I'm sorry you're struggling. I started with a nipple shield with my little one before we left the hospital because of tongue tie issues and nipple damage. I'm not sure that I can offer any advice that the LC didn't but these are things that I tried: pumping for a couple minutes prior to nursing to help shape nipple and get flow going then offering bare nipple, nursing with shield for a while then quickly removing it and continuing with bare nipple, trying without shield when baby is calm and relaxed or sleepy.
You might want to check her tongue tie again. We had to get DS's frenulum clipped a second time, the PA that did it the first time didn't clip enough.
Have you checked with your local LLL or hospital/birthing center for free help at a breastfeeding club? Maybe other mamas or a different LC can help. I found it easier to nurse in a room of other nursing women. It was at one of these clubs that DS stopped using the shield.
Also, a friend's DS had to be in daycare but refused a bottle. She gave him a sippy cup with breast milk starting at 5 months.
Hope things get better!
2/13 2005 2011
Chicago girl transplanted to Colorado, nanny, doula in training
I had to use the nipple shield with my preemie...I know it's horrible...I thought we'd NEVER make the transition. The sleepy baby trick worked a couple (2) times but mostly, not. The switcheroo worked once. After being rejected repeatedly I stopped offering the bare breast except maybe once a day and one day out of the blue, around 6 months old, she took it and never went back!
Keep up the good work, mama...this too shall pass!
I'd definitely check out what free advice there is about the place (mind you it may not be any more helpful than your LC, but still worth having a support network like la leche league around you)
Also some other things you can try:
Whenever she starts to chew/gum at you, detach her and wait a few moments before reattaching.
Is your supply decreasing (dt pain probably if it is)? if so try taking some fenugreek etc to increase (and make sure you're drinking and eating plenty etc) to make sure it's up high enough to not make her suck harder
Every time it hurts take her off for a few moments. She'll get the message (as she's old enough now) that she's doing something that makes you take her off
Get the lip and tongue frenulums checked again - even if it was cut fully the first time they can sometimes reattach a bit
Ask the dentist if there's any tongue exercises you can do with her
Check out your latch (she's so old now that it may be difficult to change, but worth a try) - she should have more of her lower jaw over your nipple than her upper lip - an asymmetric latch, so that the tongue is doing the work behind the nipple itself in the areola area, rather than her chewing on the nipple (if you hand express you notice the milk comes out better when you start further back on the areola rather than just on the nipple) hope this bit makes sense, hard to write and not show.....
if you can, try to start a feed without the shield then put the shield on once it's too much (this is how I would stop using the shield eventually. I do not recommend starting this bit til you get the current feeds to not hurt)
good luck xx
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Enjoy your breastfeeding and mothering journey!
We have had a hard time breastfeeding too. My preemie wanted/needed the nipple shield too. Don't give up!
After 2 months of bleeding/sore nipples my babe figured it out. The clamping down was a big problem but I solved it by placing my finger on his cheek. I was pushing some tissue from the babies cheek into his mouth, so when he is biting down, he is also biting down on his own inside of his cheek. While this sounds cruel to the baby, it also solved the biting down issue(I did it gently but so that he got the point). He is drinking normally now and is in the 50th percentile for growth (versus 0.3 % 2 months ago)
Check the Dr. Sears website for the latch stuff, for upping milk production have as much skin contact as possible with the babe…it's a suggestion of Midwife Ina May Gaskin and really helped me, the website kellymom as mentioned before is also great.
I'm sorry you are so frustrated! I'm a Lactation Consultant and do occasionally use nipple shields in my practice. They need to be used judiciously and carefully, however, when carefully used, they can really help.
My suggestion is to schedule an other visit with an IBCLC. The LC you hired "did nothing to help?" Was she Board Certified and Private Practice? How long did she spend with you? Most of my consultations are about 1 and a half to 2 hours. Was she the one who prescribed the nipple shield and showed you how to use it? Has she stayed in touch and given you weaning strategies.
If you didn't care for the style of the LC you hired, you may want to see someone else. Some children take a while to wean off the shield, often because they still need it and are unable to form a proper nipple from their mother's tissue. Was the tongue tie snip done with a scissors or with a laser? I really prefer the work done with lasers and done by an oral surgeon who does them all the time. I've found about a quarter of babies who have had the scissor technique need a follow up surgery as either some tissue was left or it was an undiagnosed posterior sub mucosal tongue tie and needs a more thorough job to really help the baby be able to elevate his tongue and use it properly.
Are you dampening the shield before you use it? Wetting the flange of the shield before applying it will help with any rubbing. Also, what size are you using? The vast majority of mother baby dyads are comfortable with a 24mm, but a few need smaller or larger diameter shields.
Also, washing the shield in antibacterial soap can predispose you to thrush, because the residue is left on the shield and can kill good bacteria on your nipple and areola. You may want to also have an other consultation to rule out thrush. From my experience, most Pediatricians are not trained enough with breastfeeding dyads to be able to properly diagnose thrush in breastfed babies. They were mostly trained of formula fed babies and the symptoms of thrush are much more overt in FF babies and more subtle in BF babies and Peds often miss thrush in breastfeeding moms and babies.
Have you tried starting the feeding with the shield and then sliding it off when the baby is half asleep? This works for some moms and not for others, depending on how alert the baby is. In the long run, it doesn't matter if you do wean off the shield or not. I'd say 98% of the clients I use shields with wean from it, many in the first few weeks, some in a few months, some after only a few days, and a few use a shield for a year or more. If the shield is being used properly and you do not have thrush it should not cause pain to use it.
The clamping the baby is doing is an other story and will need to be addressed in person by a Lactation Consultant, without seeing this baby, there's no way I could tell why the child is clamping. (Again, Peds are NOT feeding experts and most have no experience with consulting in lactation cases, and can't really help in these problems.) Clamping almost always starts at birth but I wonder if this baby has a Posterior Tongue Tie and that is the reason. Again, no one can tell you over the net and it isn't something you can diagnose yourself, (most of us have seen thousands of babies mouths before we felt confident and experienced enough to dx posterior or submucosal tongue tie, and there is a clinical maneuver that goes along with diagnosing this more complicated form of tongue tie.
There is certainly a lot more than can be done to help you, most complicated lactation situations require more than one consultation, so personally, I would go ahead and schedule an other consultation so you can get this situation resolved.
What worked for my first, when I kept loosing the dang thing, was to make bare breast easier. I put a nipple from a bottle on my breast. It kind of worked, but bare breast was so much easier. Baby chose the easier "choice."
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