Is nipple preparation necessary?.
Not really. The nipples will toughen up as the baby nurses. Rolling
or tugging at the nipple during pregnancy or rubbing a rough towel on them actually makes
them more tender, because it removes part of the outer layer of skin. And never use
soap or alcohol on the nipples. It will make them too dry. The key to
preventing sore nipples is to POSITION
THE BABY CORRECTLY. (1)
What should I do if I have inverted nipples?.
To find out if you have inverted nipples, you should gently pinch the base of the
nipple. Inverted nipples go in when they are
pinched and normal nipples stick out. Flat nipples stick out but
look somewhat flat. It is fairly common to have flat nipples but it is extremely
rare to have completely inverted nipples. But even if you do, you can almost always
breastfeed. There are little plastic devices available called breast shells
that can be worn in your bra during the last months of pregnancy to help bring out
inverted nipples. They work by putting pressure around the base of the nipple, which
pushes the nipple out. If they are worn several hours a day in the last trimester,
they should help the condition. If you don't find out until after the baby comes, it
is not too late. Breast shells can be worn between feedings, but it might take a few
weeks for the nipple shape to improve. You can buy them at maternity stores or from
a lactation consultant.
If you do have flat or slightly inverted nipples, you may be able to gently pull them out
with your fingers (far enough out for the baby to latch on to). And some mothers
have been able to get them to stand out by putting a cold cloth on them. (1)
What are the drawbacks of using a nipple shield?.
The nurses at the hospital gave my wife a nipple shield to keep on her
breast while feeding. The baby has gotten used to this shield and now has a terrible time
feeding without it. Do you know what the drawbacks of using the shield are? There is
a warning on the package that says the shield can reduce the mother's milk production.
Nipple shields can be a big help if you are really struggling to
get a baby feeding at the breast, but as you have seen, they can also be difficult to wean
from! I have found that the best way to wean from a shield is to work backward. A hungry
frantic baby is in no mood to try something new. Allow him time to get a full tummy and he
will probably be more willing.
Tell your wife to spend time at or near the end of the feeding in working with latch-on
without the shield. She may have better luck on one side than the other. If she is
persistent, your baby will learn how.
Once this is happening, begin mid-way through the feeding, progressing toward the
beginning. I have never seen this not work. The key is persistence. Also, realize that
sometimes babies will latch on better if they are not yet fully awake.
In answer to your question concerning the warning on the package--because the baby's mouth
is on the shield instead of directly on the breast, the nerves in the breast do not get as
much stimulation. What that means is reduced milk transfer. Studies have shown that the
silicone nipple shield can reduce the amount of milk transfer by about 22%. For example,
if a baby feeds for 30 minutes without a shield and gets 2.5 ounces at a feeding, then
feeding with a shield might result in only about 2 ounces (about 1/5 less). If you
understand this, then you know that what you need to do is feed a little longer and/or
more often to make up for any difference.
It is important that your baby is having at least 6-8 soaking wet diapers per day and
frequent stools. Weight checks will help assure you that your baby is gaining adequately.
If your wife needs further help in weaning the baby from the shield, I would recommend
that she contact a Lactation Consultant in your area. Good luck!
Cher Sealy, RN, BSN, IBCLC, LLLL
What is nipple confusion?.
Sucking on a rubber nipple is very different than suckling at the mother's
breast, and many babies have become confused after only a few bottles. They actually
seem to "forget" how to nurse.
It takes more effort for the baby to nurse since he has to move both his jaws and his
tongue a certain way to get milk. With a bottle, all he has to do is create a
suction and swallow.
If your baby has become nipple confused, he CAN be "retaught" to breastfeed.
Keep trying and take away all bottles and pacifiers. If he won't nurse at
all, pump your breasts and feed him with an eyedropper, spoon, cup or supplementary
nursing system.
Most of the time, after a couple of days of effort, he will get back on the breast.
But if he doesn't, don't give up. Ask for help from a lactation consultant or a La
Leche League leader. (1)
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