PDA

View Full Version : Need help with nipple shield, constant nursing, etc.


papayadoc
10-14-2008, 06:16 PM
Help! I'm having several BF’ing issues, not sure if they're all related or not. Sorry for the long post, but I am not enjoying the BF’ing experience much, but would really like to continue and not end up resorting to pumping alone.

My son is 4 weeks old, was full term, delivered by c-section. He had latching issues in the hospital, and the LC ended up having me try a nipple shield at day 3, which he took to right away. I started to try to wean the shield after about a week, but ran into the same latching issues – he either wouldn’t take the breast at all without the shield, or would sit there with it in his mouth, but wouldn’t suck. I tried offering the breast (w/o shield) when he was sleepy, after flow was established, and when switching breasts, all to no avail. He takes a long time to nurse, though, (sessions often lasting 1h, sometimes1.5h), with him falling asleep on and off, and I have to try to wake him frequently. Many times he doesn’t come off on his own. Weight gain has been appropriate, as well as the number of wet and dirty diapers.

I continued to try to wean the shield, but then about 2 weeks ago he began having episodes where he would nurse constantly for hours and hours at a time, at which point just maintain sanity became the priority. Initially, I attributed this to a growth spurt, except it happens for a few days, he’ll have a “good” day (nursing every couple of hours, sometimes goes 4 hours once a day), then the next day it's back to the constant nursing. During these episodes, he’ll nurse for a few minutes, get sleepy, and stop. If I try to take him off the breast or move him, he startles awake and starts screaming and frantically rooting like he’s starving. It goes on for hours. It seems like it’s sometimes preceded by him having nursed recently, so there isn’t as much milk present, but it then becomes a very frustrating and tiring vicious cycle. One of these episodes lasted over 9 hours, from 11pm to past 8am, with me only drifting in and out of uncomfortable sleep. I often end up resorting to side-lying position, and dozing that way, but wake up in pain from a tense position on one hip.

Another issue I’ve had is that my breasts are not producing evenly – the left is larger, make 2/3 of the milk supply, and has a faster let-down. Consequently, when I try to nurse the right side, he often gets upset and frustrated, especially during those feeding frenzies. I’ve tried to pump the right sometimes, and to start him off on the right more often to increase production, but neither has seemed to help. Less importantly, I’m looking pretty lop-sided… I’ve also had problems with blocked milk ducts repeatedly, mostly on the less-producing right side.

Now, it seems like he’s sucking so hard sometimes that my nipple is trying to come through the nipple shield – it hurts, and I end up with 4 raised dots on my nipple after a feeding! I’m using the largest nipple shield (24mm), so I’m not sure if he’s just latching improperly onto the shield itself or what.
We have offered a pacifier during the feeding frenzies, but it doesn’t really work. We have given him a bottle a few times in an effort to allow Mommy a bit of sleep, which he took readily, but he often still seems hungry even after 3oz. Not sure how much he should be getting from a bottle? If pumping, I generally get out about 2.5oz total.

Any help with these issues would be greatly appreciated. How long should I be letting him stay on at a time? Should I be offering one breast per feeding or two? Are all of these problems due to the nipple shield? I’m really hoping to enjoy BF’ing more eventually if I can work things out. Thanks in advance!!

CherylParrott
10-14-2008, 06:23 PM
Well, first let me say this is a fairly common concern. I think some of your issues are shield related, but it sounds like he needs it for latch so that is of no consequence now. SO< he sounds very flow dependent..enjoy the gush then do nothing. You need to check out Dr Jack Newman's video on breast compression to get him to DRINK at the breast or get off. hour long feedings are not normal, nor any fun...as you know. But it will take some training to teach him how to nurse at the breast, not drink from the faucet. I hope you can find a good LC or support group in your area so someone can watch him feed, do a before/after weight and really help with latch. Hang in there!

papayadoc
10-14-2008, 06:31 PM
I actually watched Dr. Newman's video and have tried the breast compression. It didn't seem to work very well, which I attributed to the milk having to fill the shield before going into baby. Sometimes, though, he falls off when asleep and the shield still has a fair amt of milk in it. What a shame to waste it!
One LC I spoke to recently thought most of the issues were shield-related, and rec'd more attempts at weaning, although it's hard with minimal sleep... I guess I'll just keep plugging along.

CherylParrott
10-14-2008, 06:37 PM
Have you tried pumping prior to latching? or let him nurse a bit on the shield then take it off. I still think he sounds like a lazy nurser and he needs to learn to be more active...again, a good support group might help

papayadoc
10-14-2008, 06:46 PM
I've tried letting him nurse a bit with the shield on, then taking it off - didn't really work. If he latches at all, he may suck for a couple minutes at most, then comes off and doesn't want to go back on w/o shield. Maybe I just need to be persistent. How do you teach them to be more active? Does it just come with time?
I'll try pumping a few minutes first, and will also look into our local LLL.

papayadoc
10-14-2008, 06:48 PM
Also, is it a bad thing to offer a bottle of pumped milk once a day so I can maybe get a little sleep? If it's ok, how much should he get? He doesn't get that he's full when he sucks it down quickly, I think.

CherylParrott
10-14-2008, 06:56 PM
Absolutely let him have a bottle...volume..try around 3 ounces and see how he does. pace it out slowly over 5-10 minutes perhaps and then let him relax and let his brain catch up with his belly and if he wants a little more than ok. Yes, teaching him to be more active will come with time, he has had 4 weeks of poor feeding pattern, so a week at least is normal.

papayadoc
10-14-2008, 07:09 PM
Just to clarify, by teaching him to become more active, are you referring to weaning the shield, or taking him off every time he sleeps, or is there something else I can do?

CherylParrott
10-14-2008, 07:16 PM
I would n't worry about the shield, I would get him to be more active..drinking not sleeping at the breast. If breast compression doesn't get him going, take him off, rouse him around, switch breast and try him again...repeat as needed to get a good active 30 minute feed in. You will need to be fairly diligent in keeping after him. Also, after 30minutes, take him off and see if he can comfort or distract him, even for 20 minutes. Just trying to gently train him that he needs to eat, be done, take a break, then eat again. His belly is used to a continuous small amount of milk and we need to teach him to have a good full belly then break then get hungry and so on. I'm less concerned about shield use than I am the patterning.

CherylParrott
10-14-2008, 07:16 PM
jUst try it for a week and see how it goes

papayadoc
10-14-2008, 07:23 PM
OK, I'll give it a try. Thanks!!

CherylParrott
10-14-2008, 07:26 PM
you are welcome! good night!

papayadoc
10-14-2008, 07:33 PM
ONE more quick question - during the day and early evening, when he does sleep and isn't doing the super long feeds, he'll often sleep hard and go 2.5-3h in between feedings. Should I be waking him and feeding every 2 hours during those hours to try to get him to sleep longer at night?

Thanks again!!=)

CherylParrott
10-14-2008, 07:36 PM
NO, NO, NO...let him sleep and enjoy that time. he is still too little to figure out day vs night. I wouldn't let him sleep more than a 4 hours stretch during the day though.

papayadoc
10-14-2008, 07:42 PM
OK, cool. Then is it still ok if he were to go for a 4-5 hour stretch at night?

CherylParrott
10-14-2008, 07:44 PM
Absolutely, let him sleep!

papayadoc
10-14-2008, 07:48 PM
Whew!
Thanks, and have a great night!
=)

CherylParrott
10-14-2008, 07:54 PM
you too!