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Thread: ouch! (and when to lose the nipple shield.)

  1. #1
    Join Date
    Aug 2007
    Posts
    115

    Default ouch! (and when to lose the nipple shield.)

    so, i have my 2 week old guy (after being in labor for literally a month....) and i was able to nurse him immediately after he was born. that was the best, and last, easy feed. i started noticing a problem, so i asked for a nipple shield (had to use it with all 3 of my girls, as well, so it wasn't anything new to me...) the next day, i asked to speak to the lactation consultant and she watched me nurse... she said it seemed like a great latch and he was swallowing well (she could hear him while she was standing at the end of the bed. lol,) so he was getting what he needed.... fast forward to now and, after some weight issues (resulting in hand expressing and syringe feeding 25-30ml after each feed) he is slowly gaining, but i don't want to take the nipple shield away before i know his weight is stable enough.... it HUUUUURTS! my nipples take on a slanted shape, like his tongue is pushing up into the bottom of the nipple and the roof of the mouth is keeping the top straight. my nipples are also turning white (from pressure, not thrush.....)

    any advice? could it be the shield that is causing this? or is it just really that bad of a latch? he is getting what he needs, now... consistent swallows, plenty of poops/pees, content baby, milk dribbles after he unlatches..... but i would love to get rid of the nipple shield! using it at home is one thing, but i would rather be able to NIP without having to "set up," so to speak. lol.

  2. #2
    Join Date
    May 2006
    Posts
    24,153

    Default Re: ouch! (and when to lose the nipple shield.)

    Congratulations on the new baby!

    The biggest problem with shields is that they can slow/impede milk transfer, and thereby have a negative impact on weight gain. So if weight gain is a concern, then the sooner you take away the shield, the better (potentially).

    Clearly the shield should not be hurting you. If you're getting compressed nipples and vasospasms (i.e. nipples turning white) with the shield, the baby's latch isn't deep enough. Would it be deeper without the shield? Perhaps. Perhaps not. It sort of depends on WHY the baby's latch is shallow. Is it a tongue or lip tie? A reaction to a fast letdown? A quirk of the baby's anatomy or sucking style? If this were my baby, I would want to make 100% sure he didn't have lip or tongue ties of any kind, which would mean seeing a pediatrician, LC, and/or pediatric ENT or pediatric dentist. I would definitely want to see a lactation consultant, preferably an IBCLC, for tips on positioning and latching. In particular, I would want her to show me something called the sandwich technique, which is ideal for cramming maximum breast into a tiny mouth.

  3. #3
    Join Date
    Jun 2009
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    9,179

    Default Re: ouch! (and when to lose the nipple shield.)

    does it hurt to nurse without the sheild?

  4. #4
    Join Date
    Aug 2007
    Posts
    115

    Default Re: ouch! (and when to lose the nipple shield.)

    i forgot to ask about tongue tie at his last weight check, i really should write my questions down. lol!

    he can't even latch without the shield. i forgot to mention, the reason i asked for the nipple shield was that, after that first "perfect" feed, he was drawing blood with every feed. i know the blood doesn't matter in the fact that it isn't hurting him, but it was sure hurting me! he has a REALLY strong suckle.

  5. #5
    Join Date
    May 2006
    Posts
    24,153

    Default Re: ouch! (and when to lose the nipple shield.)

    Okay, so you asked for the shield because his latch was causing pain, and if you attempt to nurse without the shield, the pain is worse. Correct? If so, then to me the puzzle fits together like this: baby has an innate difficultly getting a deep latch. The shallow latch causes pain, and may also cause slow milk transfer- this would explain the weight issues and need for supplemental top-offs. The shield makes nursing bearable for you, but does not treat the underlying problem with the baby's latch.

    IMO, it's definitely time to see the IBCLC and to talk about positioning and tongue and/or lip ties. Because if you take the shield away and the latch problem is still present, it's quite possible that you will end up reinjuring yourself. That being said, if you can bear to nurse without the shield, even if it's just a few times a day, that's likely to be to your advantage. It will give baby practice at the bare breast, and you may find that his latch has improved since those first newborn attempts.

  6. #6
    Join Date
    Jun 2009
    Posts
    9,179

    Default Re: ouch! (and when to lose the nipple shield.)

    he can't even latch without the shield.
    If your baby cannot even latch & nurse without a shield, and nursing is incredibly painful and causing injury with or without the shield, then I agree with mommal that babies latch is off. This is something that is NOT fixed by a shield, although a shield can in some cases help allow baby to nurse at the breast when baby is unable to latch without it. So I agree seeing a LC for a one on one in person appt would probably be the best course of action at this point.

    You lose the shield when baby can latch and nurse without it. Until then, definitely use the shield if that is all that is keeping baby nursing at the breast. If baby CAN latch & nurse without the shield, and it hurts you the same either way, then the shield is not helping with anything and you can stop using it.
    Are you able to see an IBCLC? (again, I know you saw someone in the hospital)

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