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Thread: Nipple Shield Woes

  1. #1

    Default Nipple Shield Woes

    My baby is 1 month old and we have been using the nipple shield since we left the hospital. I hate it only for the fact it falls off and I have to constantly wash it.

    When I try to take it off and see if my baby will latch without he panics. He opens his mouth really big but wont latch and he just cries and kicks hysterically so I give up because I don't want him to dread breast feeding.

    We started him off on a bottle in the hospital because he wouldn't latch and that's just what the nurses did for me. Mixing my colostrum with the formula.

    Well, I am wondering if the shield can affect milk supply this early on because after every feeding my baby still cries and routes as if he needs more. We end up giving him a bottle of formula after a lengthy breastfeeding session.

    I've even tried letting him feed (back and forth between breasts for over an hour) and he still came off hungry. I'm utterly exhausted and about 80% ready to just go to straight formula.

    Breastfeeding isn't fun Or enjoyable.

    I've tried drinking Mother's Milk tea and eating Lactation cookies and nothing seems to be working as far as him filling up.

    I don't know, I'm just really discouraged right now.

  2. #2
    Join Date
    Nov 2012

    Default Re: Nipple Shield Woes

    I can't really speak to the issue of the nipple shield, but the rest of it doesn't sound all that abnormal! Wanting to nurse round the clock at this age is pretty common - I spent the first couple months parked on the couch in my pjs, just nursing the baby! A lot of babies will still guzzle down a bottle, even if they've just had a good feed -it's just the nature of the bottle. Here's a link to some info about weaning off the supplements http://kellymom.com/bf/got-milk/basi...rease-formula/
    The difficult part about supplementing is that every time you do it, your supply takes a hit -your body isn't getting the cue that it needs to make more milk! Just a thought though, has your LO been checked for tongue and lip ties? Those can interfere with effective milk transfer. How has weight gain been, diaper output, etc?

    Hang in there mama. I think a lot of people don't find breastfeeding to be truly enjoyable so early on, especially when there are issues. I know I didn't! But sticking it out is so worth it. The time you invest now will pay off in the long run!

  3. #3
    Join Date
    May 2006

    Default Re: Nipple Shield Woes

    One of the dirty little secrets of breastfeeding is that nursing a newborn often isn't that enjoyable. Newborns are all take, take, take- pretty much all they do is eat, create diapers for you to change, sleep, and cry. And they're tough to nurse because they are so weak and uncoordinated. But all of this improves with time- as your baby grows he'll get stronger and more coordinated, and that will make it easier to position him, and he'll become a more adept nurser, which will make latching him on much less of a challenge. And best of all, he'll start to give back: he'll smile at you, giggle, reach up with a gentle touch...

    Shields can definitely impact milk supply. The shield gets in between the baby's mouth and the breast, and that can reduce stimulation to the breast, making feedings slower and less effective and resulting in reduced supply. So the shield could be a problem for you, and you're going to want to keep trying to wean from it. This link from kellymom explains how: http://kellymom.com/bf/concerns/child/wean-shield/

    Formula supplements are even more likely than shields to cause supply problems. The PP posted a great link on how to wean from formula.

    Can you tell us how much formula you're using right now? How many oz do you put in a bottle, and do you supplement after every feeding?

  4. #4
    Join Date
    Jun 2009

    Default Re: Nipple Shield Woes

    Hi! So I used a nipple shield with my oldest, loved and hated that thing! I may have some suggestions for you (I hope) but I need more info please. I am repeating some of mommals questions because they are so important

    Are you putting the shield on correctly per instructions? (sorry if this is a dumb question but even some lactation consultants I have met do not know how to put a nipple shield on!)

    How old is baby

    how many times in a 24 hour day does baby nurse- I need the total number of times. 5? 10? 20?

    Weight check history

    stool output history

    How many ounces is baby getting of formula each bottle and how many bottles per day

    Are you pumping and if you are, how often and with what kind of a pump and how much milk is extracted per pump session?

    Why is baby only able to nurse with a shield? Do you know (or have some idea?) These are good tools when used appropriately and correctly, (even though they are a headache to use)

    are you working with anyone (such as a board certified lactation consultant-IBCLC) to figure out why baby needs the shield and on fixing that problem?

    What position(s) do you nurse in, do any work better than others?

    How are you doing-are you engorged, have sore nipples, does it hurt when baby nurses, etc.

    Like anything else, nursing your baby can be very enjoyable when nursing is going well and it is not so enjoyable when there are problems. So the key is to solve the problems so you can start to reap the rewards. The rewards will be there, I promise you.

  5. #5

    Default Re: Nipple Shield Woes

    I hope that I answer all of the questions asked. Thank you, by the way, for replying.

    Okay, they told me the day my baby was born that I had flat/inverted nipples. We tried and tried to get him to latch but he wouldn't. The nurses seemed only educated in one breastfeeding position that I absolutely hated. The football one. It was awkward and uncomfortable and I couldn't get him up to my breast well that way.

    The LAST day at the hospital they gave me a nipple shield and the lactation consultant showed me how to use it. I have no idea if I'm using it right, I didn't take instructions home with me. I just took the shield. But, it doesn't hurt at all when I use it and it fills up with milk when LO is using it.

    I only give him 4-8 oz of formula total a day, just depending on how hungry he is. We use slow flow bottles and take it out frequently to see if he'll be satisfied or not before he actually drinks the entire thing. Sometimes he is, sometimes he isn't.

    When I do supplement with formula I give the bottle to my husband and I pump while he feeds him. I pump between 1-2 oz total and I pump for about 15-20 minutes on each side.

    I do not pump often because I am trying to put him at the breast as often as I can. So I pump 1-2 x a day. I give him what I pump before I try the formula.

    He poops several times a day and has lots of wet diapers. He's at or above the average output that I've read is normal. Sometimes I feel like I just dump my breastmilk straight into his diaper ha ha ha.

    Anyways, I am going to try to wean him off formula but the fact that the shield can affect my supply terrifies me. Especially because I try daily to get him to latch and it's extremely stressful for the both of us.

    I am going to make an appointment with a lactation counselor, I think, to see if they can help me get him to latch. I just know I've tried so many different ways. I did get one successful latch and feeding a few weeks ago but it hasn't happened since.

    Thank you for your kind words. I was told to give BF 6 weeks before deciding to give up by lots of friends. He is 5 weeks right now. I feel ok some days, other days I just want to quit and spare us all the nightmare.

  6. #6
    Join Date
    Jun 2009

    Default Re: Nipple Shield Woes

    OK I am going to start with your last comments first-I am so glad you have supportive friends. In my experience, the "6 week' magic mark is a general point of 'ok it's getting better" for when breastfeeding is going perfectly, no problems. The newborn period is so very tough that many mothers give up breastfeeding in the early weeks even when it is going just fine because they think breastfeeding is the problem when actually the problem is that caring for a newborn is HARD AS BLEEP and they are simply totally exhausted and overwhelmed.

    For those of us who face actual breastfeeding issues in the early days and weeks, it can often take a little longer for things to start feeling more manageable, that, "ok maybe I can do this after all" feeling. How much longer really depends, but as long as mom is getting good assistance and support, not usually too long. Then if all continues to go well, mothers usually get to the "breastfeeding is really amazing how would I mother without it' feeling, which I am sure at this point you do not believe me even exists, and I do not blame you at all, I felt exactly the same when someone told me about it when my oldest was little and nothing was working and I was ready to go mad. But it does.

    So, I think there are lots of real benefits to mothers to working through any difficulties even if it takes longer than 6 weeks. That has been my experience and the experience of many, many, many mothers. That is why LLL and other breastfeeding support organizations exist, and why the entire profession of Lactation Consulting was created in the first place-not to force people who do not want to, to breastfeed, but because when mothers who have trouble early on breastfeeding get help and support and work through their problems, they are so very glad they did. Yes, it feels like a nightmare when it’s this hard, that is a perfect description. But I have never ever talked to a mother who, looking back on difficult times, wished she had stopped trying to nurse earlier than she did, but I have talked to plenty who regret stopping when they did.

    BUT when you decide it is time to stop nursing (or trying to nurse) is up to you, it can be today or tomorrow, or it can be weeks or months or never (until your child weans.) There is no shame ever in not nursing, and, if you feel you have tried everything YOU could, and it was still not working for you, there should not be regret either. I hope I am making sense…

    OK, so let’s look at your experience step by step. So the person who told you to use a shield was a lactation consultant in the hospital. I am going to guess she was not able to work with you for very long and that you have not had any follow up with her or anyone else? Unfortunately that is the usual way it goes with hospital based lactation consultants, who are often wonderful but working under very restrictive conditions. It's unfortunate because follow up and tweaking in these situations is so very very important.

    This does not mean it was wrong to give you the shield! It got your baby nursing at the breast when nothing else that had been tried was working, and that is a very, very, very good thing.

    The way to put a shield on is to turn it almost inside out, place the tip over your nipple, and then smoosh it on while pressing your breast tissue into it. (You have probably developed your own tricks to doing this part.) It is really good if a kind of mild ‘vacuum’ effect takes place, sealing the shield to your breast. Can you take away your hand and your shield stays on? Do you feel your nipple pull ever so slightly into the tip? Then you are probably doing it right. Yes it may and probably will pop off a few times as you try to get baby latched, or the shield gets slippery with milk or sweat, etc. That is normal and is what makes using shields so maddening.

    But here is the thing. If the entire problem was your nipples, (which I doubt, but, anyway) then, is that still the case? 5 weeks along, how do your nipples look to you? The same, different?

    Because lots of things can make nipples ‘flaccid’ or to seem ‘flat’ in those early days. IV fluids during birth. Medications before and after birth. Engorgement. If your nipples are clinically inverted, that is something you would have noticed long ago about yourself.

    And guess what? Even in those cases, flat and even truly inverted nipples sometimes-a baby can often latch and nurse without a shield. But it may take getting more help than you were given, better help, and working at it.

    I am only telling you this because I want you to stop doubting your breasts, your anatomy. Your body can nourish your baby-in fact, it IS doing so, and how! Isn't it amazing? Your milk goes through your baby like that becasue it is the perfect, unique food for your baby-and it is coming from you!

    I was also told I had flat nipples and given a shield when my oldest son could not latch. I did not know ANYTHING about breastfeeding. I thought I had something wrong with my breasts for the longest time. It was only years later that I learned enough to understand that my breasts were not really EVER the problem!

    OK, the formula supplements. So, a breastfed baby of 5 weeks old would typically be taking in about 25 ounces of breastmilk per 24 hour day. Maybe 30 at most.

    So if you are giving your baby 4 ounces a day, that would represent a little more than about an 8th of daily intake. 8 oz is over a quarter of what a baby normally needs. Another way to look at it is, 4 ounces is about one and a half normal nursing intake per nursing session, and 8 is 3 sessions. So there is a big difference between 4 and 8, in that sense. You might want to track exactly how much you are giving your baby for a few days.

    You may not need to be supplementing at all. The way you can tell if a breastfed baby who is nursing with normal frequency requires supplements is by weight gain, or lack thereof. Not by behavior, not by if the baby takes a bottle-these things mean little or nothing and can be very misleading. You don’t mention weight gain but I am assuming it is good. Output sounds normal. But even so, a gradual weaning off the supplements is probably safest. I would suggest, don’t give your baby 4 ounce bottles at a time. 2 or 3 at most. If you are supplementing just because the baby is acting hungry after nursing, try instead to nurse him again, or, if baby is getting frantic, give baby a little supplement in the bottle and offer the breast again after baby is calm. You want to keep baby associating the breast with all good things-yummies, fullness, comfort.

    Also there is actually a way to give the bottles that is more breastfeeding supportive. It is described here: http://www.llli.org/docs/00000000000...astfedbaby.pdf

    It is good that you have been pumping when supplements are given. That has helped maintain your production.

    Yes, there is a concern with nipple shields that mothers lose production, so many IBCLCs will often tell clients to pump 6 or 8 times a day when using shields. But nipple shield design has improved and not all mothers see a reduction in milk production when using shields. Others definitely do. It simply depends on many many factors. If you are truly concerned about your production, you can add a couple more pumping session a day. But I agree it is generally more important to nurse baby frequently than to pump, so if it’s a choice, I would say, choose to nurse.

    I see no problem with your pump output, that is normal per session pump output when a mother is nursing her baby around the clock (no separations.) Keep in mind that pump output is not a great indicator of overall production, and usually baby is able to get more than a pump as long as baby can nurse effectively. How much the shield will interfere with this is just not knowable without doing some before and after nursing weight checks, which your IBCLC may want to do.

    You do not mention pain when nursing. Do you have any?

    I also do not know how many times a day you are nursing your baby. It has to be at least 10. More often is normal and fine.

    You did not like the football hold, which I get, it’s a very hunched over position. It can be a very good one for when a baby is having difficulty latching but it needs lots of tweaking to be really comfortable, which I bet they did not know how to show you how to do in the hospital.

    so what else have you tried? What does work best for you? Have your tried sidelying, laid back? Did you know that with laid back you can have baby in any position, even football, and you do not need to be lying down, just leaning back? If you would like more info on positioning ideas let me know.

    I think at this point it is an excellent idea to see an IBCLC. I suggest calling around to your local breastfeeding support groups or doctor etc. for referrals, getting as many phone numbers as you can (three will probably be enough) and calling them all first. You want to find someone you will feel comfortable with and confident in. Ask them about their experience working with mothers with babies this age and with these issues. Ask them how long an initial appointment usually is (it should be an hour at a minimum) ask them if they have helped a mother wean her baby from supplements and wean off a nipple shield etc.

    Here is a description of a typical private appointment with an IBCLC http://cwgenna.com/lconsult.html
    And this website has a look up function. Not all IBCLCs will be on here though. www.ilca.org
    Last edited by @llli*lllmeg; April 13th, 2013 at 03:43 PM.

  7. #7

    Default Re: Nipple Shield Woes

    Wow, extremely informative. No, no pain during nursing with the shield. Now, when we try to latch without it, yes. He like...clamps down out of frustration and it hurts. So thankful he's toothless. I need to keep better track of his daily feedings and formula bottles. I had an app on my phone that I was using but I just got tired of having to pick up my phone and log it when he was in between feedings/diapers etc. I am feeling better though, I think I could start up again.

    One last question and then I'll be sure to keep you posted on how things are going- is it common for newborns to get sleepy after just one breast? Sometimes he's starving and he'll take both sides, other times he'll suck on one for a few minutes and go to sleep.

    Weight gain, he was 6.8 when he was born and was 6.4 when we left the hospital. He's up to about 8 now, last time we weighed. The only thing is I don't know if that's soley breastmilk weight gain since we've literally been using formula since day one at the hospital.

    The hold that I prefer is the cradle hold- it is the most comfortable to me... everything else so far has been really awkward. I did try the laid back type once and that is where I got a little bit of a latch. Just a little latch. 5 seconds or less.

    Thank you so much for your information!!

  8. #8
    Join Date
    Jun 2009

    Default Re: Nipple Shield Woes

    One last question and then I'll be sure to keep you posted on how things are going- is it common for newborns to get sleepy after just one breast? Sometimes he's starving and he'll take both sides, other times he'll suck on one for a few minutes and go to sleep.
    yes it is very common and normal for a baby to take one breast at a time and also to fall asleep nursing.

    Nursing sessions especially in the newborn period can be very variable as you have found. So some are going to be more productive as far as milk intake than others. This is normal. You do not eat exactly the same amount at every meal either!
    But this is one reason why frequent nursing sessions are so important. Frequent. At least 10 times a day. at least!
    So sleepiness is only a cause for concern if it is causing baby to not nurse well enough, often enough.
    So baby has gained approximately 28 ounces in approximately 28 days? That is an ounce a day-good gain. Yes you were/are supplementing but there is no way that good gain came only from supplements.

    do what works but also keep experimenting. position is often the key to getting a good latch. Any ability to latch even for a second without the sheild is a step in the right direction. weaning off the sheild is a process, Be patient with yourself and baby.

  9. #9
    Join Date
    Mar 2013

    Default Re: Nipple Shield Woes

    Not sure if it was mentioned in one of the previous posts but have you tried pumping for a couple of seconds before latching on LO? I heard that it sometimes helps to bring out the flat/inverted nipples for nursing....just a thought....
    Happy Mama of 4 beautiful boys ages 17, 13, 10, 3 and just welcomed the newest member of the family on 3/22/2016 OUR FIRST GIRL!! :
    Was not able to BF first 3 boys but now successfully and thriving

  10. #10
    Join Date
    Mar 2013

    Default Re: Nipple Shield Woes

    I agree, pumping a little first or using the nipple shield to start, then removing it helped to pull out my nipples so he could latch better, plus milk was right there, so baby was rewarded immediately for latching. Also, offering your finger, nail side down, for baby to suck on if it upsets him can help him to calm down so you are able to attempt again. It took about a week to wean from the nipple shield on one side for us, because the skin was more elastic. The other side we still have trouble with at certain times of the day on bad days (but that side has had a major abscess and surgery just a few weeks ago, so it's totally different in size and texture so I can't really blame him)!

    To add onto the nipple shield usage directions from a pp: Make sure that baby latches and actually gets mouth around the base of the nipple and as deep a latch as you can. The nipple shield is not a straw and you don't want LO to just suck on the end of your nipple! They still need to stimulate the breast.

    PS I hated the nipple shield too! The cleaning is a pain (my heart goes out to all who use SNS and EP!) and LO always managed to shake it off and then would be all upset while I was trying to replace it.
    Last edited by @llli*babyhiccups; April 13th, 2013 at 08:46 PM. Reason: PS
    DS "milk monster" 2/7/13
    Abscess didn't stop us nursing!
    DH 6/26/10 is the best support

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