How Can We Transition Off Nipple Shield?

Kathleen Tackett's picture

QUESTION

Dear Lactation Consultant,
My name is Kate. I'm a 25-year-old first-time mom. Miranda and I have had problems with breastfeeding from the start. She was born June 30th 2003.

Let's see..where do I begin? I did get a few good latches right after birth. I had a very quick labor -- only pushed for 30 minutes and no drugs. (Just trying to give you all the information here.) I did get her to latch a little right after birth, but since then it has been awful! I haven't been able to get her to latch at all really. The hospital had me pumping and finger feeding her for the first day. The next day they had me supplement with a bottle.

I went to a lactation consultant the day after I checked out of the hospital. After $180 she told me Miranda and I are a mis-matched pair but to keep trying! I have slightly flat nipples and apparently Miranda doesn't have a strong rooting reflex. I dunno. I have been wearing the shells and I pump 8 times a day and give Miranda breastmilk through a bottle. That's what the consultant told me to do. The consultant also put me on blessed thistle, Fenugreek, and domperedone to boost my milk supply. She also had me putting Miranda to the breast with a breast shield which she will take and suck on pretty well now that she's almost a month old.

What should I do? Should I just give up? Should I use a supplemental nursing system and abolish the bottle? I really really want to breastfeed. I have spent hundreds of dollars on consultations and a professional grade pump to keep up my supply. Recently I read on the internet that I won't be able to maintain any kind of supply if I'm just pumping. Help! Please!

I feel like the other consultant sorta wrote us off when she said we were a mismatched pair and told me to just pump and give her a bottle. If you have any suggestions or advice I would greatly appreciate it!

ANSWER

Hi, Kate. You've been through a lot! I'm sorry you felt as though your lactation consultant "wrote you off." While there are some cases of mothers and babies having "fit" issues (that is, mothers with very large nipples and babies with small mouths), usually in this case, some time and efforts to preserve the milk production are all it takes for the fit to improve and the baby to move to breastfeeding.

I would definitely not give up on the idea that you can breastfeed. In my experience, the first month can be the most challenging time for latch-on issues, because that is when the baby is most uncoordinated.

You mention Miranda breastfeeding when you use a "breast shield." There are breast shells and nipple shields, and I'm almost certain you mean a nipple shield, which is a soft silicone nipple that fits over your own nipple that a baby nurses through. If Miranda will breastfeed with a nipple shield and you are sure she's taking milk well (her daily number of wet diapers and BMs do not decrease), that can be a great transition from bottle to breast. I would suggest just breastfeeding with the nipple shield for the moment and avoiding the bottle. By giving giving it a little time with shield, Miranda will learn that the breast is where milk comes from.

Breastfeeding with a nipple shield is far less work than pumping and bottle-feeding. Then you are just one small step for breastfeeding without the shield.

When you want to try to wean from the shield, start Miranda on the breast with the shield and wait until you hear her swallowing so that you know that the milk is flowing. Then slip the shield off and *quickly* put her back to the breast. If she is ready to make the transition, this should work.

If you can't get her off the shield when you feel ready, don't make it a battle. You can try once a day at a calm time (maybe when you have some extra help) until it works. The time to wean from the shield is when Miranda is ready.

Miranda is very lucky that you have been willing to work so hard for her to give her the best. I wish you all success in your efforts to breastfeed.

-- Nancy, IBCLC