Breastfeeding Help

[Swtpinkbabi]

My son was born at 36 weeks and was given my EBM in a bottle while in NICU. While we were still in hospital we met with a lactation consultant who suggested using a nipple shield because baby wouldn't latch directly to me. I was pumping for the most part and only getting to try nursing once we got home from hospital. It's been almost two weeks, and he still will only latch with the shield. He still seems hungry after nursing on both sides so we give him a bottle afterwards. I've not been pumping as much as I'm trying to nurse on demand, but now it seems my supply has gone down considerably. I can hardly pump a whole bottle now. Baby only nurses about 10-15 mins maybe 5-7 times a day along with bottles during the night. I'm worried I won't be able to make milk for him when I return to work. Any advice would be appreciated

 

[missk1989]

To increase your supply you need to be pumping regularly. There are a few supplements you can take to help too (fenugreek i think). If you pump one side whilst feeding from the other you will get more. I would do this at every feed to help build your supply.

 

[noon_child]

Hormones produced when you nurse or pump at night also increase supply, so if you can face nursing at night rather than giving bottles it should help. However there may not be a supply issue at all. There are so many growth spurts at this time that he may just be having one of those and needs to nurse almost constantly to build your supply. After he has drunk both sides you can always swap him back to the first breast, as milk is constantly being produced, and you can go back and forth as many times as you want. However it is hard work for a newborn (and Mum) so if you feel you have to top up with a bottle remember to try to pump for every bottle given or your body won't know to speed up production.

 

[AnonymousCAT]

I used a nipple shield initially with my lo and it took a few weeks to wean it. We did successfully wean it. What worked for us was attempting to latch no shield start of feed for 5 attempts as well as when we switched sides in middle of feed. Sometimes if he came off the middle of one side I could switch the shield out without him noticing too. Latching to start a feed was the last to come. Eventually he just got it. Interms of your supply, I would just keep EBF until lo is satisfied, rather than topping up with a bottle. This could mean some serious cluster feeding. Also pumping after each feed until the breasts are empty will help build supply's if lo is not emptying your breasts completely.

 

[Swtpinkbabi]

I have started trying to get him to latch without the shield. He will stay latched for a little while. I think the biggest problem is him getting enough milk. He won't stay awake at the breast for more than 10 min at a time and the only way I can get him to wake and feed again is to completely move him away from the breast. Then he is frantic smacking his lips and trying to get him to latch is a major task all over again. At the end of the day Dh finally gives him a bottle because it's the only way he will settle down and sleep in his bed. I don't know what else to do. Dh thinks our baby is starving and I keep trying to tell him he's not. He still has a lot of wet and poopy diapers so I know he's eating but I can't help but feel sad that my baby is hungry.

 

[noon_child]

I have started trying to get him to latch without the shield. He will stay latched for a little while. I think the biggest problem is him getting enough milk. He won't stay awake at the breast for more than 10 min at a time and the only way I can get him to wake and feed again is to completely move him away from the breast. Then he is frantic smacking his lips and trying to get him to latch is a major task all over again. At the end of the day Dh finally gives him a bottle because it's the only way he will settle down and sleep in his bed. I don't know what else to do. Dh thinks our baby is starving and I keep trying to tell him he's not. He still has a lot of wet and poopy diapers so I know he's eating but I can't help but feel sad that my baby is hungry.

That is all very normal, it's just how newborns act, especially when building your supply. He won't starve!

Could you try a nappy change mid feed to wake him up a bit? Then when you finally WANT him settled you could try wearing him in a sling, or DH could do that while you sleep! Nothing you have said makes me think your newborn is starving, as long as the dirty diapers and weight gain continue. If your DH keeps giving bottles he's giving you extra work to do as you then have to go and pump to ensure your supply.

 

[AnonymousCAT]

I agree with PP. My lo was a late term prem too and we really had to push him through his feeds for him to feed longer. Things that worked for us: starting the feed with a diaper change and stripping him down to his diaper, stimulating him if he paused for more than 10 sec between sucks by rubbing his hand, foot, lifting his arm, blowing on him, touching his head with a cold wash cloth, and/ or breast compression. When he could no longer be stimulated to suck on the first breast we would do another diaper change to wake him again mid feed and repeat on the other breast. It's a lot of work but eventually he did it all on his own.

 

[mara16jade]

Try starting off with the nipple shield, and mid-way in feeding on the same side take it off quickly and re-latch LO.

We had HORRENDOUS latching issues in the beginning and the nipple shield saved us. I used it for a few weeks (and then on the random occasion that I was super engorged and he couldn't latch). But now things are super easy. Hang in there, it'll get better.

Its also possible LO is hungry/acting hungry due to a growth spurt. I believe they get a growth spurt around 3 weeks, and then for sure at 6 weeks. For us, the 6 week growth spurt was horrible. I felt like he was attached 24/7 and still screaming for more food. Just keep offering him the breast, try to not supplement (I will admit I did since he was just acting soooo hungry), and try and pump for a few minutes (4-5 mins.) after he eats. That will help trick your body into thinking he's eating more...and hence you'll start to produce more.

Fenugreek is great too. Oatmeal, lots of water, no dieting...

ETA: Tickle LO's feet or neck (or even lightly scratch his head). That helped wake ours up. We even has to resort to a cold wipe on the forehead.

 

[Swtpinkbabi]

I'm going to have to try the cold wipes to his forehead, tickling does nothing at all. He's definitely fighting not using the shield, I almost gave up this morning. It's like he hates my breast and keeps pulling away. The only way I get my nipple in is while he's crying. This doesn't make for a good latch and my nips hurt terribly after feeding, but I can tell he is eating. I know the latch is bad but hate to unlatch because of the hard work getting him latched in the first place. I just hope we can get passed this before I go back to work.

 

[noon_child]

I'm going to have to try the cold wipes to his forehead, tickling does nothing at all. He's definitely fighting not using the shield, I almost gave up this morning. It's like he hates my breast and keeps pulling away. The only way I get my nipple in is while he's crying. This doesn't make for a good latch and my nips hurt terribly after feeding, but I can tell he is eating. I know the latch is bad but hate to unlatch because of the hard work getting him latched in the first place. I just hope we can get passed this before I go back to work.

Can I ask why you are trying to wean off the shield? Yes they can cause supply issues but a bad latch will do too as it won't stimulate as effectively as a good latch, LO will tire quicker, and you'll be disinclined to feed due to pain.

A latch during crying is nearly always bad because of the position of the tongue.

I'm not saying don't try without the shield but Im not sure it is worth doing to the point of distress. Have you tried any biological nursing?

 

[Swtpinkbabi]

I'm not sure what you mean by biological nursing. I'm trying to wean him off the shield because he's not nursing efficiently with it on and I feel like my supply is being effected. He nurses longer without the shield but getting him to latch without it is causing both of us distress. His pediatrician told me to keep offering him the bare breast and as others have suggested here to help keep my supply up.

 

[noon_child]

I'm not sure what you mean by biological nursing.

This is where you don't "get" your baby to latch but lie semi-reclined with baby tummy to tummy with you and their head somewhere near your breast (between the two gives them choice). Your body should be fully supported so you can relax. Then you just wait for baby's natural nursing instincts. It may be that baby just sleeps there, and you have some skin to skin, but when baby starts to get hungry they will root for and 'crawl' towards the nipple by themselves, and often latch with little or no help. However some need a bit of help and that's OK too. There is a whole website about it https://www.biologicalnurturing.com/

I had massive issues in the beginning thinking it was my job to "feed my baby" but you can't make a baby eat, you can just provide the environment in which they are able to follow their own desire to eat whether that be by encouraging them to be a bit more awake by stripping them down etc. or by keeping them near the breast for long periods. I also had a lot of trouble following bio nurturing as I was SO tired I was terrified of falling asleep with LO on me. That's why if there is anyone who can just take a few days off work to be with you keeping you and LO safe while you sleep and nurse, nurse and sleep, etc. it is so valuable. I'd consider paying someone to do this for me if I had another child!

 

[AnonymousCAT]

I'm going to have to try the cold wipes to his forehead, tickling does nothing at all. He's definitely fighting not using the shield, I almost gave up this morning. It's like he hates my breast and keeps pulling away. The only way I get my nipple in is while he's crying. This doesn't make for a good latch and my nips hurt terribly after feeding, but I can tell he is eating. I know the latch is bad but hate to unlatch because of the hard work getting him latched in the first place. I just hope we can get passed this before I go back to work.

This behaviour sounds like just how my lo was learning without the sheid. My advice is to only make 5 attempts to latch or relatch if lo comes off and if it doesn't work use the shield. If you do more than that both of you will just get frustrated and things will fall apart more. There are plenty of times during the day and night to try. At first I did thus through the day only and just used the shield at night as I was too tired for the battle, but as it got easier we did this at night too. Also, if the latch is painful it's not right. I know it's exciting because lo is on after so many attempts, but if it hurts you need to take them off right away and try again so you don't hurt yourself (you need those nipples pain free for all of the nursing you do in a day) and you don't want lo to learn bad technique. Maybe try alternate positions or baby led latching (aka biological as PP suggested)? Cross cradle helped me to see how to position lo on my breast because I could line the bottom of my areola with his chin, but football and baby led latching were better for getting more of the breast in his tiny mouth. Google jack Newman and check out his handouts on latching and videos, they really helped me understand what a good latch was supposed to look like and how to facilitate it. Also, can you see a lactation consultant? It sounds like you may need someone one on one for some help. Having just gone through this, I understand how super frustrating it is and how annoying the shield is. Just keep at it and you will get there. It took about 2-3 wks of doing this before we got rid of the shield completely. Now my lo is a bf pro and loves bbs! Yours will be too if you keep at it.

 

[Swtpinkbabi]

Thanks for the advice ladies. It seems the only time he sleeps well is during skin to skin, hopefully he will just make his way to the breast. I'm going to try that instead of waking him and bring him to the breast. I also have an appointment with a lactation consultant on Friday. Hopefully they can help us figure out something that can make it work.

 

[Lemonade]

Wrong place - sorry!

 

[AnonymousCAT]

How's it going?

 

[Swtpinkbabi]

It's going pretty well, thanks Anonymous. I just stopped using the shield altogether. He does pretty well most of the time. Sometimes there is a struggle but I think it's because he gets super excited and tries to latch too quickly. I'm figuring that he's only doing a shallow latch because I sometimes hear a clicking sound. For the life of me I can't get him right.

 

[AnonymousCAT]

Congrats on getting off the shield! That's exactly like my guy! Clicking. Part to do with a fast let down in my case I think. Who knows. It means he has belches instead of burps. I also think it contributes to his reflux issues. Oh well as long as they gain weight! It doesn't seem to bother him.

 

[Swtpinkbabi]

He's gaining right on target so I guess it's okay. Hopefully I can get it one day. He has a small mouth and I have large bbs so it's really a struggle sometimes.