Tongue tie and coming off nipple shields

[Slavetominidictator]

My sister has an 18 week old DS who had his tongue tie snipped at 3 weeks, on the advice of a lactation consultant. She's fed him since then using nipple shields (also on her advice) with episodic attempts at feeding without them only to have more significant damage caused to her nipples.
He can take an expressed bottle in 10-15 mins. It takes him about an hour to feed at the breast with the shields, which is obviously pretty limiting.
He had viral meningitis about a month ago and had quite slow weight gain around that time, not surprisingly. Supplementation/mix feeding had helped a bit but now any formula seems to give him diarrhoea, so the lactation consultant suggested returning to just breast milk, both expressed and breastfed, with shields.
Yesterday, my sister saw the lactation consultant again who said the tongue tie had regrown and snipped it again. Now that her DS has a chance to learn to latch effectively, does anyone have any tips for how to lose the shields? She's had a hell of a time with this and has asked me to post on here as she isn't a member. Many thanks.

[Slavetominidictator]

Bumping

[Bluebelltulip]

Is the reason she wants to stop using shields time? Babies find it easier to drink a bottle than breast feed so is quicker, removing the shield may not make breast feeding much quicker. I fed for 7 months using shields.

[Slavetominidictator]

She's worried about the shields reducing her supply (his weight gain isn't great and he's dropped two percentiles)

[Slavetominidictator]

I'd be surprised if a four month old took an hour to breastfeed. I presumed the shields were the reason for the long feeds. Of course bottles are faster, but to be his age and still taking an hour to feed seems very unusual.

[MyKingdomForBrie]

If his tt has been properly snipped this time she should be able to take the shields away without issue. My dd has to have her tongue tie snipped twice because it wasn’t cut properly the first time (they say it has ‘grown back’ but not the case - it just wasn’t cut far enough the first time.

Once it’s done properly the pain and damage will very quickly stop. If there is ongoing pain and damage without shields then she needs a second opinion on the cut.

[Biscusting]

Shields can be a mixed blessing, it can be harder work for a baby to feed with them.

If the damage isn’t too bad, would she be willing to try cold turkey without the Sheilds and go with, trying for a good deep latch, and if baby isn’t latching and getting to distressed then topping up with some expressed milk. Also even if baby is feeding well, offering some expressed milk afterwards can help keep the weight up.

It’s hard work, but gradually she should find baby feeding more and the expressed milk reducing.

If she has the right support of family and maybe also an expert to observe a few feeds, it would really help her on the way. It’s exhausting, but can be done!

Kellymom.com is also amazing for troubleshooting.

Good luck!

[yolkybokey]

From my own experience in the summer - my DS had severe tongue tie and I wouldn't have been able to keep BFing if it wasn't for nipple shields. After it was snipped it took a while to get to pain free feeding, so I carried on using shields. DS eventually stopped needing to use them, more or less by himself. I would keep using them as needed but keeping trying a feed without every now and again.