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Thread: Nipple Confusion/Breast Aug.

  1. #1

    Default Nipple Confusion/Breast Aug.

    My now 3 wk old was in the NICU for 1 wk. I pumped the entire time and brought him my milk. I've since worked with him to try to bf. I've purchased a nipple shield which seems to work, but he will NOT take my breast if I slip the shield off and try to get him to latch. This was all fine for now, however, I've been having trouble keeping my milk supply up to his needs, I think due to an augmentation I had done 4 years ago. Has anyone on here had an augmentation and still had success bfing? I want to keep my milk as long as possible before I need to think about doing mainly formula...any suggestions on this? I've tried a lot of things and am willing to try anything to keep up my baby's health; all tips are appreciated!

  2. #2
    Join Date
    May 2006

    Default Re: Nipple Confusion/Breast Aug.

    Welcome, mama, and congrats on the new baby!

    First thing I want to do is suggest checking out this forum: http://bfar.org/ I think they may have some good information for you.

    Second, a few questions:
    - How much milk were you able to get when you were pumping? How many oz per day, how many oz per session?
    - Were your implants put in under the muscle, or under the areola? (Surgeries that sever all or part of the areola tend to be the ones that cause the most problems for breastfeeding.)
    - What sort of pump are you using?
    - How often are you pumping right now? Or are you just nursing while using the shield?

  3. #3

    Default Re: Nipple Confusion/Breast Aug.

    Thx for the congrats and the link. All suggestions are appreciated.
    To answer your questions, I generally get 2 oz if I pump at the 2-hr mark. I try to do this, but over the holidays at times it's been every 3 or 4 hours with guests at home. My implants are under the muscle; however, the doctor made my incision along the areola at the bottom. Might this have an affect? I hear of women talking of leaking and a "let down" feeling, and I've experienced neither. For pumping, I use a Medela In Style Advanced pump. As far as the use of the shield, I try to use the shield for most feedings. Usually, though, I have to supplement with a bottle afterward, as he unlatches and refuses to take more from the breast but still shows signs of hunger.

  4. #4
    Join Date
    May 2006

    Default Re: Nipple Confusion/Breast Aug.

    Thanks for answering those questions! 2 oz at the 2 hour mark with a PISA is decent output. Not super high, but not low, either! This link covers normal pump output (and also what to do to increase pump output): http://www.kellymom.com/bf/pumping/p..._decrease.html

    I think the likely cause of your decreased supply is the holidays and the fact that you were unable to stick to your pumping schedule. Some moms can go 3-4 hours without it affecting their supplies, but many cannot. The best thing you can do aside from getting your baby to nurse is to immediately get back to a 2 hour schedule, and to pump more often if possible. A better pump may also help- the PISA is a good pump but a hospital-grade rental may give you an edge.

    The incision under the areola could have an effect; however the fact that your implants are under the muscle is an indicator tha you're not in the worst possible situation.

    Experiencing a letdown sensation and leaking are common aspects of breastfeeding, but they are not universal. Some moms don't feel letdowns- I don't, and with my second baby I had crazy oversupply- and many moms don't leak or leak very little.

    Given the fact that your baby won't nurse without the shield, and the fact that you've been supplementing with a bottle, I think it would be a really good idea for you to see a lactation consultant, preferably an IBCLC, for some hands-on help. I am sure you would benefit from help with positioning, and the LC can help you get 2 tools that I think could really help you: the hospital-grade pump and a professional baby scale. Right now your evaluation is that the baby isn't nursing well, and that's leading you to supplement. But if you have a scale, you can weigh the baby before and after every feeding, subtract the before from the after, and gain a very accurate picture of milk intake. Several days' worth of weigh-feed-weigh measurements might be a really good way for you to figure out if you really need to use bottles.

    Hang in there, mama!

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