Nipple shields, tell me they're OK?(111 Posts)
DS was born 5 days ago. I always struggled with breastfeeding DD 3 yrs ago, i never got the famous endorphin high, but i kept going through guilt etc (mixed from 3/4 mths, 2 breastfeeds maintained till 8 mths) and, as a result, had a rather miserable experience of early motherhood. I'd really like to enjoy the experience this time and I do think DS is a better feeder, but i'm struggling again with the discomfort, and this time i'm clear that i'm not going be a martyr to it and make my life -- and that of DH and poor DD -- grislier than it has to be.
Various midwives have told me the positioning is fine, but whatever, there is a problem with pain, esp when latching on. My main MW says i have signs of nipple trauma, tiny colourless blisters on the old nips, but seems to think the thing is just to persist regardless. She is very pro breastfeeding, which is great, but when i mentioned nipple shields to help me through this rough patch she said they inhibited milk production, and basically implied using them would be a mistake.
well, DS is a hungry chap, i'm struggling to keep up with him as it is, and i have to say that i did buy some and started using them yesterday and it's fantastic: the pain goes, and i can feel my uterus contracting gently which i think (?) is linked to let-down (it feels great btw), and he is soused in milk, esp by day. The last 2 nights have been a bit fraught, i guess my supply has got to catch up with his appetite, but i'm sure i'm feeding him for longer and in a better state of mind than if i wasn't using them, so it has to be good, right? or am i making a terrible mistake?
I have been trying to use them only for alternate feeds, but it's so much more pleasant with them... do i have to give them up?
well, I used them with my first child (who's now 4) and if I hadn't, I would never have breast fed. I used them exclusively for around 4 weeks (trying every now and then to see if I could manage without). Suddenly, after 4 weeks I found I could breastfeed fine without them and never looked back. They saved my sanity and it seems like they are saving your so I can't see a problem! Just keep trying every now and then to see if you can manage without. You'll probably find you will at some point.
If you can avoid him becoming used to them, so he won't feed without them, they're probably ok, particularly if his gain is good. (Using them for every other feed seems like a good way to achieve this.)
There are things you can do to reduce discomfort, too, though ... leaving your nipples out to air dry, smeared with milk, can soothe the skin. Many mums swear by Lansinoh, although I've not used it.
I'd get the latch checked by a breastfeeding counsellor, just in case the pain is caused by bad positioning. Pain (and stress related to it) could be preventing let-down when you're not using the shields.
I do agree about getting the latch checked by a real expert.
With DS3 I thought I knew what I was doing, but didn't realise for quite a while that he just wasn't latchking on properly at all and was just sucking on the nipple instead of getting a big mouthful of breast. Pain ceased as soon as I realised and made him latch on properly, but unfortunately he'd already got in the habit of just sucking on the nipple, which was quite hard to get him out of again.
Bakdpotato - there are downsides with using nipple shileds but you sound as though you know what they are. The main problem is women being given them without being aware that they can cause more problems than they solve.
Your nipples are sore because baby has probably damaged them whilst learning the technique of breastfeeding. Nipple shields do not teach your baby to breastfeed properly but if you are using them for alternate feds and feeling happier, then continue as you are. If your baby is correctly latched then the pain will start to subside. I personally had very painful nipples with DS2 and found it was the 10th day before they started to improve. The tips were scabbed and I was rather embarrassed to let the midwife see what I had allowed to happen through poor positioning. I put breastmilk on my nipples which helped. Get some Lansinoh cream - it is expensive but lasts a long time and definately helps. It is the nipple cream to have (or Purelan).
Feeds may be longer with the shiels because it takes longer for the milk to get through to the baby. If you are happy to do that then continue. It might be an idea to hand express after/between feeds just to stimulate the breast more to produce more milk as the shield reduced the stimulus to the breast. Long term shield use can reduce milk supply by up to 40%. That isn't a problem for women who have an abundant supply but it can cause real problems for women who are not producing enough.
If your baby is fixed properly the pain should not persist through the whole feed. I used to count to ten after fixing baby, if the pain was still there I repositioned. Remember not alwys to feed in the same position so that it is not always the same part of the nipple getting traumatised. Alternate with the rugby hold position.
Bottom line is do whatever is going to help you continue feeding but bear in mind that long term shield use can cause more problems. Also remember the painless feeds you are experiencing is what breastfeeding will be like when your nipples are healed.
I have got flat nipples and therefore my dd just couldn't latch on so in the hospital was recommended to get some nipple shields which my dp brought in for me.
I therefore was able to breastfeed fine - initially. However, only lasted for 8 weeks as my dd started to lose weight and my hv thought it was because dd was just using the nipple shield as a dummy and not really drawing milk. I could express fine so it wasn't an issue re my milk supply. I continually tried to breastfeed without nipple shields but it just wasn't working - so my dd is now formula fed.
I was really disappointed to have to give up breastfeeding but nipple shields seem to have helped initially - but weren't the answer in the longer term. Therefore, I think they are fine for short -term use - but don't depend on them - it's worth getting some guidance from a breastfeeding specialist - I will be next time.
hotmama, I had a similar experience with DS1, only I managed to persevere (and ignore hv telling me to supplement), and got off the shields around three months (nobody told me the shields were maybe part of the problem - I just hated the hassle). I then successfully breastfed to 18 months.
Which, it turns out, changes the shape of your nipples. I think mine were only flattish to begin with. With DS2, I've had no problem, no shields, and good gain.
At any rate, I've heard that expressing in pregnancy, or before feeds, is a good fix, as it draws the nipple out more.
bakedpotato, my experience is the same as foxinsocks's. I used shields to get me through, when I just couldn't feed without them. After a few days (after the worst of the nipple damage had healed) I did keep trying without them and - in the end - things got better. Good luck!
Thanks notquitecockney - it's nice to know of someone who has persevered and got this sorted - it gives me hope that next time I will get things sorted - and will do some advance planning to get some support available if I need it.
I will have the confidence to ignore the hv and hassle for assistance if needed.
this is all so useful. thanks for all your responses. it's good to know that they can help if used carefully. i will stick with them for every other feed for the time being till nips heals, and then experiment with a view to dropping them eventually.
have already got lansinoh. DH has just raced out and bought a mini electric pump to keep supply up.
i think the prob is that i can't get DS to 'gape' widely enough when latching on. i'm putting pressure on his chin which encourages him to open up more, but it's hard to do this manoevre when the pain is bad. however, i think it might be improving, sometimes it seems to hurt slightly less when i'm not using the shields, but i will look into getting a breastfeeding counsellor to check us out. there must be threads on how i can find a b/c.
if they were jeopardising supply, how long does this take? is it an overnight thing, or progressive over a longer period?
I used them with dd and breast fed with them till she was 8 months. She never did latch on properly.
With ds I ended up using them again and kept trying as it is a pain to keep sterilising them. At 4 months he did latch on and I fed him for 15 months.
MW and HV all frowned at me using them but if I hadn't they would have been bottle fed. luckily though I seem to produce copious quantities of milk so supply did not seem a problem....
BF counsellors with NCT, LLL, Association of Breatsfeeding Mothers and Breastfeeding Network.
Where in the country are you? Are there no BF clinic near you?
For a big gape, I find a crying baby is the best !
I used nipple shields with my 1st but as a BFC I really would suggest you try to get rid of them as soon as you can... they do affect your supply and the way the baby feeds. If they make you feel better I can totally sympathise but you will probably delay fixing it IYSWIM.
BTW- lansinoh is available on prescription.
i used them for a few days for a rest as i was in so much pain. M/w who I really respect wasn't keen but they saved me. Knew they weren't a long term solution though.
Had problems with the 'gape' with dd too. Seemed to have got it a bit better this time with ds by touching his nose/upper lip with the nipple so he has to sort of stretch up to it and then take the chance to get the boob in!
i have an inverted nipple on left breast and used a nipple shield for 6 months. dd1 fed fine and i had to wear a hand towel folded, at night because of my milk supply. nipple was fine with dd2 but used a nipple on shield on both nipples for a week when my nipples cracked because dd2 fed 24/7. mw in hospital discouraged me but eventually when dd1 lost over 1lb, the breast feeding co-ordinator for the hospital introduced them to me. with dd1 i could have not managed without a breast shield and she would have been on formula.
I was introduced to them in hospital as ds couldn't latch on efficiently and it was either that or succumb to pressure to bottlefeed him as he became increasingly jaundiced and sleepy. Within 10 days we were feeding without as I gradually dropped them over a few days once he was more alert and got the hang of it.I think my crunch came one nightfeed when couldn't be bothered to get up and fetch freshly sterilised ones - he fed well and I realised we could manage without.
Nipples can heal pretty quickly - use a recommended cream and expose to fresh air rather than a damp breastpad, and when I had problems (pressure points very sore, found that alternating position helped. Think your idea to use them for alternate feeds is a good one but try to only see it as a protem measure.
bakedpotato - the 'gape' problem sounds very familiar - look on this thread if you want to know what advice I got.
I used NS with DD1 when my nipples were cracked and sore and I was about to give up out of pain and frustration. As the others have said - once the nipples were healed and DD knew what to do a bit more we could throw them away and went on Bfing for over 6 months.
I'll have no hesitation in using them again if I have problems with no.2. Better to try them than give up I reckon.
Best advice my HV ever gave me BTW.
wow, HD, you really went through it.
need to see a bfc, that seems obvious. my MW says she and her colleagues at the hospital (i'm in north london) are trained in b/f counselling, but i don't think she's really grasped what is at stake somehow. there's a local clinic run by the hospital but if the advice given out there echoes the line she is giving me (ie, just keep going anyway through the pain), it'll just depress me even more.
can't believe some people put up with this pain for wks and wks before it got better. there's no way i could do that.
Usually BF clinics are run by infant feeding specialist (lactation consultant) and BF counsellors.... if that is the case.... it's worth the detour ! Just asks who runs it and who gives support there...
I should add you would get out of your visit
1. a better latch
2. ways of improving it on your own
3. support not what you just describe*
I would recommend to take DH with you if you can so he can hear too what you need to do and help you when latching time comes. Sometimes there is so much info that you can only remember a fraction of it - 2 brains are better!
* small comment - not aimed at bakedpotato in particular - but I have seen women (my clients basically) sometimes totally misinterpret or misunderstand a HV or MWs advice and take it much more negatively....
The "gape" problem is exactly what I had, bakedpotato. Hopefully a visit to a proper breastfeeding counsellor should help an awful lot. It is tricky, isn't it - you have to get baba to open wide first, then bring him swiftly to the breast - which is much easier said than done.
i'm sure it's the gape thing. tonight using the shields, i've been sticking a finger in and forcing him to open his mouth properly. the difference, even through the silicone, feels great. the prob is, without the shields, i can't adjust him without screaming. and the thought of relatching just makes the soles of my feet pour with sweat (i've had to throw out my nice lilac slippers from Office after the last few days).
pupuce, thanks for those pointers. yes i will definitely follow up. but i do think my MW, who, i really like, hasn't really clocked that the situation isn't quite as happy as it seemed in the hosp the day after delivery, when she pronounced the latch 'textbook' and DS 'a natural'... i had my doubts even then.
bakedpotato - I went through the same as you recently (dd3 is 3 and a half weeks old). i would definitely advise going to see a breastfeeding counsellor before your nipples get really damaged. Mine did and it was absolutely agony. I live in North London too and can let you have details of some counsellors - they have really helped me (I was ready to give up 2 weeks ago, it was such agony).
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