'nipple confusion' - comments anyone ?

[hub2dee]

Hi all,

Our baby (one week old) was in NICU / SCBU for a few days, fed mostly on NGT (nasal tube to tummy) and bottle. A few sucks on the breast, but not much so she could conserve her energy.

We are now home, and have been continuing to bottle feed, and try at the breast, but not for extensive periods as the baby seems to find it difficult / boring / tiring - it's obviously not as 'easy' as sucking on a shaped teat with gravity assisted milk delivery !

A health visitor today said to dw that our baby has 'nipple confusion' and basically she should have been bfing more, earlier, and that in her experience, if we don't 'crack' bfing in one week, that will be it.

Perhaps unsurprisingly, DW was somewhat upset at this.

The HV suggested a nipple guard might help.

Wonder if anyone had similar experience to relate.

I appreciate that at the end of the day, DW must be the one to make the decision, and she must do what she feels happy with. I think if she felt perseveering might work she would feel happier trying, IYSWIM. As it is, having the baby struggle /cry for 15 / 20 minutes is difficult IYSWIM.

It was suggested to us that the 'baby to breast for 5 minutes, followed by a bottle' would not be a helpful way to develop the baby's ability to bf. Possibly feeding from a cup would....

Hmmm.... any comments MN crowd ?

TIA.

not a problem, surprised you weren't told that method while in SCBU, I know the nurses used it for my Dds because I didn't want them bottle feed.

Funny enough, sparkly , when ds3 was in scbu, there were leaflets on cup-feeding but not one member of staff suggested it. Everyone gave bottles.

Hub2dee, is your dw double-pumping? I find it great for supply, get more in 10min than I did doing 20min on a single pump.

we ahd a great nurse, who looked after DD1 and then dd2 15 months later, so i was very up on SCBU by that point!!! She asked if I want them to give a bottle and I said no, so they cup fed them or tube fed them, but I think the nurse enjoyed having cuddles TBH

chip: is that 5 mins / massage / swap 5 mins / massage swap type thing ? I think I read about it on one of the lactation sites today.

Suggested we try something like that instead of 10 mins > dry, / swap / 10 mins > dry IYSWIM.

Night sparkly.

The cup thing DOES help, it saved ds1 when his weight dropped from 5lb 5oz at delivery to 4lb's a month later (long story involving HV on holiday and MW not allowed to care for you after 28 days and GP not wanting to get involved with HV issues- sigh!), he wouldn't feed AT ALL due to seere lactose intolerance and was scared to take his soya in a bottle due to the stomach cramps he got when we tried milk in a bottle before we knew about intolerance.

Double pumping usually means (or at least it used to) using one of the double breast pumps, which pump from both breasts at the same time, NCT used to stock the medela one? It is indeed excellent for your milk supply, an old contact who worked for Unicef on their BF initiative swore by it.

You might be able to rent one. NCT can tell you where from.

Hi H2D - Just wanted to say how supportive you sound of your DW. Good for you for putting in all the effort and energy to try and provide her with assistance.

You've had lots of great advice on this thread. For me it was a shock that bf was an issue at all. Just knowing that many women go through having to "learn" the techniques and how to work with their baby (and vice versa) can be a help.

If you have not already, try and see a professional in person. Sometimes they can show your DW things that cannot be explained by phone or email (and also reassure you of things that are being done right).

For me when I was struggling with bf ds, the best thing my dh could do was take ds for a short walk around the house when he (ds, not dh) got too upset. It calmed me to have a few minutes to collect my thoughts before trying again (and dh seemed to be able to bring ds back calmer so that another attempt at bf was easier). But dh always asked "would you like me to take him for a few minutes" (perversely sometimes I wanted to keep going, but sometimes I just wanted a break!). But even when I was in a "keep going" phase it was nice to have the option! And having someone take and calm the baby really made it so much easier (for baby and me) when I put him right back on the breast after the little "break".

Good luck to Dee

Hi KiwiKate - yeah, it is a surprise when it doesn't start off quite according to plan, and fairly often there seems to be other issues associated with a complicated birth (not always, of course, but in our case the hypertension / degraded placenta and IUGR / c-section / early delivery etc. won't have helped either DW or babba).

Today, though, we got maybe 4 or 5 minutes of licking and attempted sucking on the breast etc. which is great. I hope we both can persevere, use the professional input on Tuesday, and see how it goes !

Peachy - that first month must have been a bit scary, figuring out these food intolerances. I've seen some double pump machines. I'll ask the people we're seeing on Tuesday. Thanks.

no hub, I mean one of these gadgets No swapping necessary! I think a few people here have got this model and are happy with it. I have an Avent one which I got direct from their website and its very very good but way more expensive than the Ameda one. It would be worthwhile if your dw is going to be expressing for a long time or if she plans on going back to work, otherwise it may be overkill but I do find it great for productivity! I think it has been shown that if you stimulate both breasts at the same time, you get a better yield than doing each breast separately.

By the way, the licking and sucking on the breast sounds very good. Thats how my ds started and he went on to fully breastfeed. so much so that we've had a hell of a job since to get him to take a bottle!

The IUGHR / Hypertension etc (in our case pre-eclampsia)- that's what led to Sam being so small. It gets better OK? He's not huge but he's the strongest kid I know!

OK, understood chipmonkey. Will see how we get on with the counsellors on Tuesday, and maybe get this machine if it looks like we're in the pumping game for the long haul, LOL.

chipmonkey: Baby again spent 4 minutes or so doing little licks etc., so I'm hopeful with some learning and patience we'll get there.

Hi PeachyClair: Yes, hypertension (possible borderline PE) did the IUGR I guess. BTW - Did they advise any placental degradation towards the end of your pg ? (They grade 1 - 3) Did you deliver term or was Sam early as well as being small ? Our Camille does seem to be a very strong baby considering how tiny she is. I guess the muscle is all there but she hasn't laid down lots of lovely baby fat !

JennyWren - if you want to see a pic of Dee / me so you don't need to give meaningful smiles to all the couples with dark hair, there are photos here

(yes, that's a shameless semi demi bump for my gorgeous babba)

Hub2Dee, sorry I haven't read the whole thread, but I can really recommend a bfc in NW3 if you want her details. She goes to a few baby clinics around north London, but will also come to your house. She helped me with 2 of my babies - I really recommend her (without her I would have stopped feeding with dd2). There is an NCT one in NW11 too - she was good, but I got on better with the NW3 one. Let me know if you want her/their phone numbers and I'll dig them out. Good Luck.

Yes please Pollyanna. Would you CAT me ?

We had antenatal classes with RP in NW11, but I think she is still on hols.

Done!

No, they didn't tell us ANYTHING! In fact it took two years (after requesting a review) to find out officially that he was induced due to pre-eclampsia, and that his heart rate dropped dangerously during delivery but the consultant had lost my bloods and couldn't do a c-section in case of HELLP syndrome.. ie a big cock up! They did tell me the low birth weight was due to partial placental failure though, whilst I was expecting ds2, and I had regular extra scans to monitor.

Basically, what happened was I was in and out of hospital for a few months- bp up, in I'd go, it would go down, home I'd go. After six weeks, (at 38 weeks gestation) I was borderline but the mw said well if I send you in I'll get shouted at for wasting their time again (!! to her managers), plese call me if you get ill. Went home, ex-fiance (good friend) had a car accident and called me, bp went up, I pretty much lost consciousness, dh (then fiance) got me to unit, I had fit on table, blues and twos to main unit (bp @168+), dr tells me I am wasting time, go home in morning (it's now 3 am), overnight gained 3/4 stone, next day no-one will tell me what's going on, scan am, not allowed home but Dr too busy, next day note on bedside saying dr came whilst I was in shower, emergency induction to be started immediately. baby hasnt gained since last scan 4 weeks beforehand. Will take four days . 12 hours later, i'm in labour ward with lost bloods, can't have epidural as anaesthetist too busy, Sam born small but OK, sent back to local unit after 2 days, Sam ok but I'm ill- sweating, shaking, the lot but I'd been so beaten down i was too scared to say anything.

TBH, I'm glad Sam and I am here! Sis had similar, but procedures have changed now and her DS was born at 34 weeks and in ITU / SCBU for four weeks, two of which she was too ill to see him. they're much more on the ball now thank goodness, and it is hard with the cases where BP goes up and down.

Lucky really that Sam is OK. he does actually have sn, Aspergers, but I put that (as does the consulatnt) down to genetics, as BIL shows signs.

Despite that Sam rarely gets ill, has been told he could train at national level in gymnastics (he can't be bothered!) and won all his school races on sports day. DS2 and DS3 had perfect pregnancies BP wise (I also had other problems early on, something called hyperemesis).

Sorry- bored you now!

Hi Hub2Dee. Great photos! Now I know how to recognise you. Camille looks a poppet. I've just realised how small she is - I've made a friend at the clinic whose baby was about the same size I think. She's having help while her baby grows big enough to feed well, too.

I know that Waterstones and WHSmith had a problem with the listing of the book - the importer stuffed up I think, and so it has gone on their computer system incorrectly. I'm not sure where else you have locally to try - maybe a smaller shop?

I do have a dh, who is great and very supportive, but he is back at work now and can't be on hand for every feed - we really need to crack this for ourselves. Besides which, I think that for dd the essence of our success has been the expert nature of that third hand! But I'm keeping my fingers crossed that this week we can start to drop that hand...

JennyWren - looking forwasrd to meeting you / the counsellors / your 'friend with small baby'. LOL at the specificity of the magic Third Hand... I understand what you mean, and hope your progress towards just needing two hands goes swiftly and smoothly !

PeachyClair - Sam's birth story sounds damned stressful, and not very funny at all. I am sorry there appears to have been a lack of proper care / understanding about your PE, but I'm glad you were able to fight for your review and more detailed info.

We had a similar experience of the bp up > hossie > bp normalises > home (repeat till bored). We really only did this for one week or so as I get sooo pI**ed off with self-admitting, only to not have our problems adequately explored, to see a different person each time who could only see 'woman with normal bp following spike > send her home'.

We saw an EXCELLENT consultant privately who adjusted DW's meds to better control the BP and also he explained that it would probably be best (due to risk of BP going crazy) to have a c-section. As consultant was not only an obstetrician but also a sonogrpaher, one person monitored Dee, did her scan, decided her treatment strategy and called her c-section day. A few days before Camile's birth DW had grade 3 placental degradation / inefficiency (not sure exactly what they measure), reduced amniotic fluid, baby's growth had further dropped from previous norms, raised umbilical arterial pressure etc. etc. (V. V. lucky cerebral pressure unaffected. TBH, not sure ordinary NHS sonographer would have picked up on all this as we'd had one done just a week or so before and nothing was picked up. Possibly there was nothing to be picked up, IYSWIM, but even I could see a slow down in some of the growth stats etc.)

(If anyone is in Northish London and needs to see a Private Consultant, his name is Demetrios Economides.)

We were lucky to find the right guy, and lucky to be able to afford his fees, and subsequently lucky DW had BUPA to cover the c-section and recovery in a private hospital.

Towards the end of the pg we were anally careful about checking for proteinuria, getting regular bloods done, and monitoring BP at home (the consultant told us to go ahead - it was useful data for him, the mws / doctors we had seen till then told us we were only making things worse). I also made our presence felt by faxing our 'named' NHS consultant when DW was admitted overnight for the first time (not that it helped much, LOL) and we continued to see our 'named' obstetrician's registrars etc. rather than having one point of contact to assure continuity of care.

Feel absolutely furious and also scared at how your bp was managed (we had similar 'wtf you doing here again' vibes - despite a very caring and skilled labour department, but I wasn't about to keep my gob shut, LOL) - and the subsequent mismanagement of your admission by ambulance, and the dramatic implications it had on your health. It's just crap, isn't it.

You definitely didn't bore me, and thank you for sharing. An extremely valuable story IMHO.

Hub, hadn't realised quite how scary the time before Camille's birth had been - thank goodness you are persistent, knowledgeable and don't mind making a fuss when you know it's important. What lucky girls Dee and Camille are

(Is it inappropriate for me to call you a marvel again - no, I don't think so )

No, Hunker, not innappropriate at all! Hub2dee is a marvel! (or thats what he tells us, maybe in reality he just loafs around drinking beer all day!

Well, we got away with it and I ended up doing work for pre-eclampsia charity, having the story published in a mag- if i helped change the system a little then something good came of it!

Glad you saw the private Ob- we didn't know they existed back then. Shame that you have to pay for what is really basic care though isn't it?

I'm very annoyed, hunker and chipmonkey: you updated my thread and I had to leave the pub to come and post.

We just had a GOOD mw visit us.

About 15 - maybe more - minutes on the breast with no 'screams from the bowels of hell' LOL.

DW is v. v. v. happy and I am chuffed too.

Hope we can build on this success.

Peachy: I am glad you both got through it ! Is it APEC you did some work for ? I am sure sharing what happened helped other parents know what to look for and also provided something to think about for the staff who cared for (or who didn't IYSWIM).

I agree it's very sad feeling you need to go private to get adequate expertise when things start to require closer monitoring.

typo... cared for you

Sounds like it's getting good 15 minutes is great! Congrats [grim

it was a small group called PETS, a bit of newsletter editorial stuff and some telephone support stuff. nothing major but it helped them and me.

The Pre-Eclampsia Society (PETS) - more info here

Tel (Helpline): 01286 882685
Best time to telephone: 9am - 8pm, Monday - Friday.

PETS is a registered charity and a support and information society for women, run by women who themselves have had Pre-Eclampsia. Alternative names are Pre-Eclamptic Toxaemia (PET), Toxaemia, EPH Gestosis or Metabolic Toxaemia of Late Pregnancy. There are also interested professionals amongst the membership.