Fussiness while nursing

[@llli*babyfleet1]

I have this same problem with my 4 week old premie, she came 5 weeks early and spent a week in the NICU where she had a feeding tube and bottles. I have to wear a nipple shield in order for her to feed at all (flat nipples I was told and pumping to pull them out does not help) and she does the same fussing and screaming (and I mean major screaming!) and knocks the shield off. I feel like bad mom and end up having to give her a bottle instead. I have to give her 1 oz of high calorie formula after her feedings regardless of bottle or breast but I am in tears everytime I try to feed her and she screams. Will bottles at night ruin breastfeeding for me, its the only way she will eat? : ( Will this pass?

[@llli*lllmeg]

Babyfleet1: I think your situation is a bit different. Basically, you have some complicating factors, namely, baby (perhaps) cannot latch without a shield and you have to supplement. Yes it will get better, but it will take some work and getting to the bottom of things. If you have not contacted your local LLL Group or a good, helpful Lactation Consultant I suggest you do so.

If you have to supplement, then that is what you have to do. Consider alternatives to bottles, as babies can learn poor sucking habits that will make latching more difficult and develop something called flow confusion, which may lead to breast refusal. Cup feeding, when done properly, is an effective and safe alternative, you could try an at the breast supplementer, (lactation aid) or at the very least, try paced bottle feeding.

See this website for a cup feeding vid and a lactation aid vid. If you want more info about either, please ask http://www.nbci.ca/index.php?option=...id=6&Itemid=13

Paced bottle feeding: http://www.llli.org/docs/00000000000...astfedbaby.pdf

Are you using a nipple shield under the care of a Lactation Consultant? Was your shield sized to you and baby? Were you shown how to put the shield on (vital), warned of the potential milk supply issues and encouraged to pump to offset those? Were you given alternatives, ideas for latching besides using the shield? Nipple shields can be a helpful tool but that are meant to be a temporary bandaid, not a permanent solution, to allow nursing at the breast when a baby simply cannot latch without one while mom continues to work on latch. There are drawbacks and you need to be aware of those.

Since baby is pulling the shield off anyway, you may want to keep trying to nurse without it. Try the breast sandwich technique; (I don’t have a good link for this, sorry, anyone???) Also, look at this video for asymmetric latch for ideas. http://www.ameda.com/resources/video If your nipple is flaccid, you could try hardening your nipple with stimulation or cold compress or ice prior to nursing. Are you on pain meds? That can make it difficult for the nipple to become more erect which helps baby latch, so things may improve when you are off them.

I am a big advocate of laid back breastfeeding. Not only can it facilitate a good latch, it can cut down on flailing at the breast, plus it is a comfortable position for mom. This is a research based nursing style, not a rule oriented position. The only rule is mom is comfortable, tilted back and well supported, and baby is on his own front, usually on top of mom. But mom can be reclined to any degree, from a lot to very little, and baby can be in any position at all as long as baby is on his own front. See http://www.llli.org/docs/00000000000...astfeeding.pdf and http://www.biologicalnurturing.com/

More positing ideas, including football which can really help when mom needs to eyeball things to get a good latch. http://www.llli.org/faq/positioning.html

You want to be nursing (or offering to nurse) very, very frequently. Keep baby on you as much as possible, and nurse at the earliest cue. Are you engorged, or overfull? This can make latching with flat nipples more of on issue. Make sure you are not pushing on back of baby's head when latching.

[@llli*mommal]

Link to the breast/nipple sandwich technique: http://www.mother-2-mother.com/NippleSandwich.htm IMO the pictures do not show quite enough compression, and the mom's hand is too far back from the areola, but that's just me: I had to put my hand more or less immediately behind the areola and squish until my areola was a nearly flat oval. (Does that make any sense?) I'm sure the way it works is different for every mom, depending on breast shape and density. So if the technique doesn't work for you as shown, try varying where you put your hand and how much compression you use.

[@llli*LLLKaren]

I split this out from the other fussiness thread so the responses wouldn't get too confusing.