'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.

Hi Hub - just popping on to see how you are doing. I am still jet lagged and knackered so am just going to answer a point you have raised.

I am a big believer in nipple confusion (not all midwives are) but I think it is better to avoid teats when a baby isn't latching on and cupo feed instead. It is something we do routinely in our unit when babies are given formula feeds when breastfed. Babies in SCBU would be tube/cup fed whilst trying to establish breastfeeding.

You are doing the right thing by seeking breastfeeding counsellor support but I would suggest you stick with one counsellor supporting you so that you do not get confused with a range of options. Cup feeding is actually very easy and babies are veryu good at it. It my experience babies are desperate to suck and when they have been deprived of a teat they are more anxious to suck the nipple. A teat is sucked in a totally different way.

Skin-to-skin contact is a vital component of encouraging a baby to latch onto the breast. It means the baby has the tactile stimulus of mum's skin which in itself encourages the baby to seek the nipple. It is best to let baby enjoy lying next to the breast without being forced to feed which can compound breast rejection.

Babies can certainly take to the breast despite a poor start. Berolina is a great example. You need good support from a counsellor you trust.

Don't dismiss cupfeeding immediately - better done sooner than later. You might be surprised at how Camille gets on.

There are other ways as well to tempt baby to breastfeed - supplemental nurser has been suggested too.

Hope you get someone to help Dee and Camille 'get it on'. Have looked at her pics and she is gorgeous. Encourage Dee to keep going with the expressing - it is not too late to establish breastfeeding at all. Good luck.

ps - ankle stil giving me jip - assignemnt still not completed. Holiday fab!

mears !!!!!!!!!!!!!!!!! Welcome Back !!!!!!!!!!!

So, how was the holiday ? Did you hobble all over looking odd ? How about two great highlights ?

Just done a long feed. YAWN.

A few points:

• in our SCBU they only tube / bottle fed whilst occasionally attempting breast. Perhpas that was the beginning of our probs !

• Yeah, everyone seems to have a slightly different 'take' on how to deal with the issue, so we've purposefully not been to see too many people. Chloe Fisher and Sally Inch at the John Radcliffe came highly recommended, and tbh, they did get two great feeds when we were with them for the day, but it IS a very long way to go !

• Will suggest some 'nekkid all day on chest' events to dw

• yep, read berolina's threads.

• ASSIGNMENT NOT COMPLETED ?????? !!!!!!!!!! MEARS ! For some reason I thought you'd knocked it out immediately before leaving.... Hmmm... there may be trouble ahead...

X

Hub2Dee,

when dd3 was in SCBU i was very adament that i was breastfeeding and that NO bottles were used. she had a tube and was fed hourly through that, i was doing the tube feeds myself after breastfeeding first. i was constantly back and forth to the SCBU unit.

Good luck.

What were Chloe and Sally's thoughts on cup feeding out of interest?

If Camille has done it with them, she can do it again. As she gets bigger she may well find it easier. It is a shame teats were introduced to her instead of the breast like Misdee did.

How is Peter Misdee?

Hi mears, Chloe essentially thought cup feeding was a waste of valuable breast milk seeing as close on 40% (apparently) goes all down their clothes etc. She also basically dismissed 'nipple confusion' as a label - not sure if this was specifically for Camille, or more generally as a concept (I believe the latter). I think she also feels all the supplemental tube-taped-to-nipple type feeding systems were also somewhat un-necessary / gimmicky.

(If anyone knows her opinion to be different to my interpretations above, do post !) We spent less time talking to Sally so I'm not quite sure if she is 100% in agreement, but I get the impression she is.

Obviously many other professionals (mws / lactation consultants) disagree with her / them, but she got Camille to latch properly, and easily for the two feeds at her clinic without much fuss at all.

I think Camille will find it easier as she gets physically larger and stronger in the jaw / lovely pink tongue department.

hi misdee - sadly, dw couldn't get up to SCBU for several dyas, and even then only in a wheelchair because of the c-section / her bp etc. etc. Whenever we were there, we did try on the breast, and each midwife / nurse did their best to help with positioning / latching, but Camille just seemed to like having an easy lick IYSWIM !

Hmm - there certainly can be spillage with cupfeeding but I have not seen at least 40% down babies' fronts. Perhaps because it is done as the norm here staff and mums are more expert at it? Who knows. What did she suggest then regarding getting baby to feed and what to do if unsuccessful? Did she latch Camille or did she instruct Dee how to do it herself? Lots of questions sorry. Just interested.

Sounds as though she is worth another visit. Perhaps she could recommend a counsellor closer to you? She will no doubt have a network of them. Hope you sort a solution out that you are all happy with. Hands on personal is vital rather than virtual in this instance.

Am going out on the old night shift tonight so will be working and sleeping over the next 2 days. I am sure you will be night shift too

Hiya mears - I think I've escaped the night feeds for much of tonight.

But we'll see....

I think Chloe had got her numbers from some piece of research that suggested 38%. I agree that hossies with expert cup slurperers should be able to better that !

Re: Baby - she gave us a small handout with about a dozen points to work on (from skin-to-skin, to positioning etc.)... not sure there is a 'if unsuccessful then try this' strategy in place. I think the message is 'with 100% correct positioning, this baby will feed'... we can go up whenever we want...

Interestingly, she didn't really know / recommend anyone in London straight off... with a bit of questioning we got a few names, but no 'see this woman, she's great' type of thing...

BTW - I put my finger for the first time in Camille's mouth today to see if she might be satisfied with a little bit of delicious finger instead of her main feed > 1/2 hour > 10 - 20 mil top up > 1/2 hour > 10 - 20 mil top up type pattern.... this little one can suck harder than my Dyson, LOL ! WOW !!! She didn't seem at all upset the finger had no milk; she was perfectly happy sucking on it for several minutes...

Don't know if this means a dummy might keep her happy, or that she just likes the smell / taste of daddy's finger, or that the little 10 - 20 mil feeds are 'comfort feeds' rather than 'proper feeds' IYSWIM...

Have a nice night shift, catch you around.

Defo no dummy till she gets the hand of breastfeeding

I often help babies latch on once they have had a good old suck at my finger. Have you tried that by the way?

Agree with you about comfort of lots of snacky feeds. Babies do not always need fed every time they are unsettled though. They will always 'sook' when something is put in the mouth. Try a shoogle in the pram or swaddling to settle to eek out feeds. Avoid dummy just now if poss.

Am off to bed now. Night.

You mean you don't want a third / fourth nipple in the Confusion Equation ? LOL

Blimey, back a day from hols and straight into some night shifts. how's the jet lag feeling ?

We haven't tried finger > latch, but we will do. I presume you let baby suck at one of your pre-trimmed fingernails for laydees and babees ? LOL. DW will hate me if this works and she needs to go short on her pinkie !!!!

If my baby tries to sook I will chastise her and shoogle instead.... Scotland - is that an island off the coast or sommit ? Are you sure they speak English ?

Thank you for your help, and , again, welcome back. BTW Lou33 has taken some time off else disappeared for good... I know you go way back too so thought I'd let you know. There is a thread about it, I don't know much more than that...

Hi Hub2Dee

I cup0 fed for a month. I found it fairly easy and I am sure it is the reason why we eventually got ds to latch on. I wouldn;t say we lost anywhere near 40% of the milk, except when my hand slipped and I spilt the cup but totally my fault.

What a shame RP is away, so close to a good bfc and yet so far away. She has been posting on an email group I am on but then again always does from wherever in the world she goes!

I've read the Bestfeeding Book and I do agree that Sally and Chlow seem to know their stuff but I woulodn;t dismiss cup feeding, it certainly worked for us and I do think that if a baby learns to suck on a teat it will be less inclined to take to the breast.

Just e-mailed RP incase she is back from hols.

I take it you live fairly close to me / RP ?

Nowhere near you its just I am on an NCT email group with her. She comes across as a lovely person and I have learnt so much about her culture.

Hi Hub2Dee,
Just thought that I would share our great news - breastfeeding seems to have 'clicked' with Megan! She only had one bottle yesterday, all the rest of her feeds were direct from source . I don't know what it was, I just tried her as usual an she took it. Then she took the other side, and she hasn't looked back. She gapes really wide and tends to go on easily as well. Sometimes she gets upset, but if I just keep calm and keep trying her, she gets there - it has never taken more than a couple of minutes. The change is amazing!

The one thing we were wondering was whether she would go for less time between feeds on the breast than she had on the bottle, in case we had been giving her more in the bottle than she would normally take from the breast, but that doesn't seem to be the case. In fact, she slept from 10pm to 6am this morning, so that is great. Unfortunately, my breasts didn't sleep so long - I woke up at 4am full to bursting, so I had to pump a little to make myself more comfy. Hopefully my supply will settle down to what she needs soon. I'm being a little cautious - I always have a bottle ready, using milk from my breast shields of where I have pumped eg last night at 4am, but so far it has mostly just been for my peace of mind. I'm freezing a lot so I think I'll try to donate some to the milk bank - I want to keep some so that she can have a bottle if I am out, but I don't need 2 litres and rising!
I'm going to be at the clinic next week, so maybe I'll see you there. Either way, take heart - if we can get there, there's hope for everyone!

Hey JennyWren, that's really great news. I bet you are chuffed. Well done for your patience, and congrats to clever Megan.

Hoping to see you soon (but not sure when !)

Should be able to see her next week, JulieF !

Thats great JennyWren. Its how it was for us, one day without any warning it clicked. I still had to express as the latch was very painful for about another week but from then on we never looked back.