pediatrician wants me to ditch the nipple shields ASAP, and supplement with pumped breast milk 3-4 times per day. She has nursed a few times with out the shield (in the presence of a lactation consultant) but I never feel like she sucks as much or gets as much with out the shields. The lactation consultant said there is nothing wrong with my nipples and is unsure why I was given the shields in the first place. Unfortunatley our hospital did not have lactation consultants on staff. I had to see them separately after we were home. She seems to be satisfied, yet she's not gaining weight. If she's not up to her birthweight by Tuesday, the pediatrician said we may need to give her some formula to get her growth up. I'd really like to avoid this, so any help anyone can offer to help me get her off the dumb shields and nursing appropriately would be REALLY helpful. At the next feeding I may try pumping for two minutes to stimulate let down and then try to put her on the breast without the shield. Wish me luck and please send recommendations!

    Thank you.

  2. #2
    Join Date
    May 2006
    Posts
    20,799

    Default Re: Nipple Shield/Latch Problems

    Welcome and congratulations on the new baby! If she is producing the right amount of wet and poopy diapers and is gaining weight (even if that weight gain is slower than you want), you know that things are going right on a basic level, and while you may need to tweak things you are not in deep trouble.

    The first thing I notice from your post is that your baby lost nearly a pound between her birthweight and her lowest weight, which I presume was taken when she was 3 days or so old? That is a very large weight loss for a newborn, and there are 3 potential explanations:
    1. She wasn't nursing well and the weight loss was real.
    2. There was a significant discrepancy in calibration between the hospital scale and the pediatrician's scale.
    3. The scale was accurate and the weight loss was real, but the baby's birth weight was artificially inflated- this could be the ce if you had IV fluids during your birth, particularly if you had them for a long time.
    If your baby wasn't latching, wasn't producing adequate diapers, or wasn't passing her meconium, then #1 might be a good explanation for what was observed. But if she was latching on, was producing the right number of diapers, was voiding her meconium, or if you had a lot of IV fluids during birth, then #s 2 or 3 might be better explanations. Basically, what I'm trying to say is that your baby may have reached her birthweight already- it's just that her birthweight as recorded may have been off from what the pediatrician's scale indicates. Does that make sense?

    That being said, shields can sometimes cause problems and it is probably a good idea to at least try nursing without one. This link talks about shields and how to ditch them: http://www.kellymom.com/bf/concerns/...an-shield.html

    So, let's say Tuesday rolls round and your baby hasn't yet gained back her birthweight. What are your options? Here's what think they are:
    1. Supplement with pumped milk. It has more calories per oz than formula and pumping will prevent your milk supply from decreasing if you must supplement.
    2. See a lactation consultant, preferably an IBCLC, for help. If you must supplement, you want to do it in a way that is most conducive to keeping your baby on the breast, and a good LC should be able to help with that.
    Coolest thing my big girl said recently: "How can you tell the world is moving when you are standing on it?"
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  3. #3
    Join Date
    Mar 2006
    Posts
    10,440

    Default Re: Nipple Shield/Latch Problems

    Quote Originally Posted by @llli*mommal View Post
    Welcome and congratulations on the new baby! If she is producing the right amount of wet and poopy diapers and is gaining weight (even if that weight gain is slower than you want), you know that things are going right on a basic level, and while you may need to tweak things you are not in deep trouble.

    The first thing I notice from your post is that your baby lost nearly a pound between her birthweight and her lowest weight, which I presume was taken when she was 3 days or so old? That is a very large weight loss for a newborn, and there are 3 potential explanations:
    1. She wasn't nursing well and the weight loss was real.
    2. There was a significant discrepancy in calibration between the hospital scale and the pediatrician's scale.
    3. The scale was accurate and the weight loss was real, but the baby's birth weight was artificially inflated- this could be the ce if you had IV fluids during your birth, particularly if you had them for a long time.
    If your baby wasn't latching, wasn't producing adequate diapers, or wasn't passing her meconium, then #1 might be a good explanation for what was observed. But if she was latching on, was producing the right number of diapers, was voiding her meconium, or if you had a lot of IV fluids during birth, then #s 2 or 3 might be better explanations. Basically, what I'm trying to say is that your baby may have reached her birthweight already- it's just that her birthweight as recorded may have been off from what the pediatrician's scale indicates. Does that make sense?

    That being said, shields can sometimes cause problems and it is probably a good idea to at least try nursing without one. This link talks about shields and how to ditch them: http://www.kellymom.com/bf/concerns/...an-shield.html

    So, let's say Tuesday rolls round and your baby hasn't yet gained back her birthweight. What are your options? Here's what think they are:
    1. Supplement with pumped milk. It has more calories per oz than formula and pumping will prevent your milk supply from decreasing if you must supplement.
    2. See a lactation consultant, preferably an IBCLC, for help. If you must supplement, you want to do it in a way that is most conducive to keeping your baby on the breast, and a good LC should be able to help with that.
    The weight differences have me . That's such a big difference that I'd be wondering what was going on too. I'd wonder if the hospital scale and the ped's scale are at all similar; I actually ran into this a bit with this last baby, when everybody was worried about his weight gain at the beginning.

    When you go back to the doc, make sure baby is weighed on the same scale and is dressed the same way (or naked). Then figure out how many ounces she has gained between appointments. 4-7 a week is what you are shooting for; since it will only be a few days since your last appointment, even a couple are good.
    http://www.askdrsears.com/topics/bre...weight-will-my
    Susan
    Mama to my all-natural boys: Ian, 9-4-04, 11.5 lbs; Colton, 11-7-06, 9 lbs, in the water; Logan, 12-8-08, 9 lbs; Gavin, 1-18-11, 9 lbs; and an angel 1-15-06
    18+ months and for Gavin, born with an incomplete cleft lip and incomplete posterior cleft palate
    Sealed for time and eternity, 7-7-93
    Always babywearing, cosleeping and cloth diapering. Living with oppositional defiant disorder and ADHD. Ask me about cloth diapering and sewing your own diapers!

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