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Flat nipples
Weaning off shield

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#1 Franny Glass

Posted 01 May 2012 - 12:14 AM

Just after a bit of advice and/or inspiration to keep me going really!

I didn't think having flat nipples would make a difference when breastfeeding (everything I read in pregnancy indicated babies don't care what breasts look like as long as there's milk in them) but apart from the initial first feed after birth my daughter has found it almost impossible to latch on. We started with expressed milk using a finger and syringe and then moved onto nipple shields and the occasional bottle with EBM when my nipples are thrashed due to her efforts to latch on. I am very thankful for the shields as I might not have been able to breastfeed otherwise, but I'm now at the stage I want to get rid of them: they're clumsy and it feels a little clinical, it's a hassle having to remember where you put them for each feed and when Clementine gets really hungry she flings her arms about and knocks them off so it takes longer to latch on and we both get frustrated. She also seems to gag on them sometimes or pull a face like its uncomfortable or unpleasant to use them. She also gets cross that the food isn't immediately available.

I have managed to attach her without the shield once only, and that was towards the end of the feed so she was relaxed and not starving so not as panicked when it took some time. I've tried a few times since and not had much luck! As a result I'm lacking in confidence, especially because it's so hard to have enough hands to hold her and shape the breast at the same time. She doesn't seem to recognise I even have a nipple there (fair enough really, it is incredibly flat, little more than a mosquito bite!) and gets so cross I feel like I'm forcing it on her. She seems quite able to latch on to the nipple shield and has no problem getting milk when she does. Her weight gain has been good - 300g the first week after hospital and 500g the following week. Does anyone have any advice or positive stories that might help me with this? Clementine is 3 1/2 weeks old. Thank you : )

#2 Emily of New Moon

Posted 01 May 2012 - 01:08 AM

I don't have flat nipples so I've never tried this and I'm not sure if it will work for you.  But when I express, it kind of elongates my nipples.  Can you try expressing for a bit before you feed your DD at the breast?

Another suggestion is maybe start the feed with a nipple shield and then take it off after a bit when she is not so hungry and has a bit more patience in trying to attach?  This worked for me when I had initial problems with attachment when DD was born.  (Although ... I know you said that your DD doesn't like the nipple shield.)  Or perhaps you can start the feed with EBM?

ETA:  Your daughter is beautiful btw.  Congratulations original.gif

Edited by duckypond, 01 May 2012 - 01:15 AM.

#3 TwiceThe Woman

Posted 01 May 2012 - 01:50 AM

Hi Franny Glass, What a great job you are doing!  Just want to say as an LC of 24years, that flat nipples are incredibly common and you've obviously been doing all the right things with those wonderful weight gains.
As Clementine is only 3 & 1/2 weeks you could try;
- before offering the breast, try rolling your nipple between you thumb and forefinger to encourage any erectile tissue
- offer to her while she is still sleepy* (so before a nappy change and not fully woken), or,
- go back to staying with the shield for a while, continue to offer while sleepy*, wrapping her arms down with a bunny rug to initiate the feed, then if you wanted and felt confident enough you could, as described above, take the shield away after she has been sucking for a while.

Re: her being sleepy......... does she generally go 2/3 or 4 hours between feeds? Try to estimate when she will wake and pick her up when you think she's just starting to stir.

Try not to be disheartened, getting rid of the shields will eventually happen, it mostly depends on the size of her mouth and with her weight gains, it shouldn't be too long before her oral cavity will latch easily.
Any problems, don't hesitate to see the LC at the hospital where you delivered for further support.

Good luck and congratulations on your dear little daughter - she's gorgeous!

#4 sjm218

Posted 01 May 2012 - 02:08 AM

I have flat nipples and on the advice of the LC at the hospital, I would use a hand pump to express a little before each feed - this literally sucked my nipples out. Maybe this would work for you?

#5 SuboptimallyPooks

Posted 01 May 2012 - 05:54 AM

Just expressing my empathy, those shields are annoying, but they work. Bfing didn't work for us for additional reasons but the shields are the only way it happened for the time it did. For me, the pump thing didn't work though I know it does for others. I've met a woman who was able to move her baby off the shield once he was a few months old by doing as you described, removing it once bub had had a bit of a feed, but I think a younger baby can have more problems from what I was told anyway. Best wishes, I hope you get more answers here. I think the info about how flat nipples shouldn't prevent bfing os bit misleading about how challenging it can be. maybe an LC would be able to watch you and bub feed and give tailored suggestions? I found their help great.

#6 Franny Glass

Posted 01 May 2012 - 05:27 PM

Thank you so much everyone, I will try these suggestions and with a bit of patience and perseverence, I think we'll get there. The fact that she has latched without the shield twice (once directly after birth and the other time earlier this week) is promising as at least it shows she can do it.

Thanks again! It's nice to know this isn't an unusual problem because some of the midwives at the hospital (only one or two, the majority were wonderful) made me feel like a bit of an oddity! So good to know I'm not the only one who has struggled with this original.gif

#7 SlinkyMalinki

Posted 01 May 2012 - 05:37 PM

I breastfeed DD1 for 10 months with a shield.

I was determined I wouldn't use it again for DD2, but I had to again from the start.

At about 2 months, I had a go without shield, and found she could attach more often than not, and feed fairly well.  I did this for a few weeks.

I actually found it more uncomfortable without the shield, so I ended up going back to using it, she's 5.5 months now and feeding well still.

#8 White-Lily

Posted 01 May 2012 - 05:37 PM

It gets better/easier as time goes by! It really really does!!

When I was weaning DD off the shield I started with the shield on for the first few big sucks so the milk was flowing and the nipple was drawn out, then quickly detached her, took the shield off and then reattached. She didn't really have too long to get grumpy at me by doing this.

We didn't get rid of the shields until about 4 months when DD was bigger and stronger to suck the nipple out and latch herself. She had other health issues which hindered us a little.

Also as PP's have mentioned a breast pump for a few pumps would also bring the nipple out enough for bub to latch.

#9 trinyweeny

Posted 01 May 2012 - 05:41 PM

It took DD and DS till they were about 6 weeks old before we were able to ditch the nipple shields for the flat nipple side (the other side is inverted so was about 12 weeks for DD and DS refused that side completely at 4 weeks.) I tried for one feed a day when they were not starving and I was relaxed.

#10 TwiceThe Woman

Posted 01 May 2012 - 05:52 PM

Just wanting to add that around the 6 week point, your milk supply usually settles down to equal demand. Many people mistake their loss of excess supply as "losing their milk" as it amy coincide with growth spurt demand for 24/48 hours, so hang in there as the nipple becomes more supple at this time, it may be easier for you to manipulate the nipple to offer for feeds. Give it a go every now and then and Clementine will eventually get the jist.

#11 mks81

Posted 01 May 2012 - 06:01 PM

has anyone got a link so I can have a look at a shield, possible it attached as well?

I had flat nipples for my DD9 and though I have heard of them recently, no one ever mentioned them to me back then.

#12 Hooray Henry

Posted 01 May 2012 - 06:10 PM

wub.gif OP your baby is beautiful!

I used shields for 6 months with DD, until she refused to attach to them and pulled them off herself.   We then fed til she was 21 months.   My efforts to wean her off shields prior to 6 months were unsuccessful, I hope you have more luck.  

#13 trinyweeny

Posted 01 May 2012 - 06:10 PM

ABA nipple shield info

There is small photo of one attached.

Medela Nipple Shield

#14 Lagom

Posted 01 May 2012 - 06:24 PM

Well done OP!

I have severely inverted nipples and after much perseverance am continuing to feed DD2 at 21mths with no shield.  I had to pump and feed her EBM for the first 4 weeks.  Then I fed her with the shield until about 6-8 weeks (I can't remember exactly) when I weaned her off them.  I found that she needed to be a bit bigger to be able to get enough breast tissue in her mouth to suck out the nipple.  I found the Medela shield to be the best IMO as it does not have silicon over the nose area but has enough for it to stick on properly.  I have tried them all!

To help get my nipple out in the beginning I tried feeding her after first using my pump for a few minutes, which didn't empty the breast but helped to stretch it out a bit.

Best of luck!

Oh, and I just love her name.  wub.gif

#15 Feral-as-Meggs

Posted 01 May 2012 - 06:52 PM

My midwife made me a little sucky thing out of a syringe with the top cut off, the same size as the nipple, to draw it out about before latching.

#16 Lokum

Posted 02 May 2012 - 12:43 AM

Heaps of good ideas here.

We used shields until 7 months - very flat nipples, and a very small, sleepy baby with small mouth and slight tongue tie. I did try from time to time to feed without, but it took until 7 months. We continued to feed without until 14 months.

I do remember how hard it is with a frantic newborn, their hands, your hands, the shield sliding everywhere, milk dripping on everything. I used to get DH to come and help hold DS sometimes until I could get everything and everyone in their place!

I agree that wrapping baby tightly so they're less wriggly helps. Generally though, if you can't wean from the shields in the short term (I hope you can) they do get much easier to use, for you and the baby.

I fed in front of a certain group of friends for months, and they didn't even realise I was using shields!

If you do have the misfortune to be stuck with them for a while, make sure you replace them regularly. I was sterilising mine in the microwave, or giving them a quick boil from time to time, and I had one shield literally disintegrate into pieces in DS' mouth.

After that I replaced them more regularly, and just went back to hot soapy water to wash them.

#17 Le-a

Posted 02 May 2012 - 01:15 AM

I used a shield for about three weeks after my milk came in and my boobage got so mammoth that my nipples became flat. Yowzah, them were some big boobies... Luckily  my midwife took one look at me and gave me a shield.

I too found them fiddly, and difficult to use in public, and messy, and time consuming. But with out it, I'm not sure that we would still be breastfeeding now, at 15 months.

Im not sure how I weaned off the shield, I think I just decided one day, that the next day I was going  to try one feed without it. And to my surprise it worked. Not every time, but gradually things became easier, and DS got better and my nipples stretchier.

I wish you all the best, please dont feel like you have to rush to get your DD off the shield, don't pressure yourself.

#18 EmilyStrange

Posted 02 May 2012 - 01:31 AM

I had inverted nipples that gradually came out through the course of my pregnancy, weird I know.  I used Medela nipple formers in the last few weeks of pregnancy too, which I believe really helped me.  While I was in hospital, all the midwives who saw me breastfeeding commented that I had "good equipment".  They didn't believe me when I said I'd always had inverted nipples until recently!

QUOTE (meggs1 @ 01/05/2012, 06:52 PM) <{POST_SNAPBACK}>
My midwife made me a little sucky thing out of a syringe with the top cut off, the same size as the nipple, to draw it out about before latching.

I saw on the Pigeon website that they had this device called a nipple puller...  Might be worth looking into?  Best of luck, OP!

#19 klr70

Posted 02 May 2012 - 01:32 AM

Little Clementine is only 3.5wks. You're doing a fabulous job - she's gaining weight & looks adorable. It takes time to establish BF - the LC at the hospital told me "it takes 6 weeks to establish BF. You & baby both need to learn how it all works. Give yourself time to adjust." Best advice I was given.

My DS (now 7mths) fed successfully for the first feed after birth, lulling me into a false sense of security (I remember thinking "that was easy"). That was the ONLY time he latched on... The midwives commented on my flat nipples & recommended I see the LC (AFTER all sorts of poking/prodding/hand expressing, etc). The LC advised the use of a Medela nipple shield. I found it unwieldy - hard to get it in the right place, wouldn't stay there, & then I had to get DS to latch on... but I persisted (being incredibly stubborn had to come in useful sometime! wink.gif )

I also got some medical tape & taped the shield in place (tape all round at first, then only a strip top & bottom) - this really helped, as once the shield was taped on, my hands were free to get DS into position. Eventually (about a week or so), I could get the shield to stay in the right place without the tape (which was great, as I was starting to have a reaction to the adhesive).

Every so often, I'd try a feed without the shield. Sometimes it worked, sometimes it didn't. If it didn't, I went straight back to using the shield. I was also giving EBM every second feed or so, to give my poor sore boobs a chance to recover! I can't remember exactly how long I used the shields for, around 4mths, I think. I figured so long as DS was getting breast milk, it didn't really matter how it was being delivered. Eventually, more & more feeds were without the shield, until one day, we just didn't need it anymore. Now, at 7 months, DS feeds really well.

As others have advised, a good LC is worth their weight in gold. Mine gave me the confidence that I could BF successfully, despite the frustrations & pain that I encountered in the early days.


#20 GingerTea

Posted 02 May 2012 - 08:16 PM

I have been breastfeeding my first baby for 13 weeks and my nipples were very flat to begin with. He was only small when he was born - 2.2kg and coupled with my flat nipples the lactation consultant recommended i use a nipple shield. I have only attempted to feed without it a couple of times. Agreed that it feels clinical. And my DS sometimes knocks it off with his hands too (grrr). The good news is that after 13 weeks my nipples are no longer flat - the constant suction has popped them out and if i wanted to i could probably try feeding with out the shield.........but ive kind of put it in the too hard basket. Yep - its an extra thing to keep track of and clean, but its just so easy for him to latch on!! It definitely gets easier, so hang in there original.gif

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