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Thread: Help! Not latching, and not getting enough milk with shield

  1. #1

    Exclamation Help! Not latching, and not getting enough milk with shield

    I'm a first time mom of an almost 1 month old premature baby. He is probably around 8lbs now, and was eating with a nipple shield quite well until recently. I don't think he's getting enough anymore with the shield, as he's super fussy at the breast, will often fall asleep after eating for 10 minutes and as soon as I reposition to burp him he's fussy and hungry again...sometimes this behavior can last over an hour.

    I'm starting to get frustrated because I'm positive the problem is the shield, but I cannot get him to latch at all. He just gets more upset if I try without the shield, and often pushes me away. This, in turn, upsets me because I feel like something I should be able to do I'm not...I feel like it shouldn't be that hard to do something which should be natural.

    I have flatter than normal nipples and that was the initial problem, I've only managed to get him to latch without a shield twice and I'm honestly not sure how I managed it but I was laying down at the time.

    Please, if anyone has any advice let me know. Having a fussy, hungry baby that needs an hour or more to eat is about to drive me insane knowing it's such a simple fix, even if it's not easy. It's also interfering with my need to build up a supply of milk for when I go back to work full-time. I currently work 1 day a week, and only have 4 bags of milk because I'm afraid now to pump after he eats because he eats off both breasts now and I feel like if I pump for the extra milk he'll get hungry and I won't have any to give him...nor any to save.

    What I have tried is letting him start eating for a little bit with the shield, then take it off and see if he will relatch without it. So far, no luck with that. I've tried letting the nipple fall in his mouth, but he just upset and more fussy the more I try that. I've tried pinching it, or sandwiching, to get more nipple in his mouth but he tried to latch but isn't able to...as in, you can hear it's not an air-tight latch.

    Please help!

  2. #2
    Join Date
    May 2006
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    24,794

    Default Re: Help! Not latching, and not getting enough milk with shi

    Welcome to the forum!

    First question- has baby been checked for lip or tongue ties?

  3. #3

    Default Re: Help! Not latching, and not getting enough milk with shi

    Yes, and he doesn't have either one of those. That was initially what I thought the problem may have been as well.

  4. #4
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    Default Re: Help! Not latching, and not getting enough milk with shi

    It sounds as if you're basing your concern about whether or not baby is getting enough at the breast primarily off of baby's behavior. But this can often be misleading. Has there been any reduction in output- poops -or any problems with weight gain?

    When mom is using nipple shields it actually is very important that she pumps after at least some feedings. Nipple shields are linked to poor milk production and it is thought might interfere with milk transfer this is why pumping is important not just to have expressed milk for your baby should baby need it but mostly to make sure your milk production is not impacted while you are using shields. In other words pumping is actually going to only help your milk production and consequently help your baby get more milk at the breast.

    It would help us to know how often baby nurses - how many times in 24 hours -as well and also what kind of pump you have etc.
    Also have you seen a lactation consultant, are you still seeing one or are you able to do so?

  5. #5

    Default Re: Help! Not latching, and not getting enough milk with shi

    Quote Originally Posted by @llli*maddieb View Post
    It sounds as if you're basing your concern about whether or not baby is getting enough at the breast primarily off of baby's behavior. But this can often be misleading. Has there been any reduction in output- poops -or any problems with weight gain?

    When mom is using nipple shields it actually is very important that she pumps after at least some feedings. Nipple shields are linked to poor milk production and it is thought might interfere with milk transfer this is why pumping is important not just to have expressed milk for your baby should baby need it but mostly to make sure your milk production is not impacted while you are using shields. In other words pumping is actually going to only help your milk production and consequently help your baby get more milk at the breast.

    It would help us to know how often baby nurses - how many times in 24 hours -as well and also what kind of pump you have etc.
    Also have you seen a lactation consultant, are you still seeing one or are you able to do so?
    Not that I've noticed, but the problem is more he's not getting all he needs in one sitting. Though I do have a pump, I hadn't thought to express after he eats for any reason other than to stock up for when I'm gone. The hospital gave me the nipple shield after a couple hours of having problems getting him to latch...I'm beginning to resent them for not having warned me about using them or encouraging me later to stop using it.

    I have a medela pump in style backpack and as far as I can tell it works well for me. Because I was worried about his eating habits I downloaded a BF app, and yesterday for the whole day from midnight to midnight he ate 9 times with an average of 15 minutes. Though yesterday was a good day, he didn't have too many problems...but this morning he has. He's eaten off the same side the last 3 times because he will only eat for 5 minutes, and I know he hasn't emptied the breast and I keep getting plugged ducts because of it. Between 7 and 9:30 he ate 3 times, once for 5 minutes, 10 minute and 7 minutes.

    No I haven't seen a specialist, but to have it covered by insurance I need to be referred. I have an appointment with my OB on the 14th, and I was going to talk to him about seeing one to try and prevent the plugged ducts, and another bout of mastitis.

  6. #6
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    Default Re: Help! Not latching, and not getting enough milk with shi

    OK I have a couple suggestions.
    First off call your OB or your baby's pediatrician today and ask for a referral don't wait for two weeks. If your baby is not able to latch without nipple shield you need to find out why and that is why you see a lactation specialist for those kind of questions. This is also who you should be seen to discuss tongue-tied and how that may or may not be impacting your babies ability to latch. You need to get this taken care of sooner rather than later because if there really is a problem then the longer it drags on the more difficult it will be to solve.

    I'm not sure what you mean by baby not being able to get enough at a single feeding if your app is suggesting that there is any such thing as a single feeding that lasts X amount of time every X amount of hours then please delete the app it is misleading you.

    You can expect a newborn baby to nurse a minimum of 10 to 12 times in 24 hours that's the minimum that's how much babies actually do need to eat. It is also normal for the time lapses between nursing sessions to vary considerably anything from a couple minutes to a couple hours, with some babies giving moms a single stretch per 24 hours of about four hours at most.
    Nursing sessions normally vary considerably in duration anything from a total of about 10 minutes to 45 minutes is normal at this age. Sometimes babies want one breast sometimes they want both typically it's fine to let baby decide which although if you wish to make sure baby is getting more or you think baby needs to be more wakeful or active during nursing session, you could have baby switch sides at least once during every session.

    If your baby were not getting enough milk your baby would not be pooping within normal parameters and your baby would not be gaining weight that is how you tell whether baby is getting enough milk by how much they poop (up until about six weeks when some babies who are getting plenty of milk start going several days between poops) and by weight gain.

    Just to give you a different perspective about nipple shields nursing your baby with a nipple shield is still really nursing. This is far, far better a situation for many reasons than having to pump and bottlefeed your baby so if the nipple shield is what you need to do right now keep doing it, obviously it would be nice to wean off of it but don't panic about that. But yes it is unfortunate that you were not given better assistance early on unfortunately this is all too common a story.

    Kelly mom.com has a good article on shields including weaning off nipple shield she also has a very good article about low milk production and how to tell you actually have it - many mothers mistake normal behaviors as meaning they have low milk production when actually they do not. The last thing you want to do at this point is supplement unnecessarily or more than is necessary.

    Start adding a little bit of a pump session after some nursing sessions you probably don't have to do it after every single one just maybe half? Just a few minutes just to make sure your breasts are getting that extra stimulation and extra milk removal. Do not ever worry about how much you "get" when you pump. Pumping like this is really just a precaution but it is important whenever mom is using Shields especially if she is concerned about her milk production. Obviously any milk that you get you can save it for baby when you are at work.

    If you go to the "breast-feeding news " section of this forum you will find another new article about what does and what does not signal low milk production and why so many mothers think their babies are not getting enough milk when in fact they are.


    Plugs a and mastitis are best avoided by nursing frequently. Are you ever getting engorged or overfull?
    Last edited by @llli*maddieb; August 4th, 2015 at 12:55 PM.

  7. #7
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    Default Re: Help! Not latching, and not getting enough milk with shi

    Quote Originally Posted by @llli*maddieb View Post
    When mom is using nipple shields it actually is very important that she pumps after at least some feedings. Nipple shields are linked to poor milk production and it is thought might interfere with milk transfer this is why pumping is important not just to have expressed milk for your baby should baby need it but mostly to make sure your milk production is not impacted while you are using shields. In other words pumping is actually going to only help your milk production and consequently help your baby get more milk at the breast.
    Can you provide some updated sources for this? My understanding is that problems with nipple shields affecting supply were linked with older, thicker forms of shields rather than the more contemporary, thinner forms. Am I wrong?

  8. #8
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    Default Re: Help! Not latching, and not getting enough milk with shi

    I think that the issue with nipple shield is simply more complicated than the old shields cause problems and the new ones don't.

    First off those old shields are very old - thin silicone Shields have been in use for a long time something like 15 or 20 years.

    I am camping and don't have any textbooks with me with studies but anecdotally there is no doubt that many mothers who use shields tend to see a reduction in milk production not everybody but enough that there seems to be a connection.

    What is not understood at this point and may never be, is whether this connection is due to the shields itself or because the situation is already precarious with the baby's ability to latch and nurse efficiently in the first place which is why the baby needs shields to nurse.
    And of course there is the problem that many mothers suspect they have low milk production when actually they don't and that makes studying this area even more difficult. A mother who is using nipple shields and has a baby with latch issues is probably going to be even more likely to have the perception of low milk production even when it is not the reality. But that does not mean that sometimes it is not the reality sometimes it is.

    This is further complicated by the fact that what often happens is that in the early days shields are used not as a last resort tool By a certified lactation consultant who should know the precautions that need to be taken with shields, which would include closely monitoring the baby's weight gain and the breast-feeding situation as a whole repeatedly over The entire time shields are in use, but instead they are too often used as an instant fix or crutch by those who are either not trained properly in how to help a mother and baby latch correctly, or they simply don't have the time to do so.

    Considering the above pumping after some nursing sessions seems like a common sense precaution to take whenever we are not sure how well the baby is transferring milk and how well milk production is being stimulated.

    My source is the womanly Art of breast-feeding eighth edition 2010.

    I also have personal experience with using a silicone nipple shield 12 years ago and I have about 10 years of experience supporting mothers with breast-feeding problems as a volunteer.
    Last edited by @llli*maddieb; August 5th, 2015 at 11:01 AM.

  9. #9
    Join Date
    Jul 2015
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    Default Re: Help! Not latching, and not getting enough milk with shi

    Quote Originally Posted by @llli*maddieb View Post
    I think that the issue with nipple shield is simply more complicated than the old shields cause problems and the new ones don't.

    First off those old shields are very old - thin silicone Shields have been in use for a long time something like 15 or 20 years.

    I am camping and don't have any textbooks with me with studies but anecdotally there is no doubt that many mothers who use shields tend to see a reduction in milk production not everybody but enough that there seems to be a connection.

    What is not understood at this point and may never be, is whether this connection is due to the shields itself or because the situation is already precarious with the baby's ability to latch and nurse efficiently in the first place which is why the baby needs shields to nurse.
    And of course there is the problem that many mothers suspect they have low milk production when actually they don't and that makes studying this area even more difficult. A mother who is using nipple shields and has a baby with latch issues is probably going to be even more likely to have the perception of low milk production even when it is not the reality. But that does not mean that sometimes it is not the reality sometimes it is.

    This is further complicated by the fact that what often happens is that in the early days shields are used not as a last resort tool By a certified lactation consultant who should know the precautions that need to be taken with shields, which would include closely monitoring the baby's weight gain and the breast-feeding situation as a whole repeatedly over The entire time shields are in use, but instead they are too often used as an instant fix or crutch by those who are either not trained properly in how to help a mother and baby latch correctly, or they simply don't have the time to do so.

    Considering the above pumping after some nursing sessions seems like a common sense precaution to take whenever we are not sure how well the baby is transferring milk and how well milk production is being stimulated.

    My source is the womanly Art of breast-feeding eighth edition 2010.

    I also have personal experience with using a silicone nipple shield 12 years ago and I have about 10 years of experience supporting mothers with breast-feeding problems as a volunteer.
    Thanks -- and happy camping!

  10. #10

    Default Re: Help! Not latching, and not getting enough milk with shi

    For what it's worth, I was convinced that the nipple shield was the silver bullet that finally had her feeding at the breast, only to realize 3 days later that it made the situation worse. She turned into a really cranky baby with a totally different temperament, and I realized she was using the tip as a pacifier, passing a little milk and saliva back and forth without pulling very much milk. She lost weight again during the period we used it.

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