Getting DD off nipple shields & directly onto breast- help please!

[madmumNika]

Be warned this is long!!

My DD was born 4 weeks early due to pre-eclampsia, weiging 5lb 8oz. She was 'grunty' so ended up in neonatal unit for a week & was on IV drips & eventually tube-fed my expressed milk. After 4 days we started to try her regularly to my breast but despite her good efforts she couldn't seem to latch & then start sucking. Sometimes she would latch pretty well but not suck...then let go. My DS also had these probs but he was born at 30 weeks so that was a whole other ball game. I eventually got him to breastfeed after many tears using nipple shields (because he was nipple confused from having to have bottles in hospital). As DD was having probs latching and after her other health issues were resolved I was advised that if she didn't start to feed from me in the next couple of days they would have to start bottle feeding, so in desperation I tried nipple shields They worked instantly- she latched & sucked. We were home 48 hrs later

But now some 2 weeks on despite trying her to the breast without the shields, sneaking them off halfway through a feed etc. I can't seem to get her to latch I really want to get rid of the nipple shields if possible but am stuck for ideas. My nips aren't the most protruding of sorts so I think that could be the problem? Any ideas (ice cubes?! )? With DS I didn't get him off nipple shields until he was 6 months old but hope to get DD off them asap!!

Can anyone help?

Thank you for bearing with me xxx

just keep trying - it took me a month to get DS 1 feeding directly from the nipple.

I found it best to start a feed with the shield on and then when they weren't wuite so hungry try it with it off. Sometimes it worked, sometimes not - but it did in the end.

Both my dc have fed with nipple shields - just couldn't get a latch without. I found with both that trying to ditch the shields before 3m just didn't work, but that at that age (maybe because they were bigger, stronger, had a better suck??) they would take the nipple if offered and within a few days be 100% without shields. My dd is at the moment going through this process and only needs the shields for her 'dreamfeed' when she is not really concentrating.

So I would say, offer the nipple from time to time, but if there is no headway wait another week then try again, etc. And don't worry about it!

Do not, whatever you do, try cutting the end of the nipple shield. My HV suggested this with my dd as a way of getting her off them. She thought I might be able to trim them back gradually till dd was sucking from the actual nipple. It doesn't work. Dd sucked my nipple through the hole I'd cut, which then clamped shut in all its sharp plastickyness on my nipple. It really hurt. In fact, it felt like it was going to sever the end of my nipple. I did't try again.

Not the best person to advise, as I never did get dd1 off them and ended up stopping bf as she was losing weight at 6 weeks. However, like you I have quite flat nipples and with dd2 I did try expressing for a minute before putting her to the breast (to try to pull the nipple out a bit). I also found, with dd2, that the 'rugby ball' position was much more successful than the conventional approach. Not sure if that's any help though - dd2 was keen to feed and my main problems were with pain and blisters.

Good luck.

I used shields to get DS back on the boob after he rejected them from various things that happened after he was born. He was fed ebm for a monthish until I tried shields & they worked really well - he had got used to the silicone feel from the bottles I think. I did worry at first about using them and we watched his weight for a while (on the advice of my LLL leader) just in case they did interfere with my supply...but he gained weight very happily so I stopped worrying tbh & just kept using them. I did occasionally try him without them but he didn't like that at all so kept going, thinking he would have a silicone fetish all his life .

Then at 3 months old I suddenly decided one feed to try him without them...have no idea why...maybe mother's intuition?...but he took his fave side quite happily like he hadn't noticed ...the left side (his least fave) was another story & so we kept using the shield with that one for another month before I tried again shield free on the left & it worked!! ...I think I carried them round with me for a few months afterwards just in case he decided he didn't like my boob any more but I never needed them. He is now a strapping 3 years old & still bfing very happily several times a day.

Kellymom has an excellent page on nipple shields: www.kellymom.com/bf/concerns/baby/wean-shield.html
& LLL do a very good leaflet about them - do you have a group near you?

Ellbell - ouch! Were they silicon shields by any chance? The HV was kind of right re her advice...it's just that cutting them down only works with rubber ones...silicon ones shouldn't be cut as it leave too sharp an edge...

You could try using a breast pump to suck your nipple out a bit before each feed. A lady I know used shields because of sore nipples and was advised to just throw them away and go for it. That worked for her. I alo have heard of women gradually cutting the shields down so the baby gets used to it gradually. Depends on what type of shield and if that would mean sharpness though I think. I also know of mums that have fed with them for quite a while.

The best thing you can do in my opinion is get intough with your midwife/health visitor/ breast feeding support organisations and try to get someone to come over and help you with positioning. That really helped me. And when you have got the positioning cracked (and you will!) make sure the baby doesn't slide diwn the nipple during feeds. If she does, re-attach. She has to learn as well as you.
Also, google 'exadurated attachment'. That's the technique I used when I found it hard to latch at the start. You basically press down on your nipple on one side with your thunb and then latch the baby on...

tummy to mummy
baby to breast
angle of the dangle 'i.e life your breast up if you need to but not at an angle'
bottom lip about 2 cms from the middle of the nipple and roll the nipple into the baby's mouth giving her a good mouthfull of breast. Pics online should help.

It's early days and you are already doing so well. Early weeks of breastfeeding can be very hard and or confusing. There is the support and help out there. Go and grab it and don't look back. I did and I breastfed my son for two blissful years after a very rocky start. You'll be glad that you did and this time in a month or so you'll probably be latching her on without even thinking about it.

Good luck!

Also, is there a Surestart near you. They can give fantastic support in the form of

Thank you ladies, I am feeling more positive about this now. I think to be honest she is still tiny & maybe with time as she gets bigger it may be easier for her to latch, but I will try using the pump to pull out my nipple & also try the different ways of holding the breast to form a better nipple shape for her to latch to.

I saw my midwife this pm & she's getting the bf counsellor to come visit us next week to work on DDs latching...

Thank you for your support

Hi madmumNika

Glad to hear you are feeling better. I have a really nice NHS leaflet that has a picture by picutre guide of that latching technique which I told you about. I had latching problems with my DS as I mentioned. He was quite small and my boobs were very big which complicated things. I had this leaflet next to me when I breastfed every day at the start and found this technique so useful. By far the best out of all the breastfeeding stuff I read in books and saw in other leaflets. I would be more than happy to send you it or scan it in and email it to you. Just let me know if you are interested.

madmum,

My dd2 also was 4 weeks early and i needed nipple shields to help her latch. They are horrible things but it may be that she will need then until she is big enough to not need them.. just keep trying at every feed and some day she will latch without.. consistency is the key here. My dd2 did not latch without until around 8 weeks.. at that point i binned them and have never looked back.

You will get her off them, just keep thinking - she is still getting your liquid gold and thats all that matters eh?!

Why dont you give Sharon Trotter a call and see what she thinks?

I don't know her number but i think her www is www.tipslimited.com