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Discussion Starter · #1 ·
First of all, a summary of my situation: My daughter is now two weeks old. She was born a bit early (36 weeks 6 days) and spent 4 days in NICU. While there she had formula from a bottle despite my pleas. As a result, she was slow to catch on the breastfeeding. I am happy to report that she has had nothing but breastmilk since last Saturday, but I have some concerns over how breastfeeding in general is going.<br><br>
First, the lactation consultant at the hospital told me I needed to use nipple shields because my nipples are too short. So I've been using them, but in doing a bit of research I've seen some information that indicates using nipple shields reduces supply and may cause early weaning. I try to offer my breast without the shield every couple of feedings, but so far my daughter has not been enthusiastic about taking it--she's only done so twice. So my questions regarding this are: is it true that the nipple shields have the above negative effects? and how can I persuade my daughter to nurse without them?<br><br>
Second, the above lactation consultant implied that my daughter would establish a nursing pattern by now. As near as I can tell, there's no pattern. Sometimes she goes an hour between nursing sessions, sometimes three. Every once in a while, she goes four-five hours. And when she's nursing, the amount of time she spends at the breast is quite variable--anywhere from 20 minutes to over an hour. One marathon nursing session lasted an hour and a half. Is this normal or at least not indicative of a problem?<br><br>
Third, I'm pumping about once a day when she goes longer between feedings in hopes of keeping the supply from dwindling. I usually get about 2-4 ounces. Does that seem like a normal supply?<br><br>
Please help if you can. I have dial-up Internet at the moment and just don't have time to spend surfing for the answers to my questions.<br><br>
TIA!<br>
Jenn
 

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Keep up the breastfeeding for at least 4 weeks. That is the average time it takes for you and baby to learn. For your first question.<br><br>
"So my questions regarding this are: is it true that the nipple shields have the above negative effects? and how can I persuade my daughter to nurse without them?"<br><br>
Nipple sheilds will reduce your supply. Your baby is not able to stimulate your breast as much as skin to skin. Keep trying to nurse without the shild. If the baby is fussy start with the sheild and then when the milk is coming try taking it off. Try with every feed.<br><br>
"Every once in a while, she goes four-five hours. "<br><br>
This sounds like a very long time. Does she fuss at all? A baby this age usually eats every 2-3 hours. Offer the breast during this time to see if your baby will eat.<br><br>
"And when she's nursing, the amount of time she spends at the breast is quite variable--anywhere from 20 minutes to over an hour. One marathon nursing session lasted an hour and a half. Is this normal or at least not indicative of a problem? "<br><br>
Variation is normal I believe. Is your baby having lots of wet diapers?<br><br>
"Third, I'm pumping about once a day when she goes longer between feedings in hopes of keeping the supply from dwindling. I usually get about 2-4 ounces. Does that seem like a normal supply?"<br><br>
Sounds like a normal pumping supply.<br><br>
I am not a lactation expert just breastfeeding my three boys mother. I hope some of this helps. Try to get your hands on THE WOMANLY ART OF BREASTFEEDING. Check your local library of ask the LC if they have a copy you can look at. Will asnwer a lot of your questions.<br><br>
Take care
 

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Shane speaks true!<br><br>
The shields are every bit as bad as you've read, and they can contribute to nipple confusion, as well. I've used them for a short while, myself, with my first ds.<br><br>
There's no reason to not be able to nurse because your nipples are too short! That's the first time I've heard that one. Women whose nipples are inverted (turn in) can have problems getting a baby latched in the early days, or flat nipples, that do not protrude at all. As long as your nipples protrude, there's no reason other than preference (nipple confusion) for her not to latch on fine.<br><br>
I would toss the shield and offer the breast very often, ideally every hour during the day, to get her when she's not very hungry, and willing to work at latching on. I would also not let her go longer than 2 hours during the day without nursing.
 

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The shortest time to expect that the baby will establish a nursing pattern is 6 weeks. Many babies never set a pattern or just when it seems the pattern is predictable it changes. Thats the way babies are.<br><br>
Pumping 2-4 ounces is a lot in the early weeks. If you feel you must supplement, you can feed your baby by spoon, cup, dropper, or syringe. The NICU may have shown you spoon feeding. If not, go to <a href="http://www.google.com" target="_blank">www.google.com</a> and type in 'cup feeding breastfeeding' and you will find instructions.<br><br>
You can pump just before nursing to draw your nipples out. Nursing when the baby would go longer between feedings is better for your supply and your baby. Allow your baby to end the feeding even if it is 2 hours. It may seem like all you are doing is nursing, that's OK. Now is the time for you to recover from childbirth and for you and your baby to get breastfeeding established. It may be hard during the holidays to change your lifestyle so much, but its worth it!
 

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I used these for a very short time. Just enough to get the hang of it. I have flat nipples too. I also used one on one side for a very short time because I had part of my nipple actually detach from my breast. Not a pretty sight, but the nipple shield helped to fix this in the shortest amount of time possible and get back to our normal nursing schedule. Nipple shields are used for only a very short period of time.<br><br>
I second the pp about LLL Breastfeeding book.
 

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do you switch a lot during the session from one breast to the other? if so, try one side nursing and see how she does with that, first she gets formilk which is mainly just water and she will not fill up on that, the next is hindmilk which is mainly fat and will subsides her hunger. but if you are switching before she gets the hindmilk she is going to nurse more because she is still hungry.<br>
also since you are using a sheild the sessions will last longer because the flow of your milk isnt as fast, so where it may normally take 10-15 minutes to nurse without, it may take 20-30, maybe more, with.<br><br>
Id also try to wake her more after to nurse, 4-5 hours seems a little too long especially for such a wee one using nipple shields
 

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Just wanted to say something a little different about nipple shields. Some smaller babies - especially premature infants with weaker sucks do transfer more milk with a shield than without. There has been research with preemies that demonstrates this. Shields should always be used under supervision with a good LC or a knowledgeable doc to make sure the desired goal is being met (transferring good amount of milk at the breast, and growing!) The thinking is that the shield is a firmer texture and the smaller, weaker infant can grasp the firmer nipple shield a little better sometimes and are able to transfer more milk that way. There should always be test weights done though to ensure that this is actually the case, though, because some babies can't move milk with a shield, and some moms find that their supply suffers with a shield.<br>
I don't know about that short nipple thing, though - haven't heard that one before. I have used shields with success with moms who have flat nipples, though, when every other technique has failed to get the baby on the bare breast. Most of the time, the baby can be weaned from the shield to bare breast once they have the hang of nursing, though. I have one mom in my practice with flat nipples, and a baby that refused to try at the breast at birth. We finally convinced this baby to latch with a shield at 24 hours when he had not latched once yet. He nursed beautifully with the shield, and we watched him very carefully for weight gains in the beginning. Unfortunately, he was never willing to give up the shield once he got used to it, though. They are still nursing happily at 9 mos, though - and aside from some difficulty nursing in public because of the shield, they are otherwise doing great. It's unusual to not be able to wean from the shield, though.<br>
You can start by starting with the shield, then once the nipple is drawn out and baby is not starving, take off the shield and put baby to breast. Once this is working, then try to start feeds without the shield as well. You might have luck offering the breast when baby is sleepy, or when baby has just woken up. Some babies latch better if you take them in the tub with you, and both soak in warm water together. Babies born at 36-37 weeks are often slower to get feeding well, and you have to be more aggressive about waking the baby more often to feed. Once they are past 40 weeks corrected age, they often start to feed more aggressively, and you can often then get rid of the shield, and stop watching the clock to wake the baby and trust them to wake on their own. It's probably good to do some insurance pumping to make sure your supply stays up while you are still using a shield.<br>
Definitely time of feedings and time between feedings varies in a healthy baby. Especially while you're still working on getting a supply established, its best to nurse the baby whenever she is willing! I hope you are following up with an LC or a breastfeeding knowledgeable doc, and I hope you have good support in your personal life too! The first few weeks are hard, but once breastfeeding is established, it doesn't require anywhere near the amount of thinking and working at it!
 

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Discussion Starter · #8 ·
Thank you all so much for your responses. I am waking my daughter now if she's gone a while between feedings. I am also offering the breast with no shield at every feeding. Sometimes she takes it, sometimes not.<br><br>
Tomorrow is her first appointment with the pediatrician, so I'll also talk about these concerns there.
 
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