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Thread: Tips for Nipple Shield Weaning

  1. #1
    Join Date
    Jan 2015
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    Default Tips for Nipple Shield Weaning

    I'm a first-time mom trying to establish exclusive breastfeeding with my three-week-old. Things are more or less on track at the moment but I'm itching to get us off the shield, already. I feel like I've got a pretty good handle on the basics but it's really difficult and I feel like I'm torturing my baby when I try and get her to latch without the shield. Is it possible I'm going to teach her to hate nursing this way?

    Here's the background:

    - I was given the shield by a LC in the hospital on day two because she wasn't latching, with nurses breathing down my neck to supplement with formula.
    - We did an hour of skin-to-skin after birth, but even with that and the help of my very experienced doula, we couldn't get her to latch on after birth.
    - The LC says there's no tongue or lip tie, but my daughter is on the small side (birth weight 6lb4oz and small boned like me) and the LC felt that her suck would improve once her mouth had a chance to grow.
    - My pediatrician and midwife seem to think the LC is a good one and knows what she's talking about. I delivered at a hospital that has the best reputation in the region for being breastfeeding friendly and aggressive with lactation support.

    - I had cracked and bleeding nipples starting on day 2. It took me about a week and a half of babying but they're completely healed now. I also wound up with mastitis on Christmas but that has cleared up.
    - This whole process has been quite painful, extremely so around the time my milk came in. I'm still taking a bit of ibuprofen to cope with residual nipple soreness. I tried to quit the ibuprofen before, but had to resume it when the mastitis kicked my butt.

    - Through it all, my daughter's diaper output has been on track. She just made back her birth weight by her two week peds appointment, so her weight gain has been out of the danger zone but not optimal. This past week, though, I think she's put on much more weight and grown in length. We have another weight check on Friday and I'm confident she'll pass with flying colors this time.
    - That being said, if the idea was for her mouth to grow and make more room to latch, I don't think that she's had much of a chance for that to happen yet.

    - She latches readily and well with the nipple shield. Two of my midwives and my doula have all watched me nurse and agree that the latch is good. It's a little tight and pinchy at the beginning of a nursing session, but once she has a chance to settle down it's a picture-perfect latch with a wide open mouth, good lip flange, tongue sticking down (barely visible but sometimes you can spot it), proper areola coverage, all of that good stuff.
    - I've trained her latch to be a little more open with gentle pressure from my pinky finger on her chin and bottom lip, and I think it has helped to open up her latch some.
    - She goes from zero to pissed off in seconds once she realizes that there's no shield. She shoves my breast away with both tiny hands, whines, gags, and cries. This is the case whether I start a nursing session with no shield, or start and then whisk it away.
    - It's pretty rare that I can actually get her latched without the shield, but then again I tend not to be willing to torture her with it for more than a few minutes at a time.
    - We haven't introduced a pacifier. She's had a couple of bottle feedings with pumped milk only at times when I desperately needed a break. She's nursing 24/7 right now.
    - I'm aware that a nipple shield can affect supply, but I feel as though my supply is good right now. I'm taking fenugreek also and I think it's giving me a boost.
    - I've also tried letting her root around and control the latch on her own, and she's utterly clueless. She'll stick her mouth over her nipple and shake her head back and forth without chomping or sucking, then get upset that the milk isn't dispensing itself into her mouth and start to cry.

  2. #2
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    Jun 2009
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    Default Re: Tips for Nipple Shield Weaning

    I have personal experience with using a nipple shield and weaning off. I found the shield a lifesaver, but then I rapidly grew to hate using the thing as well. My suggestion on how to wean off a shield is to be patient but persistent. Be patient with yourself and baby. If baby is not latching without the shield and you are both getting truly upset, fine to back off and do the shield again. Choose calmer times to try nursing without the shield. Offer to nurse sans shield not only after baby cues, but whenever. Try offering in sleep or just at waking.

    Know that baby might nurse without the shield some sessions but need it again later, know that one side my 'happen' before the other, etc.

    But, also be persistent. Try to not to let a day go by where you do not try to nurse sans shield at least once. And yes, sometimes it might require pushing you and baby past the point of frustration to get baby to latch without the shield.

    What latch ideas are you trying? What positions? Have you tried all the ideas in this article? Sometimes things must be tried several times before they work. http://feedthebabyllc.com/latch-and-positioning/

    I would also strongly suggest seeing the IBCLC again, or a different one, as you choose. I know you have your midwives and doula, and they may know a lot about breastfeeding, but their training and experience specifically in breastfeeding PROBLEMS is not the same (unless they are also practicing IBCLCs.) Just as you would not have an IBCLC who was not a trained and experienced midwife midwife your birth, you cannot expect a midwife or doula to be able to do what an IBCLC can when there is a real breastfeeding problem. A baby not being able to latch without a shield is such a problem.

    Follow up care is VITAL when there are breastfeeding issues. You could see the top IBCLC in the world on day 2 of an infant's life, and she would have no way of predicting what might be happening or what adjustments might be needed at day 21. EVERYTHING changes after the very early days, so if your baby is still not physically able to latch without a shield, it is very possible this is more than a 'baby has to grow' situation. And of course if baby is not physically able to latch without the shield, trying to get baby to do so will be very frustrating for both of you.

    Are you pumping at all? This would be the typical recommendation for protecting milk production while using nipple shields. Since baby is not being supplemented, probably no reason to pump much, but I would suggest pumping or hand expressing some every day. The way shields affect milk production can be subtle, and would not become obvious in too-low production until later. Fenugreek nor any galactagogue can replace effective enough milk removal in the early weeks when it comes to promoting normal lactation. In other words, it is not so much about what you are producing today as what you are telling your body to produce a week or a month from now.

  3. #3
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    Jan 2015
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    34

    Default Re: Tips for Nipple Shield Weaning

    I've tried all of the different positions in the article, and I'm trying to rotate them. I find it's easier if I can manage without the Boppy because then she can't squirm as much. She cluster feeds a lot these days so she pretty much has two settings, "sound freaking asleep" and "omg starving why don't you ever feed me?"

    I've resumed battling with my insurance company to get seen by a LC. Maddie b, what was the underlying issue that made you need a shield? And how long was it before you were able to wean?

    I'm pumping some. Really, she's cluster feeding sooo much that I have a hard time finding a window of time where she leaves me alone long enough to pump. I'm hoping that the sheer quantity of nipple stimulation will make up for the shield. I do feel as though she's emptying my breasts well.

  4. #4
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    Jun 2009
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    Default Re: Tips for Nipple Shield Weaning

    hi we are going back 11 years but iirc I totally weaned my son off the nipple shield by about 5 or 6 weeks. One side happened a week or two before the other.

    we had a multitude of problems that led to our breastfeeding issues, but at the time we used the shield because other wise it took 45 minutes to an hour to get him latched, and he was refusing one side altogether, plus my nipples were injured (cracks, bleeding, bruising.) We saw an IBCLC on day six and she is the one who gave us a shield. Before we had our issues under control I saw another IBCLC as well, twice.

    I know that rightfully your insurance should pay for this service, but have you looked into what it would cost to just see one on your own? Or if there is any low cost options locally? For example these days, in my county, any mom can see an IBCLC free through WIC, whether or not that mom is on WIC. In a neighboring county, there is a 'scholarship' fund for in need mothers to see an IBCLC arranged by the local breastfeeding coalition. Sources for info about what might be available in your area would be local WIC, LLL, Breastfeeding coalition, or just call local IBCLCs.

    11 years ago when my son was born, there were no options aside from paying for the IBCLC yourself. No insurance covered this. There was no one to help us even at the hospital. We paid out of pocket for the rental pump, the three IBCLC appointments, everything. It was a difficult expense for my husband and I to face that at the time. However we are eternally grateful that we did.

    It actually sounds to me that you are doing really well, and it may be that you and baby will figure this out on your own. But it never hurts to get more help.

  5. #5
    Join Date
    Apr 2014
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    688

    Default Re: Tips for Nipple Shield Weaning

    with Maddieb.

    We used nipple shields for 4 months and what got us off them was a combination of seeing an awesome IBCLC and having some cranial osteopathy.

    We tried to lose them from earlier on and she would do partial feeds after a lot of patience, and removing part way through, trying to start without, doing so in to skin etc. At 4 months we had the 2 appointments within 24 hours and it was like a light went on for my DD on how to latch and within 48 hours they were gone - tho her latch still wasn't great for another couple of days it got there pretty quick after what felt like forever!
    Good luck

  6. #6
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    Jan 2015
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    Default Re: Tips for Nipple Shield Weaning

    Update: Yesterday my little girl had a follow-up with her pediatrician and I also got her in to see a new LC (the one at the hospital I delivered said they couldn't see me outpatient.) The doctor said she has a little bit of a tongue tie and a little bit of a torticollis (evaluated at my prompting) but he didn't think either is severe enough to be causing the problems we're having. She's gained some weight but nowhere near where she should be, but for now he is fine with careful monitoring while I continue to work on the nursing problems rather than supplementing with formula. The doctor also said that if the LC felt that the tongue tie was the issue, he'd still support getting it clipped even though he personally didn't think it was that bad. We sort of picked him at random but it seems as though our pediatrician is awesome.

    The new LC says that everything else with my daughter's latch looks good, in fact her latch is "pretty as a picture" and she wants to take a photo of it "to show all the other babies." BUT the fact that I'm still having trouble means something is going on, and she thinks the tongue tie is probably it. So first thing Monday I'm going to start making calls and get us in as soon as possible to have it clipped. The LC also worked with me on trying to get my daughter to latch without the shield, and the end result is that I'm doing everything right with positioning, and I have to keep trying, but my little girl just really, really, REALLY has no interest in an unshielded nipple! But hopefully when the tongue tie is revised it'll give her more room and not be so frustrating for both of us.

    My doula gave me the name of a mother and child chiropractor and I might take the baby there to address the torticollis. My pediatrician gave me a referral to physical therapy for it, but didn't have any objections to us pursuing chiropractic care instead. I don't know what I'm going to do with that yet.

    I'm going to start a new thread about the tongue tie, because it's an odd one and I want to know if others have dealt with similar anatomy.

  7. #7
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    Jun 2009
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    Default Re: Tips for Nipple Shield Weaning

    Thank you for the update, I am so glad you have a doctor you feel happy with and I think your plan of action sounds good. Dr. L. Kotlow in Albany has some good info on tongue tie on his website, http://www.kiddsteeth.com/

    there is a tongue tie facebook group some moms here have found very helpful.

    My only concern is baby's gain. You say it is not "where it should be" How bad is it exactly? I am glad your ped is willing to wait while you work on the issues, but unfortunately I have heard too often about doctors being relaxed about issues of early slow weight gain who then at 2 or 4 or 6 months suddenly get very worried and order lots of supplement or even tell moms to stop nursing. So I guess I am saying you want to be sure what doctor expects in terms of weight gain by the next check up, or be sure how closely doctor is wanting to monitor the gain?

  8. #8
    Join Date
    Jan 2015
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    Default Re: Tips for Nipple Shield Weaning

    She made her birth weight back by two weeks and we're at four weeks now and she has gained, but nowhere near an ounce a day. She looks healthy but isn't piling on the baby fat yet. The doctor keeps giving her thorough physical exams, checking her demeanor, skin tone, muscle tone, etc. And she's making enough diapers. So all of that seems to be informing the decision, but he wants us back in ten days for a recheck. I haven't asked exactly when we cross the line into needing to supplement, but with the way he's dealt with us so far I respect his advice and if he says to do it that's what I'm going to do.

    I did tell him that I plan on working in extra pump sessions when she's sleepy in the mornings and giving whatever I can express back to her the same day, and he agreed that that's a good plan. I should get more milk that way, right? Like nursing her, then pumping after an hour and a half and nursing her again after she's slept for three hours, rather than just letting three hours worth of milk build up. And then during the ravenous, fussy evenings she can have what I've pumped in addition to her constant efforts to dry me out.

  9. #9
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    Sep 2012
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    Default Re: Tips for Nipple Shield Weaning

    My son had torticollis as a newborn as well. It caused him a lot of issues with latching on my right side but he gained beyond well anyway. My local LLL had a guest speaker a few months later. He was a pediatric chiropractor and spent some time talking of torticollis and breastfeeding issues. He mentioned his experience with great improved latch after just one session but also said there were stretches that parents could do at home to achieve a similar affect (just Google torticollis exercises. Links aren't working well for me today) We had been doing most of them instinctively with our son. We didn't do tummy time as many of the sites suggest but rather baby wearing which gets similar results without distressing the baby.

  10. #10
    Join Date
    Apr 2014
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    Default Re: Tips for Nipple Shield Weaning

    My daughter had poor weight gain due to TT; it's more common than you'd think :/

    Am glad your paed seems bf friendly!

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