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Thread: Does weaning from shield=tortured nipples and fussy baby?

  1. #1
    Join Date
    Jul 2012
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    Default Does weaning from shield=tortured nipples and fussy baby?

    Hi, I'm pretty new here but have found excellent advice in response to other questions I've posted.

    I have a 7 1/2 week old baby, born full term, no problems, except I was given a nipple shield in the hospital because he wouldn't latch, I freaked out, and the nurses suggested it. (There is no LC at our hospital) The main reason I think he needed it at first was my flat nipples (??). It worked very well, I seemed to have a huge supply, and the only downside was the inconvenience of dragging the shield everywhere, having to boil it, etc. LO has gained very well, going from 6 lb. 12 oz at birth to 9 lb 7 oz at 5 weeks.

    Well, I seem to have finally weaned him from the shield! At first it was "yippee," as I wanted to wait to offer a bottle of breastmilk until he could latch effectively without the shield. So I started pumping once or twice a day for the past couple days. The first day I got 3 oz, and yesterday I only got 1 oz, and only a few drips after I'd fed him. SO...that got me worried about my milk supply.

    A few days ago, when I was first having success weaning from the shield, he seemed to want to eat constantly and my nipples were in agony. My thought=growth spurt. I use the nipple sandwich technique and he seems to have a good latch. The pain went away shortly.

    Now yesterday the pain came back with a vengeance and I was barely able to sleep last night because of my sore nipples, along with the fact he wanted to nurse every hour. In defeat, I finally resorted to using the shield. Otherwise I'd cry out in pain, remove him and try to reposition him, he'd fall asleep, and wake up crying in a few minutes. He has also pooped less and been more gassy last night and today so far.

    I have been drinking huge amounts of water and started "Mother's Milk" tea to make sure it's not a supply problem, too!!

    So, in short:
    1. Does weaning from the shield cause nipple pain at first?
    2. Could my milk supply be being negatively affected by weaning from the shield?
    3. I thought pumping would increase supply. Could it be decreasing it? I don't want to do anything to jeopardize my supply!!


    On top of all that my MIL called the other day with a bunch of snarky comments on breastfeeding (her daughter is exclusively formula feeding her baby). Ugh. I was stupid enough to invite her to stop over and I'm afraid she's gonna show up unannounced in the midst of my agony!

  2. #2
    Join Date
    May 2006
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    21,361

    Default Re: Does weaning from shield=tortured nipples and fussy baby

    To answer your questions:

    1. Weaning from the shield should not cause pain. The pain you're experiencing points to either an ongoing latch issue or to some other cause unrelated to the shield, such as thrush or a bacterial infection.

    2. Weaning from the shield almost always improves milk supply, since shield use generally slows and reduces milk transfer and also reduces stimulation to the breast.

    3. Pumping also will not decrease supply. Quite the opposite: all additional stimulation to and milk removal from the breast should result in increased supply unless there is something preventing supply from increasing (common culprits include hormonal contraception, pregnancy, thyroid issues). It is quite normal to get big variations in output at the pump based on time of day, type of pump, when you last nursed/pumped, anxiety level, tiredness, etc.

    Questions for you:
    - Can you describe the pain you're experiencing? Does it happen at the beginning of a feeding, during the feeding, at the very end, or after the feeding is over? Is it more of a stabbing, pinching pain or more of a burning, itching sensation?
    - When your baby unlatches, what shape are your nipples- symmetrical, like pencil erasers, or asymmetrical/creased/wedged/ridged/shaped like new lipsticks?
    Coolest thing my big girl said recently: "How can you tell the world is moving when you are standing on it?"
    Coolest thing my little girl sang recently: "I love dat one-two pupples!"

  3. #3
    Join Date
    Jun 2009
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    Default Re: Does weaning from shield=tortured nipples and fussy baby

    edit: ooops posted before saw mommals post. Please excuse any repitition
    If you need the shield to nurse comfortably, keep using it. Meanwhile-

    Is there any way you can see an IBCLC? Check into it. Nipple pain is usually caused by a poor latch. Some owieness at the start of feedings can be normal in the early weeks, but it should not ever hurt this much to nurse especially at this point. When there are tricky latch issues, it can be helped by having a helper watch you nurse and offer ideas. A LLL Leader could very possibly do this as well, but only an IBCLC has (or should have) clinical training in this area. Especially if there may be a physical cause (like tongue tie) it is important to see an IBCLC. Make sure whoever you see is experienced with this age baby and latch issues.

    Nipple pain is usually caused by 1) a not good latch and, much more rarely, issues such as thrush or vasospasm. It is NOT caused by a baby wanting to nurse a long time or nurse frequently, because a baby this age nursing very frequently is entirely normal.

    Milk supply:
    Every mom responds differently to the pump. Also, different pumps have different levels of effectiveness. If you are pumping on top of regularly nursing, it is normal to make about 1/2 ounce to 2 ounces per pumping session. In short, pump output tells you little if anything about milk production.
    It is not exactly accurate to say pumping increases milk production. Regular/frequent milk extraction increases milk production (or at this point, since your production has been fine, keeps production at appropriate levels.) Typically, a well nursing baby is much more effective at milk extraction than a pump.

    It is normal for a baby to poop less, sometimes MUCH less, after about 6 weeks of age. This alone is not a sign of low milk production.

    When a mom is using a nipple shield to nurse, it is typically recommended that she also pump and babies weight gain be closely monitored. This is because shields (or the underlying latch issues that cause them to be needed) MAY cause issues with milk extraction and thus production. Since your baby gained normally when you used the shield, whether this is needed for you ort not is open to question. But pumping cannot hurt, unless, of course, it DOES literally hurt to pump, or you allow your pump output of lack thereof to stress you out.

    I am sure folks have lots of latch and positioning suggestions. What have you tried?
    Oh ps sorry about MIL. Ugh, you are right, the last thing you need at this point is negativity. But his is your baby, not hers, you call the shots. Lots of mommies struggle with nipple pain and go on to a very happy and HEALTHY (for both baby and you) nursing relationship. Latch pain has a cause and so it almost always has a cure as well.

  4. #4
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    Jun 2012
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    Default Re: Does weaning from shield=tortured nipples and fussy baby

    Maybe your nipples are sensitive. It should not be very painful, from what I was told. A good friend of mine (BF her 14 mo) used a nipple shield for many months, than her LO latched before she had a chance to put it on one day, and she says it never hurt she's been nursing w/o it ever since. In my experience it hurt a little but got better quickly.
    Milk supply is not affected by using or not using a shield, just by how often you empty the breast is how quickly it continues to make more.
    Hospital pump may increase supply. Regular pump helps to keep up supply when baby isn't eating direct. I think pumping right after baby eat's you won't get much because baby should have already gotten it all for that feeding. That's just my experience, hope it helps.

  5. #5
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    Jul 2012
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    Default Re: Does weaning from shield=tortured nipples and fussy baby

    Thanks!

    After I wrote my post I went and took a nap, and when I woke up I was engorged and had milk spraying out, so I guess my supply is fine!! So far for the latch I've tried starting with the shield to draw out my nipples, nursing in a laid-back position, and the nipple sandwich, all of which have been helpful. Nursing hasn't been as bad today; I would say I have very little pain in my nipples.

    To answer mommal: It is definitely more of a pinching sensation--like getting a "tittie twister," I would imagine. He also makes a lot of noise when he eats. But like I said, today has been more like usual and hasn't hurt so much--probably 75% less pain. When he detaches from the nipple correctly (sometimes he pulls away with the nipple still in his mouth--OUCH) they are kind of flat looking with a crease across the middle.

    I'd like to meet with a IBCLC, but the closest one on this website is 4 hours away. I talked to a lactation consultant from an hour away over the phone, and she said not to worry as long as he's gaining, and my dr. said today that it would be normal to have a little pain when weaning from the shield. But I'm still concerned about his latch, figuring that he isn't opening his mouth far enough all the time.

  6. #6
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    Default Re: Does weaning from shield=tortured nipples and fussy baby

    If you got engorged and had milk spraying out after a little nap, I'm thinking your supply is probably on the high side. Often babies will "clamp down" on the nipple when supply is high and milk flow is fast, because clamping is like crimping a hose: it slows the flow of fluid. And compression of the nipple to control flow would line up perfectly with the "titty twister" feeling, the noisy eating (babies who struggle with a fast flow may gasp, gag, choke, wheeze, click, cluck, cough, or splutter when feeding), and the crease across the middle of the nipple. It would also explain why the shield was so helpful to you- it slows milk flow and that can make nursing easier for the baby, and necessitate less clamping.

    Keep rocking the reclined positions and the nipple sandwich, use the shield if necessary, and give this time. Fast flow issues usually diminish with time as long asn mom simply feeds on demand, and babies grow into a fst flow, as well.
    Coolest thing my big girl said recently: "How can you tell the world is moving when you are standing on it?"
    Coolest thing my little girl sang recently: "I love dat one-two pupples!"

  7. #7
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    Default Re: Does weaning from shield=tortured nipples and fussy baby

    Ouch! I just weaned my LO (or more like he weaned himself) from the shield a few weeks ago, so I know how inconvenient those are. :\

    I'm glad your pain is subsiding though! Keep working on his latch if it gets worse again, and try using lanolin oil. Also, don't worry about your output when pumping; everyone responds differently to a pump, and it may take time for pumping to really work for you.

    I'm Erin, wife to a wonderful husband, and first time mother of Baby Will - 05/13/2012

    "Keep calm and latch on!"

  8. #8
    Join Date
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    Default Re: Does weaning from shield=tortured nipples and fussy baby

    I am on week 2 with my third baby and still having latch pain, mostly, at this point, at the start of feedings and mostly on on one side. Along with other issues (forceful letdown, engorgement, mastitis, oh my) but that's another story. For the owie ouch latch, I have been trying everything I can think of and have managed to contort us into some very interesting positions in order to get the baby to latch at different angles etc. It is improving but so slowly! I have always thought that the best thing to do in these situations is to just keep trying everything you can think of and then trying it all again, this seems to be working for me and I hope continues to work for you.

    FYI, unless there is an LC lookup on here I am not aware of, the folks whose contact info is on this site are LLL Leaders, which means we are volunteer experienced breastfeeding moms and not Lactation consultants (some leaders are also LC's but these are two different roles.) You are welcome to call any Leader no matter how far they are, often talking things out on the phone helps. But to look up a Board Certified Lactation Consultant, should you need that, try http://www.ilca.org/i4a/pages/index.cfm?pageid=3432

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