'Oh, just ram 'em on and hope they stick...'

[Gizmo]

Here?s a question: has anyone who has had trouble breastfeeding in the past 12 months had a health professional who thought the best way to help was to grab the baby?s head and your boob and ram the two together as if trying to unblock a sink?

I?m 32 weeks pregnant and starting (as you do) to worry about the postnatal period and particularly getting feeding sorted. DS1 and I had hellish trouble with getting BF established, which resulted in his readmission to NICU for severe jaundice and weightloss after a week. At the time I put it down to one of those things ? some babies just won?t breastfeed ? but I?m mulling it over again now and the more I think about it, the more I?m convinced this is a situation that was largely created by bad handling. I was on my postnatal ward for 2.5 days, during which 3 midwifes tried to help us feed by grabbing DS?s head and holding it against the breast forcibly, while he wriggled and wailed. I even did it myself when I got home . End result was one seriously unhappy little boy with no interest in feeding whatsoever and a rapid decline. Even when we were readmitted to NICU and spent three days being ?re-educated? on breastfeeding, some of the midwifes there were doing the same thing: it was only the introduction of nipple shields that finally broke the impasse and gave DS a clue what to do.

I?m determined to BF no 2 (another little boy) and will turn psychomummy if anyone tries to do the same thing again. But before I go off the deep end, is there any justification for this ?sink-plunger? approach? Any studies on the subject? Has anyone seen it work? Do people still do it ? DS1 was born 4 years ago and it may be that the health profession have spotted that this is not such a great idea

sink plunger Never heard so much crap!
I was taught to brush the nipple against baby's cheek until he turns and opens mouth (reflex) and then bring him forward and let him latch on. Poor baby must have been horrified. Good luck this time around.

Midwives at hospital rammed DS on me... it was horrible. I refused a blood transfusion so I could get home ASAP to do it "my way"... which was take it slow, really help as much as I could by putting nipple in his mouth etc. I was expressing for a week, while working on the latch, and then he was fine. If id gone by the midwives way, hed have not ever latched and they advised formula!

It all started because he wasn't responding well to that conventional tack, Kelly. In retrospect, he was just a bit sleepy and clueless and probably would have responded to some patient handling, coupled with cup/syringe feeding to get his blood sugar up. But Oh No...that would have taken time, on a busy postnatal ward. 'Just hold his head there, dear, he'll get used to the idea in a bit'

Was this recently, Quootiepie?

did you manage to feed DS using nipple sheilds? I found them a great help in getting BF established with DS2 and then after about 8 wks didnt need to use them anymore. Then when I had DD I didnt need to use them at all. Hopefully it should be easier for you this time. Good luck.

4 months ago

mine first two were very dozy. slept through their first nights, weren't particularly interested in feeding. I found squeezing a bit of colostum out and rubbing it around the nipple helped. Making it nice and tantalising for them! Once the first 48 hours were over they improved a bit, btu still very sleepy on the rbeast. It jsut takes patience, and I agre on busy post natel wards they don't have it.

Gizmo: find a baby cafe or nct mother and baby group in your area now. click here and over here Visit (with toddler in tow) and see how it is done with little ones. Speak to the pros there, make some friendships then when you new baby is here you have already broken the ice and made some contact for where to get help. it can be so daunting to do these things after your baby gets here. speaking from experience. best of luck

Thanks Kiskidee, I'll do that. I'm developing an enormous 'fighting file' of useful contacts and techniques, in case this one turns out to be as awkward as his big brother. Bet he finds some other thing to torment me with - they always do

The nipple shields were certainly a help, spangles: I have quite small, flat nipples so they gave DS something to latch on to. I think you need to be cautious with them, though, because there is a theory that they interfere with milk production: certainly we tried very hard to ditch them after the first 6 weeks and eventually succeeded.

It seems though, from what Quootiepie has seen, that there are still health professionals out there who think ramming is a good idea. I wonder why?

remember, it is YOUR BABY if a mw grabs him in a way you don't like it, speak up! hard to do at the time I knew but just an 'ahem, that's a baby, not a doll.' kind of comment and if they are still brusque, ask to make a complaint to a senior member of staff. i complained in hospital about my treatment on day 2 was there for 8 days as i knew that if i went home with the gripes i would be more upset.

There is no research that shows head ramming is a good idea. There is a study done in Australia that compared a 'hands off' approach to the 'hands on' approach, but they only looked at the very first feed.Nevertheless the results showed that mothers who were supported and encouraged to do it themselves without the midwife putting the baby on were more likely to breastfeed for longer. So 'hands off' was better.

Breastfeeding counsellors know from experience that 'hands on' can mean what the mother experiences as head ramming. This can seriously put some babies off - they either 'switch off' and fall asleep whenever they're near the breast, or they start to scream and fight. This may not happen straight away - both these effects can happen the next day, maybe when the mum is at home, when the midwives responsible are no longer there to see what a mess they've made.

'Hands On' can feel very invasive and disempowering to the mother. I think it will only stop when mothers say 'no'.

Thanks Tiktok, that's exactly the kind of feedback I was looking for.

It seems it is international: a friend in California has just had a very wobbly start with her second baby, partly because he had a badly bruised jaw (rapid labour with umbilical cord tightly wound round neck) and partly because nursing staff in her facility did this once or twice, thus completely associating feeding with pain for the baby. She had to spend several sessions with a high powered 'lactation consultant' to reverse this - what proved effective in the end was a lot of skin to skin, while mum dripped a little milk around the nipple to encourage baby to latch on.

In any event, I will be severely displeased if anyone tries this approach with DS2. It's one of the reasons why I am keen on a homebirth, so I can put myself in the hands of some experienced BFing counsellors immediately, rather than waiting to talk to one once I have left hospital.

I just wish I had realised that it was so counterproductive with DS1 - it seems so obvious in retrospect

This happened to me TT - DS was badly handled at hospital & refused my breast when I got home. It was compounded by the introduction of a bottle as well but I am convinced that if I had been shown rather than ds being shoved the bottle wouldnt have been necessary anyway. Took 5 weeks of expressing & 2-3 months using shields before he would feed properly.

It speaks volumes to me that the bf organisations are very hands off when assisting mums. Any other babies I have will not be let anywhere near a mw when I am bf or trying to get bf started, I will stick to LLL thanks!

BTW, each baby can be totally different, different feeding styles as well as different personalities. You may not come up against this at all with your ds2. Remind yourself that you have breastfed before and that you have some idea of what to expect and of what to do. You have done it before and can do it again!

I was on the receiving end of the head-ramming approach with dd - and depite her being my second child I found myself unable to tell the midwife to go take a flying leap. Midwives - wonderful though they mostly are with pregnancy and childbirth - are woefully undertrained regarding breastfeeding. Don't even bother asking them for advice. I second another poster's suggestion about attending some breastfeeding groups now, before you have ds2. Get to know some counsellors and feeding mums so that they feel more accessible when (if) the time comes that you need their help.

You can also call the NCT's Breastfeeding line to talk to a Breastfeeding Counsellor - they are very helpful and lovely.

You can read more about 'hands off' here

I suspect the difference in approach is sort of ideological - breastfeeding counsellors tend to be wary of seeming like a healthcare professional (most bfcs actually never touch the mother or the baby - I don't ever do it, unless I feel I have to move a baby's arm and then I ask permission first). Midwives have a more robust approach to touching and in some instances, maybe hands on is fine.

Hands on can occasionally be a quicker way to get a baby on and we have to assume that sometimes, it works without ill effects. There are times when I see a mother and baby struggling, and I can imagine someone grabbing the head and 'whoosh!' - but that is to say to the mother 'you can't do it!'. Skilled help with words and pictures which the mother then uses may take a little longer, but so what?

It can take days and even weeks to repair a feeding relationship that's been messed up with rough handling.

Actually, having identified some of the mistakes from the last time, I'm feeling quite confident that it should work out this time .

Plan at the moment is to have a few pre birth chats with local bf counsellors (I can get in touch with LLL and NCT round here, will have to go a bit further for a Baby Cafe) and then set aside first couple of weeks for getting feeding established. If that means I have to spend 14 days skin to skin, cup feeding and trying to feed every 2 hours, well so be it.

You're right PC, I did do it (kinda, bit of bottle feeding involved too) with DS1, and against some pretty poor odds. So there's not reason why it shouldn't work with DS2.

After all this, of course, DS2 will turn out to have a suck like a Dyson and an appetite like Mike Tyson but some other stressful condition/habit that I haven't anticipated.

Hmmm, maybe a dodgy sleeper, I haven't had one of those yet (wary anticipation emoticon).

Gizmo, I had almost same experience of you - small, flattish nipples, so difficult latch, compounded by poor 'helpful' technique of some of the MW at hospital - I certainly came out of hospital not exactly knowing how to get the latch on my own. TBH, I think my nips were so small, ds1 didn't exactly know he had one in his mouth, as it were! Fortunately, more sympathetic district MW's, and use of nipple shield sorted us out.

Also, I think very few MW would recommend nipple shield because it can cause problems with establishing milk production! They worked for me, but like you, I tried to get rid of them as quickly as possible.

With ds2, I found that my nipples were the right shape from day one and it was SOOOO easy compared to feeding ds1.

Good luck!

I got a lot of head ramming and shoving on etc with ds. It didn't put him off at all - but I appreciate he was a typical wide-mouthed baby who wanted to latch on to anything in sight .

Despite this though he needed help with latching onto my breasts as I have very flat large nipples. I was in tears many times as he tried to latch on but couldn't get enough of my nipple in his mouth to make it less painful for me and satisfactory for him.

I had no idea how to help ds latch on and geniuinely believed he would do it all by himself if I let him but watching his desperate efforts to latch on over a period of several hours made me actually ask the midwives to latch him on for me.

Despite my nipple being rammed in his mouth several times a day by different midwives - he fed anyway. The problem was I still couldn't work out how to shape the nipple to make it easier for him - each midwive managed with difficulty but they all did it differently and I couldn't see any consistency in the way it was done.

tbh - all that skin to skin and stuff and gently encourage him was pretty useless advice for me (though I appreciate it is different for everyone)

In the end a lactation consultant helped me by showing me a few times in a consistent way to shape my nipple so he found it easier to latch on and over time his mouth got bigger and he found it easier (though we used nipple shields to help with my pain for a few weeks too).

Anyway - I suppose what I am saying is that if someone hadn't shown a practical way of ensuring my nipple actually fitted into ds's mouth as well as it could - I would have given up- I couldn't bear the sight of ds's open mouth and his desperate attempts to grab hold of a nipple he couldn't physically latch on to without help.

A couple of my friends also tried to help - who had breastfed several babies between them - both of them could see why he was having trouble latching on as their nip[ples were more shaped outwards and their babies had had no problems with a bit of gentle encouragement.

I suppose what I am saying is some of us need the practical help though in my case I asked for a hands on approach and was actaully grateful for it.

I had the boob baby suck thing with DD and getting BF established was horrendous.
This time Like you said I had identified moat of the mistakes and I had read and researched everything I could.
In the hospital I just seemed to get it, it took a couple of hours after lunch but once we had that first feed we have never looked back.

I had the "grab baby's head and push on the breast" approach by the midwives - I also had "I don't know any more about breastfeeding than you do" as a comment by one of them when I asked for help with the latch. Another one told me there was no technique to breastfeeding and just to keep trying at home. Why do midwives not know about one of the most basic aspects of having a baby? { The problems I had with bf have really overshadowed my first few weeks with my first baby & I desperately regret not getting help from someone qualified. Anyway, this is my personal rant - clearly there are people out there who do know what they are talking about & lots of women breastfeeding successfully!

It's amazingly hard to find them, though, Katrina. And while we have a situation where the vast majority of new mums think 1) breastfeeding should be a doddle, 'cos it's natural innit? and 2) that midwives are going to be able to help them with any problems, then people are not going to find them becuase they think that the problem is them in some way and expert help is no use.

They used to do this to me and my darling son, 24 years ago. I used to hate it. Obviously with this level of support I didnt last beyond 3 weeks and my nipples were just about dropping off. I had hoped things had got better, as my daughter managed nicely. How wrong can you be!

yes Gizmo, I had exactly the same thing happen to us.
After having a caesarean, we were put in the recovery room on the labour ward where MW number 1 rammed DS onto my boob. He sucked for about 5 seconds, without properly latching on, then fell asleep.( she did this for about half an hour).
Same thing happened up on the maternity ward with various MWs trying to help. DS struggled and cried, I sat up all night trying to feed him, every attempt ending in tears. Even the breastfeeding counsellor did the same thing! I tried expressing using a pump and got nothing at all out.

This went on for the 5 days I had to stay in hospital. DS blood sugar levels dropped and my blood pressure went up.

I even had one MW commenting quite nastily to me "what do they teach you in ante-natal classes? We have so many ladies who have problems like you". I was really mad about this comment, I'd read as much as possible and been on breastfeeding workshops, thought I was so prepared.

only 1 MW, on day 4 of my stay in hospital, suggested giving him a bottle so at least I could get home where its more relaxed, carry on trying to BF and use a pump if needed. And said theres nothing wrong with FF anyway. She was an angel and helped me stay sane.

To sum up,

1. Not much help from MWs in hospital.
2. Not a relaxing place to be anyway, DS didn't seem to fit into their ward routine whenI needed a bit of help feeding.
3. 1 breastpump on the Maternity ward so when I wanted to try expressing someone else was using it!

Maybe this could have been a commpletely different discussion, but still same experience with regards trying to BF.