Nipple Shields and other issues!

[Tobysmum]

My baby Toby is 3 weeks old and I am breastfeeding.  He wouldn't latch on in the hospital so the midwives gave me a nipple shield to use which worked.  I have been using it ever since.  Things were going really well (despite having to use a shield) - he has been gaining a lot of weight - over 1 pound since he was born - so pediatrician etc are very pleased.  I have been alternating breasts for each feed i.e. one breast at a time.  Generally in the day he has been feeding every 2-3 hours (I have been doing on demand feeding as per my pediatrician's advice) and then at night he can go between 3-5 hours usually!  Most nights he's only been waking once in the night (lucky us).  However, early this week I developed symptoms of mastitis in my left breast and have been on antibiotics.  My nipple is also red and sore.  I spoke to a La Leche League leader and she said the following:
1.  Nipple shields can cause mastitis (and that I really shouldn't be using one)
2. Feeding alternating breasts (changing each feed) can lead to too long a time between breasts which again could cause problems.
3.  My baby sleeps too long at night between feeds i.e. therefore one of my breasts could go 8 hours without having been used.

Any comments from anyone on the above.  Would be interested to hear from anyone who has used nipple shields long term.
Also, I have a good electric pump and have been pumping a bit - sometimes pumping the breast that he hasn't used - am I going to end up with an oversupply.  I haven't given him any bottles yet as I don't want to confuse the issue if I want to try and get him off the nipple shield sometime.  Any suggestions on when and how often I should pump to build up my supply.
The other thing is that my left breast seems to have less milk than my right - since the mastitis.
I really want to breastfeed but I'm getting fed up with all of the conflicting information!
Please Help me!

[squeaky's mum]

Hi Tobi's Mum,

Congratulations on the birth of your little boy. It sounds like you have got him off to the best start possible with your breastfeeding. It is well worth persuing and working through your problems. My dd is now 9 months and breastfeeding 4-5 times a day. I am not a breast feeding expert but I hope my experience with breast feeding will help you.

I had really painful breastfeeding for the first 3 months with Sophie. So bad at times that dh had to hurt me somewhere else on my body to distract me from the pain. At 8 weeks I asked my health visitor if it should still be hurting and she said 'no way'! All problems should have sorted themselves out by now. I sought the help of a breast feeding counsellor from the Breast Feeding Network in the UK. She was fantastic and over the course of 4 weeks Sophie and I went from the painful feeding to almost pain free feeding.

My nipple is also red and sore. I spoke to a La Leche League leader and she said the following:
1. Nipple shields can cause mastitis (and that I really shouldn't be using one)
2. Feeding alternating breasts (changing each feed) can lead to too long a time between breasts which again could cause problems.
3. My baby sleeps too long at night between feeds i.e. therefore one of my breasts could go 8 hours without having been used.

I never used nipple shields so I can't really comment on this point. I fed Sophie one side at one feed, the other side at the next (on the recommendation of my midwife) but my bf counsellor told me this was probably at the route of my problems. For the very reason you gave above I got blocked pores in my nipples (YUK!) and this was at the route of my pain. Believe me, getting the blockage out was interesting.  I was told to feed from both sides at each feed. One side would provide the majority of the feed, then I would finish off with as much as dd wanted from the other side. I would start the next feed from the side the last feed finished on. Just as the pain was starting to subside I got mastitis. The advice from my bf counsellor was to feed Sophie as much as possible, especially from the affected side.

Through my experience I learnt that the best people to help with bf problems are bf counsellors who are specially trained in all sorts of bf issues. I found other health professionals just didn't have the expertise, often their information was out of date and they couldn't pick up on subtle movements between me and Sophie.

I would strongly recommend you get to see (face to face) a bf counsellor so they can see how you bf and also have a look at your breasts. I had clearly visable white 'plugs' in my nipples which gave away the route of my problem. I had no idea what they were, or even that they weren't normal! They will be able to help you through your problems which will hopefully lead to a long breast feeding relationship between you and you little boy.

Good Luck

Claire



 

[Samuel's mum]

I would agree with seeing a bf counsellor in person if you can. I'm not sure I agree with everything your LLL advisor said but then I guess it's easy to criticise and I'm not trained to her level.

In brief here's my 2 cents:
I know a lot of women have great success with single-sided feeding and it doesn't automatically lead to problems. I single-side fed for several months.
These women also have babies sleeping for longer stretches and their breasts adapt. Some of these babies sleep 8 hours plus.

However I would agree with her about nipple shields. They can make mastitis and plugged ducts more likely. Are you using the very thin 'silicone' type? Medela make one called a 'contact shield'.

This article talks about weaning from the shield:

http://www.kellymom.com/bf/concerns/baby/wean-shield.html#disadvantages

Although using a shield isn't ideal if it has helped you to breastfeed it has been a champion. Breastfeeding with a shield is still breastfeeding even if it can make it harder!

P.S If you're taking antibiotics take probiotics like acidophilus to help prevent thrush. Thrush is also more common with mothers using a shield.

[RuthinHolland]

Hi Toby's Mum

This exact same thing happened to me, I guess they don't have time in hospital to help establish a good latch on.  Ella initially gained weight well, but I was still using the shield at 5 weeks, when she was only gaining 40 grams a week.  I also got mastitis (agony!) - didn't know this was connected to using a shield though.  In the end I found a lactation consultant to come and visit, it was great to have someone positive and supportive to talk to, she didn't make me feel bad for using the shield but gave me some ideas for weaning Ella off it.  Her main suggestion was to remove the shield halfway through a feed when Ella wasn't frantic with hunger but this didn't work for us, she wasn't hungry enough to persevere.  In the end, expecting lots of crying and a period of adjustment, we just went cold turkey one morning and I'm not sure she even noticed, just latched on straight away!  It's made a real difference to how I feel about breast feeding, I wasn't enjoying it much up to then because I felt I wasn't doing it 'properly', which was really stupid looking back, I guess I wasn't at my most rational!  Anyway, we're still going at three months, I'm glad we stuck at it.  ' Hope this helps!

[daisymelan]

{{{{hugs}}}}

Just wanted to offer my support and say that you CAN do it!  You have been offered some great advice.  Please update us.

[jhcodrum]

Hi Toby's Mum
Just thought i would give you a bit of insite into a long term breat shield user. I have used breast shields with both my babies i fed my first for 15months and am now onto the 9th month with my second. There seems to be a lot of stigma involved with breast shields like "you are not really feeding" but how can that be when the baby is getting milk isn't it! I was told all sorts of things like your supply will drop, you will get mastis blocked ducts and so on and so on. Yes i had my fair share of blocked ducts etc but doesn't almost everyone at some stage. Just remember your baby is only 2.5weeks old and it took me 3months with my first and 5months with my second to develop a good breastfeeding relationship(oversupply with 1st and undersupply with 2nd).I would pump after every feed (with undersupply issues) sometimes i would only get 1oz but over a couple of weeks increased my supply. I have also only ever feed single sided the breasts are amazing things and over time work out supply and demand. Both my babies sleep through the night early on (5 weeks with first and 11weeks with second) so they were going 10 - 12 hours without a feed. Again people would say you can't go that long without feeding you will loose your supply you must wake the baby to feed at night.My reply was always the same why wake a sleeping baby when she seems happy to sleep that long without a feed. Oh by the way i would just pump from the breast i had feed on not the other as that can create oversupply as your body thinks its got to produce large quantities from each breast at each feed. I too produce less from my left breast and both my babies have always favoured the right one. You sound like you are willing to persavere so hang in there as a good breastfeeding relationship takes time.
Good luck
Julie

[mena]

Hi Tobysmum,
Great advice you've got here!

I did use breat shields for a couple of weeks at the biginning and they did cause me problems, like open-wounded and bleeding nipples and thrush. I guess I was lucky enough not to get mastitis, but I was close to it. I was in so much pain at some stage and thinking of giving up, when I called a lactation consultatn and she was great. The pain and probs didn't disappear overnight (it took 3 weeks), but 4 months later I'm still breastfeeding and loving it.

Another thing, I also single-side feed my LO and nothing has happened to me. Ok, my unused breast would end up full of milk and VERY TENDER AND SORE in the mornings. My midwife and consultant told me that if I was in so much pain, to either wake up baby in the middle of the night (he also slept through from an early age) to feed him (which I didn't want to do!), get up myself in the middle of the night to express milk to relieve the pressure (which I was too lazy to do) or wait till the morning. I waited till the morning (the pain usually woke me up), about 30 mins before babs, expressed some milk from that side and then feed baby from the same side. This increased my supplies of frozen milk  and didn't create me any problems...

Her main suggestion was to remove the shield halfway through a feed when Ella wasn't frantic with hunger but this didn't work for us, she wasn't hungry enough to persevere. 

I did the same, and it worked within a few days. I used to latch him on and after a few mins latch him off, take the shield away and put baby back on breast.

It's early days still for you. Be patient, trust your body and everything will get sorted. Promise.
HTH

[Tobysmum]

I agree that they are probably given out too readily - I met another 2 girls yesterday who had also been given one at the hospital. My hospital has no lactation consultant and the midwives are busy, so I guess it's easy to give them out rather than spending a lot of time with mothers - because it does take a lot of time and perseverence with a lot of babies to help them latch on.
I wouldn't have used one out of choice - but I didn't know any better in the hospital. Since it was the only answer to breastfeed, then I went with it. He's been gaining weight very well and so far my milk supply has been good.
I tried him on my breast today without the nipple shield (twice) and he actually went on!!! His feeds weren't anywhere as long though - he kept falling asleep unfortunately. I plan to keep trying - I will call the pediatirican's office today to see if I can bring him in to be weighed, so I'll know if he's still gaining over the next few days of trying. Anyway, that's a step in the right direction - today is the first day that he's sucked for more than a second or two!!!
I'm praying this is the beginning of a good thing! Keep hoping for me....

[Tobysmum]

Just got back from the pedeatrician and Toby has gone from 7 pounds 9 ounces to 8 pounds 6 ounces in 8 days! Nipple shield clearly isn't reducing my milk supply (yet!) I plan to carry on trying to give him my breast without the shield - and the pedeatrican said I have a bit to play with now and we'll see what he weighs when he goes for his 4 week check up next Monday.
Here's hoping.....

[Samuel's mum]

Wow! That's great.
Good Luck with your plan.

[daisymelan]

Great news!  Thanks for sharing.

[Shdef]

My friend used nipple shield for seven months as her nipples were facing inwards (if that's how you say it in English.

She has really bad thrush and mastitis and also a very windy baby. Now the wee one is 7 months and is strong enough to pull the nipple out as much as she needs. It is possible that it will work without the shield, maybe it's a matter of strength...

[squeaky's mum]

Excellent, it sounds like everything is moving in the right direction. Well done.

[Tobysmum]

I think I will try breast shields too and see if that helps. My nipples are pretty soft and are sometimes flat too (particularly right side)and I think that's part of the reason he can't latch on properly - he just slips off! As I said, when my right nipple as "riper" he did latch on twice yesterday morning (not for all the other feeds though!) I don't tend to try him at night as generally he's pretty hungry and I really don't have the patience - just want to get the feed done and go back to sleep (lol)! He latched on once this morning for a whole 20 minutes which was fantastic but it took quite a few attempts to actually latch on properly - he was very patient with me! I think we've got a long road ahead though. I sooo want to continue breastfeeding now I've started. The good thing about nipple shields is that it really doesn't feel any different to when they are directly on the breast (to me anyway) - and now I've experienced both, I know! So it's not that part. It's more the inconvenience of the shields and the increased risk of mastitis and blocked ducts. I am continuing to pump 2-3 times per day to try and ensure I maintain my milk supply (which apparently is sometimes a problem with shields) and also to ensure my breasts are emptied regularly (as that contributes to mastitis and blocked ducts). I don't mind so much using the shield at home (apart from washing it all the time!) - it's just when we are out it's not very convenient and I can't really feed discretely in public (haven't tried but I don't see how I'll be able to do it really). I guess that's where the pumping comes in handy, when I'm out I can give him a bottle of breastmilk instead. I have quite a lot in the freezer now from my pumping - but haven't given him the bottle yet as want to see if he'l get off the shield before introducing another silicone nipple to confuse him!
Has anyone used one long term and had success?

[Shdef]

I haven't tried breast shields but I can tell you that there is a good chance that the stronger he gets the better he will be able to latch on without them. The milk supply can actually decrease if you use the shields because the baby's saliva makes the breast produce more...

Pumping is a good idea though...