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Thread: 4 week old nipple aversion, please help a desperate mother

  1. #1

    Default 4 week old nipple aversion, please help a desperate mother

    hello everyone I am a ftm and I am so emotionally drained after what's happened to my child I really would like some advise.

    I had gestational diabetes and was induced at 39w4days, the induction too 48 hours and then my bb was born naturally after, he weighed 8lbs9.5 oz and was hypoglycemic at birth so he was given similar supplement every 3 hours until his sugar stabilized. The hospital I gave birth at did not have a lactation consultant, the nurse trie to latch us but I don't think it worked. I pumped and pumped since day 1 so that helped with supply.

    Coming home, I fed him formula the first Few days, and gave him colostrum, when my milk came in, I bfed and supplemented with formula for the first week and half before my milk alone was enough for him.

    Meanwhile I have tried to breastfed him, he would not latch and would cry bloody murder and work up a sweat and turn beat red. So I would stop when that happened. And the first week was super tiring so we just let him have the bottle and I pumped like mad.
    We got a nipple shield and tried that, he would not suck on it correctly and still the same thing.

    I went to see a lactation consultant and got the SNS system, apparently he knows how to latch onto the breast shield but was frustrated the milk didn't come fast enough. We were assigned to use the SNS system plus the nipple shield 4 times a day at home. I had my mom help me but that system was a total failure, he wouldn't latch on correctly onto the nipple shield and the tube would spray everywhere, and then the milk would all be wasted and the session is literally 2 hours long and both my bb and I are absolutely exhausted at the end. I cried everyday and night, and got no sleep and was delirious and depressed. I got mad at him couple of times and felt like total crap after, I am like the most horrible mother ever getting mad at a helpless newborn!

    Meanwhile, we found a minor tongue tie, pediatrician clipped at when he was 2 weeks old, everything is normal, took him couple days to learn his new tongue.

    We went back to see the LC, she said just to try without the sNS if he hates it. So I tried not to pressure him, the mybreastfriend pillow is his worst enemy, he hates the positions that I use with that pillow. He is a big baby, and he would arch his back and head all the way back, and he is so strong I can't forcibly yank his head back.

    Meanwhile I am pumping away and we are bottle feeding because he has to survive. By week 3 I was pumping about 3-6 oz per session so at least it was enough food for him.

    It takes him a long time to practice breastfeeding, so our sessions are always an hour long, and he cries, wails and kicks and punches and turns beat red. I hear people starve their kids so they would be forced to come to th breast. I don't think I can do that, and I don't think it's recommended. At least seeing him cry until he loses his breath when he is hungry is not something I can feel ok with.

    I tried feeding him 1 oz with the bottle first and then breastfeeding, that didn't work for a while.

    One day he miraculously latched on football hold without the nipple shield and Nursed correctly for 20 minutes on each boob! And was satiated enough that he slept for 2.5 hours! This never happened again.

    For days, he would randomly latch on and suck very well for two seconds and then latch off and scream and end of story. Or sometimes he would pretend to go to sleep and not open his mouth at all, squeeze his mouth shut tight. And I would hold him in bf position for an hour to wait for him to not be able to hold his hunger anymore and open his eyes and scream and wail, arch back etc.

    This week, we made some minor progress, my milk leaks everywhere when it's time for him to feed. I wait for him to be hungry, and instead of pumping I try be bf him with the breast shield. He would, after a small tantrum latch on and feed 15-30 min per breast, and yesterdY he had one session where he didn't need a bottle supplement. Sometimes the battle of bf takes so much out of him that he ends up needing a huge supplement. Because I was not pumping as often because I was waiting to feed him, and by the time we are done, it had already been 5 hrs since I last pumped, I feel like my milk is less than when I exclusively pumped. So now I am afraid of my milk supply too. And I leak and lose a lot of milk too, when he nurses on one side, the other side would leak a large amount!

    I think my letdown is ok because I see milk fills the shield as he nurses, and it drips all over the place. He also jerks around so much when he bfs, the liquid gold spills everywhere.

    This is our practice schedule right now:
    From noon -8 we practice bf before every feeding
    After 8, 8pm to noon the next day we bottle feed just so that either my husband or I can get some sleep. It takes two of us to bf him. So we practice 4 times a day and bottle feed expressed bf the other times. Sometimes he forgets how to suck on his bottle nipple and gets frustrated at that.

    I just want some direction, how should. I proceed now, will he ever exclusively bf? I don't want to not pump enough and lose my milk supply. Should I just give up and just exclusively pump? At least he will be on bm and I won't lose my supply? Have you guys ever seen a baby like this get better? Some people say their bb gets it once and viola from then on exclusively bf! For him it's not like that, he gets it and has done it, but will not do it every time.

    I feel so helpless and hopeless, please help me!

  2. #2
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    Default Re: 4 week old nipple aversion, please help a desperate moth

    Have you guys ever seen a baby like this get better?
    yes

    Lets make a quick list of what is going well
    1) You make enough milk for you baby. This is huge, given your situation.
    2) Baby HAS nursed. Again, a great sign things can get better.
    3) This week, minor progress. Minor or not, progress is progress
    4) You have support at home and from your LC

    IN my opinion, this is all great news for you being able to breastfeed.

    I have lots more thoughts but unfortunately cannot get into it all right now. I would suggest trying other positions and get rid of the pillow. Your milk is everywhere so the problem is unlikely to be slow flow. It sounds more like a fast flow. So try laid back nursing
    Try offering the breast way more often. Don't schedule that. If you like, schedule the pumping and the bottles, but offering to nurse can happen anytime.

    No one (I hope) suggests starving a baby into feeding. A starving baby is dying.

    Nor is it recommended by those who know what they are talking about to wait to offer to nurse until a baby is very hungry. In fact, in cases of breast refusal, comfort nursing often comes first. This is why I am suggesting offering way more often. Also, A hungry, upset baby is going to have a harder time latching in many cases.

    BUT, it is also true that if a baby is being fed fully or overfed with supplements, or fed very large supplements at a time, that baby is unlikely to want to nurse normally. (With normal enthusiasm or frequency) Why should they?

    So look at how much your baby is being supplemented overall and each bottle. if it is too much, that is going to make it harder to bring baby back to the breast.

    I assume bottles are given using paced bottle feeding method?

    sometimes you have to try three dozen things and try them all again, multiple times.

    Help, my baby won't nurse: http://kellymom.com/bf/concerns/child/back-to-breast/


    latch and positions ideas: http://feedthebabyllc.com/latch-and-positioning/

    laid back feeding http://www.nancymohrbacher.com/blog/...-breastfeeding AND http://www.llli.org/docs/00000000000...astfeeding.pdf

    feeding non latching baby http://www.llli.org/docs/00000000000...ching_baby.pdf
    Last edited by @llli*maddieb; March 8th, 2015 at 08:01 PM.

  3. #3
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    Default Re: 4 week old nipple aversion, please help a desperate moth

    OK couple more things-

    Because I was not pumping as often because I was waiting to feed him, and by the time we are done, it had already been 5 hrs since I last pumped, I feel like my milk is less than when I exclusively pumped. So now I am afraid of my milk supply too.
    There is no reason to wait to feed baby. When a 1 month old exclusively nurses without issues, baby might nurse as much as 10-15 times a day. Often in clusters. Because it is perfectly normal for a baby to nurse with only a short amount of time between sessions, it is also fine to offer the breast shortly after or right after pumping, and also to pump right or shortly after baby has nursed.

    When a mom is needing to pump, supplement, and nurse, it is exceedingly time consuming. So in this situation, a mom may CHOOSE to schedule feedings and pump sessions if it helps her have a better handle on the situation. But this is not necessary for any other reason. and may in fact be something that interferes with the ultimate goal, which is getting baby nursing at the breast. So, this is another reason I suggested to offer to nurse as often as you can.

    Milk production depends on milk being removed from the breasts frequently. Until baby is nursing better, pumping will need to happen with enough frequency to support normal milk production. in other words, try not to go too long between pump sessions.

    And I leak and lose a lot of milk too, when he nurses on one side, the other side would leak a large amount!
    But this is entirely normal. I am not sure why you think this is 'lost' milk...or rather, why you think this matters, as , if baby were exclusively nursing problem free, the same thing would be happening. However, if you really want to save that milk, have you tried catching it in a sterile bowl? There is also a device made for this purpose. But I guess my advice at this point would be, don't worry about leaking milk or do anything that complicates nursing more- if baby is nursing at the breast, that is the goal- that is what you want. Milk leaking from the other side is not a breastfeeding problem so don't create more problems trying to address this normal breastfeeding scenario.

    Did your LC discuss the evidence about skin to skin and breastfeeding? Some also think any holding of baby is important. Whether skin to skin or not, when mom and baby are in close proximity, with baby having easy access to the breast, that sets the stage for getting baby to the breast quickly at the earliest cues, and this in turn facilitates easier latching and less fussy nursing.
    One day he miraculously latched on football hold without the nipple shield and Nursed correctly for 20 minutes on each boob! And was satiated enough that he slept for 2.5 hours! This never happened again.
    When trying to wean off nipple shields, it can often feel like one step forward and two steps back. But if your baby was once capable of nursing so well without the shield, obviously there is no actual physical barrier to him doing so again. This is again, good news.

    But I suggest, do NOT judge a nursing session by how long baby seems "satisfied" or sleeps after. In the newborn period, again, it is entirely normal for a baby to nurse frequently - several times an hour- some of the time, and less frequently other times. I think the nursing session sounds like a good one because the actual session felt that way to you, but baby could have had just as nice a session and wanted to nurse again in 20 minutes.

    I mention this because Thinking that baby should "go" a certain length of time between nursing sessions causes many problems. First, because mom may think a nursing session was not good when in fact it was. And in the case where a baby is being supplemented, it may lead to over supplementation.

    Also, if baby is not yet there, baby will soon be at the prime age for overt fussiness and even bouts of inconsolable crying, which in some babies is so bad it is called colic. This does not happen with all babies but it happens with many, and it can again make mom think she is not able to satisfy baby or baby is hungry, because baby is constantly needing to be comforted. But in fact, this is almost always normal and temporary and happens with babies who are getting plenty to eat and has nothing to do with hunger.

    The most accurate way to tell a baby is getting enough to eat is by 1) weight gain is normal and 2) Poop output is adequate. If gain is normal, baby is getting enough to eat. In the brand newborn, Poop output can help you know baby is getting enough between weight checks. (Starting anytime after about 6 weeks, occasionally earlier, some babies do not poop as much and even start going days between poops while still gaining normally.)

    Exclusive pumping verses Breastfeeding.

    Yes, it is very very difficult to EP long term. Few moms do it for as long as they would normally have nursed. But, it is possible, and for some moms, preferable.

    But, here are some things to think about.
    1) Again, you have lots going for you. Including, I forgot to mention, baby's age, still very young and thus, much more likely to be brought to the breast than a baby who is 3 or 4 months old or older. And yes, I have personally known mothers who brought babies that old and older to the breast.

    2) Nursing AT THE BREAST has many benefits that have nothing to do with the milk itself.

    3) There need not be a stark choice between exclusive nursing or exclusive pumping. Frankly, I think there is every chance your baby will exclusively nurse. But, say that does not happen. Say your milk production does go down, and you always have to supplement some, but baby nurses at the breast, or nurses (gets your milk) for longer than if you exclusively pumped. IN other words, the goal need not be "Only breastmilk into baby for as long as I can even if it means exclusive pumping" It could be "Nursing as much and as long as I can even if supplements are needed along the way." Or many other variations.
    Last edited by @llli*maddieb; March 9th, 2015 at 12:11 AM.

  4. #4

    Default Re: 4 week old nipple aversion, please help a desperate moth

    Thank you so much for your reply. I think we definitely overfeed the baby with the bottle, because he vomits sometimes and if we lay him down to change his diaper after a bottle feeding, he almost always spits up and gags. I am totally onboard with slow pace feeding, but my husband thinks I am torturing my son by making food slow for him. Ugh!

    A note in skin to skin. We did not do very much of that the first month, people were always over and my bb and I had to be constantly dressed. I think I will try to skin to skin more, I do it literally just once a day when I try to breastfeed. I will just hold him as much as I can, when he sleep and when he plays etc.

    After I pump there will be no milk left, would it still be good to offer the breast? Also the baby sleeps in between, so when baby is awake even when he is not hungry offer the breast? Like constantly? Would that make him hate the breast more?

  5. #5
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    Default Re: 4 week old nipple aversion, please help a desperate moth

    Okay first off please stop thinking that your baby hates breast-feeding. Your baby is compelled by nature to nurse at the breast just like every other baby on earth.
    For various reasons your baby has been trained away from breast-feeding to the bottle. The idea now is to gently train him back to the breast. Offering the breast means putting baby near the breast and see what baby does this should not upset your baby. If it does it just means you're starting back a little bit further at breast aversion. From what you said in your post I do not think you have this problem but even if you do but that's okay even this can be overcome.

    New study has shown that even skin to skin with a slightly older babies not only brand-new born is very effective in stopping breast-feeding problems. Also there is absolutely no reason to limit the amount of time you hold your baby.-month-old babies love to be held and mom should do most of the holding esp. when there are breast-feeding issues in particular. However dad can do skin to skin as well! Get everybody else out of that house and get your baby on you basically all the time with as much easy access to the breasts as you possibly can. If you're not comfortable being completely unclothed it is fine if baby is in a onesie or you are in a tank top or T-shirt or something but you want baby on you near the breast as much as possible skin to skin or otherwise, and if not skin to skin then with very easy access to the breast.
    This is another reason laid-back breast-feeding can be so helpful. Don't you want to just relax and put your feet up on the couch snuggling baby on your chest? This is what you want to be doing as much as you possibly can and then if and when baby shows any interest in nursing you get them on there as quick as you can. Or let baby get on there. Your baby may be able to do much more of the latching on his own than you think. But you're going to have to get them in the right position so that he can do that that's what laid-back breast-feeding is all about.

    Paced bottlefeeding has nothing to do with artificially slowing down feedings to frustrate a baby. What it does is it allows baby to control the flow of the milk and take natural necessary pauses as baby naturally would at the breast. A baby cannot do this when they are given a bottle in the traditional method. Some Lactation consultants call the traditional method of giving a bottle "milk boarding". Or they say "baby must drink or drown" these are harsh terms but they are accurate. The way bottles are given traditionally is completely unnatural and very harmful to breast-feeding success. Even an exclusively bottle-fed baby will do much better to be fed via paced bottlefeeding.
    Maybe your husband does not quite understand what paced bottlefeeding consists of. There is an excellent video on YouTube by lactation consultant Jessica Barton and I suggest following her guidelines. There is only also a good explanation on this website search for bottlefeeding the breast-fed baby it's a PDF file. The only thing I don't suggest is that there needs to be any specific time between feedings. There doesn't. As long as feedings are appropriately sized, baby can basically be Cue fed for both bottles and nursing. But you don't have to wait for baby to cute to offer don't forget you can always offer to nurse as much as you like. However how Q feeding with bottles is going to work as you're also trying to get baby to nurse at the breast will probably take some juggling.
    Last edited by @llli*maddieb; March 9th, 2015 at 03:59 PM.

  6. #6

    Default Re: 4 week old nipple aversion, please help a desperate moth

    Just an update:

    I think I may have overactive letdown on top of the rest of those problems. So I decided to pump out some milk first before feeding him. So for the last couple of days, he would feed with the breastshield maybe 3-4 times a day for maybe 10 minutes each side. But usually he would get hungry really quickly again and sometimes I would have to follow it up with a bottle.

    With th nipple shield, sometimes he will put it in his mouth and gag a little bit, he makes thery heaving face! Like he wants to vomit, is it because the shield is really big for his mouth??

  7. #7
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    Default Re: 4 week old nipple aversion, please help a desperate moth

    Thanks for the update.
    I think I may have overactive letdown on top of the rest of those problems.
    Ok. just do you know, 'fast' let down is common and typically comes along with over production.
    So I decided to pump out some milk first before feeding him
    . If this is working, great. but any additional pumping is going to increase your milk production and probably your fast letdown as well. Here is what can really help most of the time when there is a fast letdown: Laid back positioning (see links I posted previously) and nursing more often. If those two are not doing the trick, what about taking baby off when he starts having difficulty with the flow, letting the milk flow into a cloth, and then putting baby back on? Or, as an alternative to pumping prior to nursing, try hand expressing a little milk prior to nursing. Also, FYI, nipple shields tend to reduce a fast flow. However, since they can cause so many potential problems, it is probably rarely appropriate to use them only for that purpose.

    So for the last couple of days, he would feed with the breastshield maybe 3-4 times a day for maybe 10 minutes each side.
    Ok, so this is better than before, the same, worse...?
    But usually he would get hungry really quickly again and sometimes I would have to follow it up with a bottle.
    It is really really really important to not judge milk intake by an infants behavior or how frequently they nurse. I had overproduction and fast letdown with all three of my kids, all three gained weight like crazy, and all three nursed very frequently. Healthy, normally growing breastfed one month olds nurse a lot. 10+ times a 24 hour day. That means, 10 times or more, sometimes, much more. Also, they cluster nurse part of the time, meaning they nurse as much as several times an hour some of the time. Fussyness or length between feedings is simply NOT a reliable sign baby did not get enough at a feeding.
    With the nipple shield, sometimes he will put it in his mouth and gag a little bit, he makes thery heaving face! Like he wants to vomit, is it because the shield is really big for his mouth??
    Its possible. Have you continued to try weaning off the shield? Different positions? Different latch ideas? Are you sure you are putting the shield on correctly? Your nipple should be pulled at least part way into that tip when it is on correctly. You could try to find a different shield with a shorter tip, but that can be difficult.

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