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Thread: baby cannot get milk out of nipple shield

  1. #1

    Default baby cannot get milk out of nipple shield

    I have a 8 week old who has never latched on to me. The problem is I have bigger nipples compared to her mouth size at birth and now that she is definitely bigger, she prefers the bottle. I have been pumping for her and just find it difficult to let go of the option of breastfeeding.

    I have been working with a couple of certified lactation consultants for a while now and the last visit , I was told we are in the breast refusal stage.

    We tried everything right with this child. Getting her to my breast as soon as she was delivered, no bottle for the first few days and she was still passing meconium on 4th day, I think. I then gave in and gave her a bottle. And then again tried breastfeeding and she didnot gain her birth weight by 2 weeks and so on.

    Medela medium and NUK shields fit me well. However, she is unable to suck milk from the shield. I have read so many stories of where the baby sucks from the shield and moms breastfeeding successfully with that.

    I am just not able to figure out why my little one cannot do it. Can anyone think of any reasons.

    Thanks

  2. #2
    Join Date
    May 2006
    Posts
    21,371

    Default Re: baby cannot get milk out of nipple shield

    Was baby checked carefully for tongue tie or suck-swallow coordination issues? How does she do with the bottle- does she manage to empty it in a decent amount of time, or does she feed for a really long time? How does the bottle nipple look when it emerges from her mouth- is it ever pinched?

    I think the fact that she will take the breast with a shield is terrific. That's a huge first step with a baby who has been non-latching- which, incidentally, is probably one of the hardest challenges a breastfeeding mom can face! Are you pumping in addition to nursing? And if so, how's that going?
    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

    Default Re: baby cannot get milk out of nipple shield

    She is not tongue-tied and drinks milk from the bottle just fine. She cannot transfer milk using a nipple shield which is what I cannot understand. Has anyone's child had a problem getting milk out when using a shield. She cannot latch onto me directly also hence I am trying with the shield.

  4. #4
    Join Date
    May 2006
    Posts
    21,371

    Default Re: baby cannot get milk out of nipple shield

    The shield can reduce the baby's ability to transfer milk. The shield protects the nipple, but it can also place a barrier between baby's mouth and the tissue of the areola, where the milk sinuses are. It's compression of those sinuses that is thought to allow the ejection of milk. You can see this yourself by expressing milk by hand: if you simply squeeze the nipple, you won't get anything. Squeeze the areola and you'll probably see milk bead up on the surface of the nipple. That's why it's going to be important to pump if the baby isn't doing a good job of nursing- you have to remove milk in order to make milk.

    So baby won't take the bare breast at all? Are you continuing to try? This link has techniques which may help: http://kellymom.com/bf/concerns/child/back-to-breast/
    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!"

  5. #5
    Join Date
    Jun 2009
    Posts
    5,926

    Default Re: baby cannot get milk out of nipple shield

    Well this is a really frustrating situation, you have tried so hard and it’s still not working.

    Mommal has given great ideas-the kellymom srticle is really really helpful in many cases.

    but I am stuck on something you said in you first post…

    what does 'now we are in the breast refusal stage' mean-to you? I understand what breast refusal is, I just don't understand how now is different than before. Do they mean that now baby is capable of latching, but won't? That would sound like progress to me. Or are they saying that is why baby needs to use the shield to nurse? And is the shield being seen as one possible transitional tool or is it kind of make or break, got to get baby to nurse with the shield? What is your take?

    Anyway, assuming baby CAN, physically, latch, the ideas in the above article are really great. Especially try bringing baby to the breast when baby is asleep, sleepy, or just waking. I think of this as 'waking' the baby’s instinct to nurse. Also have you tried a lactation aid (at the breast supplementer)? This could be used with the shield or without to deliver expressed milk to baby at the breast.

    When a baby seems to ‘prefer’ bottles there are many factors to consider. Is it the actual feel of the mothers nipple that is the problem? Or is it that baby is used to getting milk very easily from the bottle and has not learned how to extract milk at the breast, but is, maybe, willing to try if brought to the breast when calm, with some instant reward techniques perhaps? Or has the experience become so frustrating for baby he actively resists even being held near the breast? Or, what?

    These are the stages of breast refusal to acceptance that a baby may be observed to go through, as described in the breastfeeding answer book. Is there a stage that sounds like what is going on now?

    • The baby aggressively fights the breast.
    • The baby cries more when being held than when he is put down.
    • The baby is willing to be held in some positions, even if not in a cradle hold.
    • The baby tolerates being held in the cradle hold.
    • The baby will attempt to root.
    • The baby will lick at the milk on the nipple.
    • The baby will attempt to suck, using an in-and-out movement.
    • The baby will take milk at the breast (using a nursing supplementer, eyedropper, or feeding syringe).
    • The baby nurses well, even before the let-down occurs.

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