QUESTION: Clay was born 5 weeks premature because I developed preeclampsia and my OB induced labor. Clay was diagnosed with RDS and spent 6 days in NICU, where he was started on formula (even though I was pumping and taking milk to NICU daily) because his nurse didn't realize that there was milk for Clay in the freezer. When Clay was started on breastmilk, I went to the hospital for most feedings; however, they continued to bottle feed him, occasionally offering me an opportunity to put him to breast.

Being a first time mom, I did not realize that this would make the transition to breastfeeding difficult. After bringing Clay home, our pediatrician advised us to formula feed for four days because of high bilirubin levels. Currently, Clay has been home for three weeks and I am pumping 8-10 times a day and bottle feeding Clay because I'm unable to get him to latch on and he gets extremely frustrated. We have met with a lactation consultant twice, and both times Clay latched on and took about 25 ccs. I am hesitant to switch to dropper feeding because Clay is gaining weight so well and our pediatrician is definitely against it. Is it too late to establish successful breastfeeding?

Thanks for your time- I am determined to make this work if at all possible!
 

Dear Amy,

It is never too late to establish breastfeeding. If you are determined to make breastfeeding work, then it can and it will! There is no reason to believe that your baby won't go back to the breast. It will just take some work on your part. There are women who have adopted babies (sometimes months old) that have never had anything but bottles, and they have been able to get them to the breast.

First you will need some good "tools." Probably the easiest and cheapest tool is a silicone nipple shield. Nipples shields fit over your own nipple while feeding. They make it feel more like a bottle nipple for the baby, so it is often an easy way to get a baby back to the breast. I have found them to be a nice transition. You may have to reinforce the fact that your baby can get milk at the breast by dropping milk on the shield as he goes to latch on. Sometimes you may have to reinforce throughout a feeding. But eventually, babies realize that this is where they can go to get fed.

Having someone else around to help you when you first get started would make it much easier. Nipple shields should not be used without the help of a lactation consultant, since they can reduce the amount of milk a baby takes at a feeding. That is because the breasts don't receive direct stimulation from the baby's mouth--the mouth is on the shield. I have worked with women who have used them for months, though. with wonderful weight gain. If your baby is having at least 6-8 soaking wet diapers per day and multiple stools, then you can usually be assured that he is gaining. Sometimes it just means nursing a little bit longer each feeding or a little more often.

Another more expensive "fix" is a supplemental feeding system. This is the type that adoptive mothers use to feed their babies. You put milk in a little bottle that hangs on a nylon cord around your neck. Small tubing taped to your breast delivers the milk to the baby. This system works very well at transitioning babies back to the breast because they get an immediate reward of milk. Again, you really need to get a lactation consultant to explain to you how to use it and tape it before you get started. You should be able to find either of these products from the LC you met with before. You can see them both at Medela's website: http://www.medela.com

Please let me know if I can be of further help. I have had a lot of experience with both of these products. I wish you all the best!

Cher Sealy RN, BSN, IBCLC, LLLL

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