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Thread: Latching woes and nipple confusion

  1. #1

    Default Latching woes and nipple confusion

    My LO is almost four weeks old and I have yet to get him to latch without a nipple shield. With the shield he can achieve an imperfect latch that leaves me sore and him hungry.

    We had never intended to do anything but breastfeed, but for the 30 minutes we had with him right after delivery he was sound asleep and the staff at the hospital fed him before they brought him back to us from the nursery.

    My milk was slow in coming in and we were told that he should be eating the full 2 oz bottles of formula they gave us at each feeding. I was terrified of starving him and so we got a pump for me to use to increase my milk supply and fed him formula while we were waiting for the milk to arrive.

    By pumping every 2-3 hours and drinking mother's milk tea I have been able to move from just a tablespoon or two of milk mixed into the formula to about a half-and-half ratio - he's eating about 4oz at a feeding.

    I was hoping at this point to transition back toward breastfeeding to let his need help increase and maintain my milk supply; as I'm sure many of you know, being up to pump milk (which may or may not coincide with baby awake times) means you're doing twice the work for half the reward.

    As might be expected, I'm having a LOT of trouble getting him to latch now. He's spent 90% of his life on artificial nipples and the other 10% on a nipple shield, but the latch he makes with the shield causes uneven pressure on my nipples and quickly becomes painful. I also think the poor latch inhibits the flow.

    I just got a smaller nipple shield which seems to work slightly better, but that wasn't the solution I wanted. I wouldn't mind talking to an LC but we live pretty far out so that's a method of last resort, which I'm rapidly approaching. Any suggestions are welcome.

  2. #2
    Join Date
    Feb 2010
    Posts
    132

    Default Re: Latching woes and nipple confusion

    I'm sorry you had a rough start. Oh how I remember! The nurses at the hospital really make me . I don't have any suggestions on this but I wanted to bump your post.

  3. #3
    Join Date
    May 2006
    Posts
    19,888

    Default Re: Latching woes and nipple confusion

    Welcome! I'm so sorry you and your LO have gotten off to such a rough start. I'm appalled (but not surprised) by the treatment and bad advice you and your baby received at the hospital. How dare the nurses feed your baby a bottle of formula when what he needed to do was go right to you? If you decide to have more kids, next time either have the baby at home (), make sure someone accompanies the baby to the nursery, or don't let him go to the nursery at all. Also, next time make sure you nurse ASAP- there's absolutely no reason why a newborn needs 2 oz of formula while you knock yourself out pumping. A newborn's tummy is only about the size of his fist, and colostrum is really all new babies need in order to thrive. In addition, it's constant nursing that causes your milk to come in.

    Okay, that's all in the past. Phew! Hopefully I didn't make you feel bad- I'm operating on the assumption that more information is better. But I know that you might take what I posted above as a critique of you, which it isn't. It's a critique of the assistance and information you were offered.

    Here's the good news:
    1. It sounds like your supply is up. 2 oz per pumping session is good output, and since many month-old babies eat only 2-3 oz at a feeding, you're very close to having all the milk you need.
    2. Your baby will latch. Even though his latch isn't perfect, you're still in a better position than a mom whose baby won't latch at all!

    Okay, so here's what I would do if I were in your shoes:
    1. Go see the LC. Yes, it's far away and may cost more than you want to ay, but now is the time to do it and in the long run the cost will be far less than a year's supply of formula.
    2. Pump, pump, and pump some more. The more often you remove milk from the breast, the better your supply will be. When I had supply issues, I pumped every 2 hours during the day and every 3 at night using a hospital-grade pump.
    3. Coax the baby back to the breast using the techniques here: http://www.kellymom.com/bf/concerns/...to-breast.html In particular, the instant reward and skin-to-skin techniques should be helpful.
    4. Try to ditch the shield (information here: http://www.kellymom.com/bf/concerns/...to-breast.html) but if that's the only way the baby will nurse, don't sweat it too much. You can work on getting rid of the shield later.
    5. Try to reduce the amount in your baby's bottles to about 2 oz per feeding. You want him to be hungry more often, so that you have more chances to get him to latch. Of course, be flexible! Smaller bottles may work, or they may not.
    6. Try alternative supplementing methods: http://www.kellymom.com/bf/pumping/a...e-feeding.html In particular, a SNS or Lact-Aid supplemental feeder may be helpful, because it will teach your baby that all meals come from the breast.
    7. Time-saving tips on pumping:
    - Keep a large basin next to the sink and throw all used bottles/pump parts into it as they are used. I found it helpful to do one large washing per day instead of a zillion little ones.
    - After pumping, leave the pump screwed onto the bottle and pop the whole assembly into the fridge. When it's time to pump again, just re-use the set-up. My LC said it was safe to do this 1 time before everything needed to be washed again.
    8. Use the best possible pump. I suggest using a hospital-grade rental pump with correctly sized shields. (Your LC can help with this.)
    Coolest thing my big girl said recently: "How can you tell the world is moving when you are standing on it?"
    Coolest thing my little girl sang recently: "I love dat one-two pupples!"

  4. #4

    Default Re: Latching woes and nipple confusion

    I can't tell you how well-timed your response was. I had such an awful day - I spilled some of the milk I had collected and my LO immediately went into distress mode any time I tried to get him to latch. I was just about ready to cry.

    Then I logged in and read your reply. It's amazing how fast a proposed plan of action can make you feel better! I called the LC and made an appointment for Thursday. She was encouraging and said between now and then to focus on increasing my milk supply and exactly what you said, to get in as much skin-to-skin contact as possible.

    I have been using the Medela Pump-In-Style and I had already bought three sets of the shields (plus two more sets of the connector parts) that seemed to work best for me, but the advice about washing them all at once has really helped. I hadn't even thought of refrigerating the assembly and re-using it. Now instead of three pumping sessions between washing sessions I can get six, which makes bleary nighttime pumping so much easier.

    After an afternoon and evening of contact without insistently demanding a latch (I decided to try for just a few minutes before every feeding and stop when he gets upset) my LO has already calmed down. I think he was associating contact with hunger and frustration, but now he's much more willing to try without devolving to baby meltdown. Still no success on the latch, but the attempts are much more easygoing.

    I'll let you guys know how it goes on Thursday. I can't tell you how much I appreciate you taking the time to reply. I really needed it!

  5. #5

    Default Re: Latching woes and nipple confusion

    It took me 2 months to totally make the transition, my best solution was breastflow bottles. Babies actually latch onto these bottles like they do the breast and experience a let down too....they are amazing. I would pump, feed with the bottle then try to latch.

    Around 2 months old we made the transition fully to breast. Now she hates bottles lol. It's amazing how something so stressful can seem so distant once you reach your goal. Hang in there!

    I also rented a Lactina pump while I was pumping, saved me hours a day!

  6. #6

    Default Re: Latching woes and nipple confusion

    Well, I met with the LC yesterday. I now have a symphony pump instead of my pump-in-style and it does pump a little more strongly, I think.

    Unfortunately, we weren't able to make much headway with the latch. Even with the assistance of bottled breast milk at hand to keep him calm he just won't stay latched on and it's very difficult to find a stable position from which to nurse him. The LC told me I should worry about focusing on my milk supply and making sure the baby is well-fed.

    Meanwhile, I've seen a major change in baby's mood over the last two days. Instead of being sleepy or cuddly or curious, he's wakeful, agitated and quick to frustrate, which seems to me to be a direct result of our frustrating time together trying to learn this basic mom-infant task.

    This is so discouraging. Someone tell me that this is still possible, that I could still coax him to latch and breastfeed exclusively and that my baby will forgive me for making him so miserable for 45 minutes every other time he's trying to feed.

  7. #7
    Join Date
    Feb 2010
    Posts
    132

    Default Re: Latching woes and nipple confusion

    are you using any pillows to support baby during feedings? The breastfriend pillow was a lifesaver for me. I had to have DS in the perfect spot for him to nurse. Lots of skin to skin might ease the frustration. You can do this! Patience mama

  8. #8
    Join Date
    May 2006
    Posts
    19,888

    Default Re: Latching woes and nipple confusion

    It's all still possible. But unfortunately there are no guarantees. Just keep working on it!!! I promise that your baby will not remember any of these frustrating moments, any more than my eldest remembers me screaming and crying in pain when she latched on. She nursed for 3 years, so I know she enjoyed it a lot despite our super-frustrating beginning.

    Hang in there, Mama!!! We're all rooting for you.
    Coolest thing my big girl said recently: "How can you tell the world is moving when you are standing on it?"
    Coolest thing my little girl sang recently: "I love dat one-two pupples!"

  9. #9
    Join Date
    Nov 2008
    Posts
    68

    Default Re: Latching woes and nipple confusion

    Have you tried giving him an ounce or so with the bottle before trying to latch him on? I'm just wondering if he would be less frustrated if the edge was taken off his hunger first.

    Or maybe you could try doing a lot of skin-to-skin cuddling without trying to nurse for a few days. That might take some of the pressure off and help him (and you!) associate the breast and closeness with comfort without the stress.

    It must be so frustrating. I can understand why you're discouraged. It can take a long time for some babies to learn how to nurse, with or without the added complication of nipple confusion. An LLL Leader I know met with a mom whose baby had major nipple confusion and they were doing finger feeding with a SNS since the baby wouldn't take the breast at all. The Leader gave her all the suggestions she could, but afterward was discouraged and said she didn't expect the mom to keep trying to breastfeed much longer. A month later the mom came to our LLL meeting and the baby was exclusively nursing at the breast. So yes, there's hope! It's likely to take some time, a lot of patience and determination, but it's possible.

    Like mommal said, even though it's stressful right now, that doesn't mean your baby will always have an aversion to breastfeeding. I can't tell you how many nights my newborn DD and I sat in the dark at 3am, both of us crying our eyes out because it just didn't work. Hang in there!
    Karen

    ~~~~
    My brilliant "babies":
    Butterfly - 13 yo - environmentalist
    NinjaBoy - 10 yo - stuntman

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