Welcome to April's Carnival of Breastfeeding!
This month's theme is "how to." Be sure to check out the contributing bloggers' posts, linked at the bottom of this post.
My contribution is on how to stop using a nipple shield.
We get started using nipple shields for a number of reasons, but it usually comes down to babies' inability to latch, or latch well, without one. That might be because of inverted or flat nipples, a sucking or tongue problem, prematurity, 'nipple confusion' from bottle use, and even overactive let down. They can be lifesavers. In some hospitals they're treated like contraband; in others they're handed out like candy.
Whatever the reason for getting started with nipple shields, it's often hard to stop using them. That's because babies get used to latching with them. It's another form of 'nipple confusion,' which is really a misnomer, because babies are rarely confused - it's more accurate to call it a 'nipple preference.' Most mothers I know don't like using them - they get lost, or you feel petrified that you'll forget it at home. Most mothers find it harder to nurse in public with them, too. And for some mothers it's a big disappointment to not be able to nurse without one.
I should also say that some mothers want to use nipple shields long term, and if they're happy doing that I think that's just fine.
But if you want to get rid of the shield, how to you break the habit? Here are my suggestions:
Start early. It isn't always possible to work on this right away, I know, but I have seen babies wean off of nipple shields in the first week when mothers have really focused on it. Medela's instructions for their nipple shields suggest: "If the Nipple Shield is being used for a baby having difficulty latching onto the breast, remove the nipple shield after a minute or two of breastfeeding...Continue to do this with each feeding until the baby is able to latch-on without the shield. Some babies need only one or two sessions with the shields, while others may need more."
If your baby has developed the preference, remember some basic things. The best resource I've seen on this topic is at kellymom.com. There are many great suggestions on that page, and they represent some basic ideas:
1) Try to make your nipple feel more like the shield before attempting
to nurse without it. You can do this by rolling it between your fingers, pumping, or even putting something cold on them before nursing.
2) Don't force it. It doesn't work, and it'll just make you both upset. You also don't want your baby to associate being at the breast with a fight. So if you feel your blood pressure rising, or if your baby seems distressed, take a break and try it another time.
3) Try it when your baby is less likely to notice that it's not there. For example, try not using it on the second breast after nursing with it on the first. Or try it when your baby is sleepy, or not hungry. They tend to have a lot of difficulty when they're ravenously hungry.
Try self attachment. I've seen this work a few times, and it's amazing. Try this when your baby is a little hungry (but not ravenous), and in a quiet alert state. Take off your shirt and strip your baby down to a diaper. Place your baby on your chest, between your breasts, with his head under your chin. Support him, but make sure he's free to move on his own. He will probably "bop" his head against your chest a few times, and then start sliding down toward one breast. Let him do this, and just move his bottom to the opposite side to help. Then wait. He just might latch on without the shield on his own. Even one suck without it is a triumph and a sign of progress.
Have patience. This can take some time, and it happens gradually, in my experience. Then one day, your baby refuses to nurse with it. Sometimes this takes six days, sometimes it takes six weeks, or even six months! So have patience and faith. It'll all work out.
Expect to re-learn latching. Latching with a nipple shield is not like latching without one, and if the reason for the nipple shield was a sucking problem, your journey might not end when you stop using the shield. If you find yourself having any pain once you've ditched the shield, get some experienced help right away.
Don't miss these posts from other bloggers (updated throughout the day):
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