Nipple Confusion

Hi E.,
My name is Lysa and my oldest daughter (who is now almost 15 yrs.) had nipple confusion, my lactation consultant recommended "finger feeding" her for a few days and it worked she got back on breast and nursed for almost two years, (a little longer than I planned!)Finger feeding requires a soft plastic syringe (available from a lactation consultant) that is filled with breast milk and placed along side your pinky finger that you allow baby to suckle, you reward her for suckling with a bit of milk through the syringe and stop when she stops, it is time consuming, plan NOTHING else for a few days but the beefits and rewards are well worth the time and effort. Best Wishes to your new little family,
Lysa

Have you tried a nipple shield. While it is actually used to help babies with latch on difficulties we found that it helped our daughter move seamlessly b/w bottle and breast as it is very much like the nipple on a bottle. (She too was in the NICU when born) It also has a space that retains the milk as its coming in thus requiring a little less effort on baby's part. Good luck; keep persevering.

I had a similar problem with my daughter who was born via C Section and had a really hard time getting her to latch on. The nurse gave her a pacifier right off the bat, (I was furious and filed a complaint with the hospital later on) it resulted in the baby not being able to nurse. It took almost 3 weeks to really get her to nurse. It's one of those things that just takes time, she will get used to breastfeeding eventually, just keep working with her every hour or so. Also, take advantage of the lactation specialist where your daughter was born, they are miracle workers!

Good luck and hang in there, it will happen!

Request a lactation consultant. Also, try to "help" her buy pumping her arms, legs, stroking her cheek, etc. Good luck and congratulations on your baby girl!

You can try a supplimental nursing system, this worked very well for client I had with early twins. Basically you tape a very small tube onto your breast that increases the amount of milk your baby gets, instant gratification, while getting her on the breast. You can ususally get these from a lactation consultant, just ask for an SNS. Good luck!

Hi--congratulations on your new daughter! It must be so frustrating that she prefers the bottle to you, but many babies have had this and gone on to become avid nursers, so don't despair. It is easy to understand that a newborn gets exhausted quickly and a bottle nipple is very easy to get nourishment from. In fact, if you nurse vigorously from a bottle, you will drown in the milk coming out too fast. A big retraining is in order. One thing that can help is a device called a Lact-Aid (http://www.lact-aid.com/prodcat.htm) that contains breast milk and is strapped onto mom and has a small tube that dribbles milk into the baby's mouth while she attempts nursing. It effectively makes the nursing easy enough to let her get satisfied, without working as hard as she would actually have to if she were only nursing. It requires that you pump some milk to fill it, which is a burden, but if it is the short lived remedy it is intended to be, that should be tolerable. The pumping has the added advantage of keeping up your milk supply while she is learning.
This product has been around for many years and has helped many moms in difficult situations. Perhaps it can be your solution too! Best wishes.
D.

I had trouble breastfeeding my first child and was worried that she would not latch on after spending the first week or so bottle feeding. I decided to sing to her the same song each time I fed her (and only then). My doctor was amazed at how well she transitioned from bottle to breast and I think it even helped when we started solid food. She knew when she heard our song, it was time to eat.

brush her cheek to her mouth continuously until your child response to open mouth takes in your nipple instead of bottle

Definitely check out the SNS (supplemental nursing system). I used one with my son and it helped. It's a tubing system that delivers more milk to your nipple as the baby is nursing so she doesn't have to work as hard. They can be a little frustrating to coordinate at first so I would get help with it. Not sure where you live but if you can go see a lactation consultant (many cities have free or low cost breastfeeding support programs through the local hospital, etc. if your insurance doesn't cover it) I would highly recommend that. All the La Leche League advice is right on. I love La Leche League and it is a wonderful support system for nursing moms, especially if you're having challenges, however they can only observe and give advice, not do the hands-on stuff that a lactation consultant is trained and licensed to do, so your best bet is to get the support of both if you can. A lactation consultant can check baby's latch too. Good luck and don't give up! I promise it does get easier and it's so worth the hard work you're putting in right now! (My son is almost 12 months and despite a very rocky start he is still happily breastfeeding.)

I did not have this problem, but I had some other latch problems. I would highly recommend seeing a lactation consultant. It is expensive, but think of it as money saved you would have spent on formula! It can be really helpful to have someone look at your problem first hand. Good luck!

I had the same trouble with my son who stayed in the NICU for 3 days I went in every two hours to nurse, but he still had some confusion. After a month of continuous mastitis, I went to a lactation comsultatnt. He was about 3 months at the time, and I thought it was too late and we'd have to bottle feed. But, she was able to help me get his latch ocrrected, and move to nursing success (well mostly). I was never fully able to get him off a bottle, so he's had mixed breast, formula feedings, but the most he'd take was 2-4 oz a day of formula. It took persistence and not caving to the bottle, and following the lactation consults directions to achieve that. I have an older son, and on the go more, so that's why I did not achieve 100% success, she thought I could if I could just spend the time to focus on it. Her name is Janaki Costello, and she is located in Albany, CA, phone ###-###-####. You can also try the breastfeeding support group at Alta Bates from the website: "Breastfeeding Support Group This group focuses on breastfeeding techniques, benefits, and emotional support. Offered: Tuesdays & Fridays from 12:00 - 1:30. Please call for location and registration information. (510) 204-1334" I found individual help more useful because Janaki was able to take the time to really understand our individual nursing situation. Any lactation consultant will probably suggest just not offering the bottle any longer, and as scary as that is, an infant will not allow themselves to starve. You can work with your pediatrician to keep close track of her weight to be sure she is getting enough nutrition, as well as seeing how many soiled diapers she has in a day. The support groups offered at Alta Bates (both the New parents support group & the breastfeeding) have access to a scale, so you can also keep and eye that way. At 9 days old she should be very easy to retrain to the nipple. I do urge you to seek the advice of a professional, I was sure glad I did! Good luck!

My twin sons were in the NICU for nearly 3 weeks. They drank from bottles and had pacifiers. It was soooo difficult to get them to breast feed! I just kept trying and then would give them bottles of either breast milk or formula. I gave up some days because I was so frustrated. They both nurse now! One twin literally took 6 weeks!!! Good luck!

Call your local La Leche group or the lactation nurse at the hospital where you had the baby. They can help immeasurably!!

I had twins who were in the NICU for 3wks and it took about 5wks for my son to grasp breast feeding and about 7wks for my daughter. Once they got it - I had the patience to wait it out - they were able to go back and forth b/w breast and bottle so my husband could feed middle of the night.
I would just give the advice - don't give up if breastfeeding is something you really want to do!

Gosh, I breast fed my daughter all day and then bottle fed the last feeding of the day, so she would sleep better. We went back and forth all the time. Seems like if she were hungry enough, she'd just suck! The milk almost spurts out, so I'm surprised to think it is a more difficult suck. When is she the hungriest? Or most energetic? Do you try to breast feed each time? I think I would just keep trying and don't give up too easily, if you are.

My daughter was in the NICU for 10 weeks (premie)and we had trouble with the same issue. She knew how to eat from a bottle, but she wasn't making the association with eating and the breast.

Basically, she liked breast milk better than formula, so after bottle feeding her breast milk for a few months (she was 5lbs when she came home), I would only give her formula through the bottle and breast milk from the breast. I also had several visits to a lactation consultant, used a nipple shield to train her to latch, and switched to a platex bottle with a slow flow niple that was the "closest" to a natural latch as possible. Bottle and nipple shield available at Target but the latter should be used as a last resort b/c it can cause blocked ducts.

It took me 3.5 months to make the transition but it has been completely worth it. Don't give up! Rent a hospital grade pump if your milk supply starts to decrease and ask the peditician for recommendations. Lactation consultants through the women's center at John Muir Medical Center are great but expensive ($95/hour) and also rent hospital grade pumps.

She will breastfeed only if she's hungry enough to eat, she just needs to get used to the nipple. Have you squeezed milk into her mouth from the nipple and then make sure she latches on good, she'll need assistance for awhile.

HI E.

Congrats on the new baby, and I am sorry that you are having trouble with the nursing.

I am unsure where you live, but you may want to seek some help either from a lactation consultant, or a PP Doula who specializes in breastfeeding problems.

I would also suggest contacting your local La Leche League leader or the Nursing Mothers counsel as they provide peer breastfeeding counseling support. I would also see if your pediatrition has any breastfeeding training or if they have a Lactation consultant available.

There are many ways to go about helping a baby learn to nurse and to assist them with the transition from the bottle to the breast. One of the first things is to make sure your bottle is really slow flow. There are also many factors that can effect her ability to nurse as well. You can use something called a supplemental nursing system, and learning more about latch as well.

When you are making this change it is important to keep an eye on how much she is peeing and how many bowel movements she is having.

Email me specifically if you want a referal to a Bay Area Lactation consultant.

T. Mclean
Senior Midwifery Student
Birth and Postpartum Doula

I had this same issue with my first born son. He was in the NICU for 3 days and was given a bottle that I had pumped. I was not able to switch him over to the breast, but did continue to pump for several more months. He grew like a weed,has no allergies, and was never sick as a baby. I am sorry if this wasn't much help, but just know that she will be fine no matter what type of food she gets. I have had so many friends get depressed because breastfeeding didn't work out. Don't be discouraged! My next child breastfed like a champion from the moment he was born.

Congratulations!
My son spent his first 10 days in the NICU so I've been through probably a similar experience. He was born 6 weeks premature so actually did not have the skill to nurse at first. But when he finally had the strength to nurse or use a bottle I had a hard time getting him to latch on and stay. We tried a couple tricks and it worked great. First I used a nipple guard. This crazy plastic piece that apparently helps bring the nipple out to the baby and makes sucking easier. That makes it easier but to really interest him the nurses helped use a little tube to fill up the nipple guard with breast milk. We did that for the beginning of feedings for just a couple days and he was hooked. Then I used the nipple guard for probably a couple weeks.

The nipple guard might help for you just to make it easier for your daughter. After you've done that for a couple days or weeks and broken the bottle then you can likely drop the guard. I got one at the hospital but they also sell them at Target etc.

Congratulations on your little girl!

E., the reality is, it is easier to get milk from the bottle than the nibble. Just keep trying, take away the bottle, she'll finally catch on.

Have you tried a nipple shield? My daughter's first few weeks were tough with the nursing and a nipple shield saved me good luck just stick with it a few hours without a bottle and she will try the breast!

Just keep bringing baby to the breast, the more stimulation there is the better (for you, and your supply) have here skin to skin to you and just keep offering it. Also you may want to consult your local la leche leauge! They are very helpful and you can talk to them on the phone, or they meet for meetings once a month. Hope all goes well for you.

My Child was in CDICU for 34 days when he was born he was tube feed and only started to eat when he about three weeks old. I got him to go back to my breast with a nipple guard. You put it over your nipple and it makes it like a bottle and then you slowly wean them off of it. At the beginning you want to massage your breast to get the milk to start flowing so she doesn't have to work as hard at the beginning of learning. I never successfully got to solely breastfeed because I didn't make enough milk but I did pump for a year so he got all the nutrients to start his life out right. Good luck!!

My sister in law had some luck with using a nipple shield to help her son transition from the bottle back to the breast. It took some time and patience, but it worked for her.

Hi E.,

I've been having the same problem with my son. I contacted La Leche League, and below is the advice I received. I just received this advice yesterday, so I can't say yet whether I'll be successful with these tips or not. Good luck!
L.

It is possible to get an infant successfully nursing at the breast, and can be well worth the effort in the long run. Keep in mind that many moms re-lactate and breastfeed their adopted children (and not just newborns, even older infants who have had nothing but bottles for their first months of life).

I'll give you some tips that may help him to get back to the breast:

Put him to the breast when he is not hungry, encourage "comfort nursing".

Give him most of his feeding by bottle, then try to switch him to the breast. Click here to learn more about the “finish at the breast” method: http://www.lowmilksupply.org/finishatthebreast.shtml

If he is used to the bottle, and completely refusing the breast, he may be willing to take the breast with a nipple shield.

Pump a little before putting him to the breast to get the milk flowing so that he gets an "immediate reward".

You can eliminate supplemental bottles so that he gets all of his sucking at the breast. You can get milk into him by cup or syringe if he still needs supplemental milk.

Another way to eliminate bottles is to supplement at the breast. This has been helpful to some moms and babies transitioning from bottle to breast. For this you will need a supplemental nursing system. Your local La Leche League leader could help you to get one. For more information on this go to: http://www.lowmilksupply.org/abs.shtml

Increase skin on skin contact:

Many mothers have found skin-to-skin is the absolute best tool we have for increasing milk supply and getting babies to nurse really well. Spending as much time as you possibly can with you undressed from the waist up and Marco undressed except for a diaper, just letting him sleep in your arms against your skin until he wakes and wants to nurse, will help so much. It organizes baby's suck and it stimulates your milk supply. Skin-to-skin contact also keeps Marco warm and secure and helps him use all his energy to grow.

The two of you can cover up with a blanket when you’re resting together. When you’re up and around, you could carry him inside your shirt/jacket (a button up works best) when he is wearing nothing but a diaper. Babies love to be held so I'm sure he would be thrilled! If you have a sling or soft baby carrier you can carry him in that under your shirt/jacket.

Warm baths have been known to help too. There's something not only relaxing about a nice warm bath, but it also help the milk flow. If you bathe with him that is even better. The warm water helps baby relax and nurse better while it helps you relax and your milk to flow better. For safety only do this when someone is available to help you in and out of the tub.

With enough skin on skin time he may latch on by himself. After spending an hour or two in skin-to-skin contact, many babies wake up, and start to show signs of readiness to breastfeed. Baby turns his head from side-to-side (rooting) and makes scooping motions with his hands. When a baby does this, he is starting to look for the breast. He will start to scootch downward, toward one of your breasts. Just let him scoot himself down toward the breast, and find it himself. The mother needs to be patient and not rush the process. Sometimes it takes several sessions of skin-to-skin contact before the baby actually finds the nipple and latches on.

If you do give pumped milk or formula with a bottle, offer it to him in only his diaper, holding him against your bare chest, turned in close to “simulate” breastfeeding. You want him to associate this feeling with feeding.

Try breast compression:

Another tool that mothers have found very helpful for baby frustrated while nursing is breast compression. To do breast compression, put Marco to your breast and let him latch on and nurse. You'll see the little fluttery sucks at first while he is waiting for the milk to let down, then his sucking will change to slooooow sucks and you'll be able to hear him swallowing. That's how you know your milk is flowing (also called “letting down”).

When the milk stops flowing quickly, he will go back to the quick, fluttery sucks. Then you grasp your breast, with your hand well back away from the nipple, and squeeeeeeze and hold. You'll see that he goes back to the sloooow sucks again, as your milk begins flowing quickly and he drinks your milk. Keep holding the squeeze until he goes back to flutter-sucks, then release the squeeze for a few moments, and repeat. You can continue breast compression, followed by releasing the compression, for the whole nursing session. Doing breast compression can really help your baby get a lot more milk in a short time.

Here are links to our FAQ on relactation as well as a link to articles on adoptive breastfeeding (many relactating moms find that information helpful as well).

http://www.llli.org/FAQ/relactation.html

http://www.llli.org/NB/NBadoptive.html

La Leche League's manual THE WOMANLY ART OF BREASTFEEDING has lots of good information on breastfeeding your baby. You can buy it through our Online Store at: http://store.llli.org You may also find it in bookstores or libraries in your area. It has been through six revisions and contains all the latest research-based information available about breastfeeding.

Perhaps it would be helpful for you to call a Leader in your area or attend a La Leche League meeting. The support and information of other nursing mothers may prove helpful to you. Check out the section of our Web site entitled "La Leche League Groups Around the World" at http://www.llli.org/WebIndex.html

Hmmm... Once you know that her latch is really correct and not interfering.....The best enticement is the milk. Try pumping off the first of your milk and make sure the "back" milk(more nutrients and substance) is the bottled milk you give her (you'll have to get ahead of her feedings to do this). The "fore" milk is sweeter usually... so next feeding, offer your breast first for a bit of the sweetness. That may help encourage her. The other is to try putting water in the bottle and see if she prefers the milk from the breast! Keep trying, it's worth it. Nursing is truly a wonderful thing for both of you. Best of luck.

Good for you for being so persistant!! My advice would be that if this continues for several more days w/o any inmprovement, see a IBCLC (International Board Certified Lactation Consultant). She will be able to further advise you on getting the optimal latch as well as tips for encouraging your daughter to breastfeed. Usually the cost is about $25/hr. I found mine very helpful w/ the latch issues we experienced. If you continue to try w/o any improvement for too long, it may be too late. But your daughter is still young enough to be "retrained" to nurse, so to speak. Best wishes!!
If you'd like a referral to an LC, I have a few, email me :)
A.

Hi E.-
My son Oliver was born 6 weeks early and was in the NICU for ten days. He is now almost five, and is strong and healthy. I, too, experienced nipple confusion with Oliver. I camped out at the hospital, and was there for most, but not all feedings. I would try to nurse him, and then they would bottle feed him. Once I took him home, I tried the same routine- trying to nurse, and then bottle feeding. It took him 2 whole months to catch on (which seemed like an eternity)! During that time, I pumped so that I could keep up milk supply. Once he latched on, he was a champ. I breast fed him until he was 2 1/2 because he was so hard to wean! Hope this info helps- and hang in there!

My son had to stay in the hospital for five days as well, and our nurses were awesome. They taught me a method that I haven't heard many hospitals teach. I delivered early and so it took a bit for my milk to come in. I had to pump with each feeding, just to get my milk in. I would give my son formula or the breast milk. The hospital gave me some plastic syringes with a fine tip, and I finger fed him for every feeding. I used my pinky finger, and let him suck on that and then slid in the syringe and the sucking would continue and he would actually suck the breast milk right out of the syringe. We did that, but we also would transition him to the breast every other feeding to see if he would take it. Eventually we weaned him from the finger feeding, and he adjusted to the nipple within a week. Hope this helps some!
-M.

I had the same issue with my first born. I went to see a lactation consultant. she gave me a thing called an SNS. It is really for helping you produce more milk. you put breast milk or formula into a bottle that hangs around your neck then attach tiny plastic tubes with tape to your nipples, so when your daughter sucks she will be stimulating your nipples and getting alittle more milk at the same time. I used this method for about 2 weeks, then was able to drop the SNS and I was producing enough milk to satisfy my baby.

Just offer the breast and nothing else. She will get angry and eventually very hungry but hopefully will make the transition. You have to do it soon or she may never take the breast.

Hi my son was in the NICU for 9 days and also drank from bottles during his stay, and it took increased time for my milk to come in because of it all. but I am proud to say that he is exclusively breastfed except for some baby food now and will not take a bottle anymore- he prefers the breast. I would suggest to keep offering the breast as much and often as she will take it, I have heard of breast shields working pretty well too because they are similar to bottle nipples and may be the transition peice your baby needs. Talk to the lactation consultant at your local hospital, they have so much information and can get you nipple shields
don't give up, she is so young and breast feeding is hard to learn for all newborns and mamas, and your little one has a bigger challenge to overcome but you both can do it
take care

Hi E.,
Congratulations on your new baby. Get in touch with a good lactation consultant right away. She'll be able to work directly with you and your daughter on positioning and latch on. Having someone assist you hands on and be able to see in person how things are going will be more helpful than getting written advice. If your insurance doesn't cover it try calling your local WIC office. Our local WIC center has a lactation specialist who sees anyone free of charge even if they aren't on WIC. Good luck, best wishes with the breastfeeding it really is a wonderful part of motherhood. - K.

It takes a lot of energy to suck, and is not laziness. It is simply easier for her to obtain food and return to sleep with a bottle, which is how she grows and matures. Just keep offering your breast, with milk squeezed out onto the nipple, rub her lips with the nipple, and be persistently patient with her. I went through this with my babies, and they do eventually get that your nipple is the food source. Good luck, and know that others have gotten through your situation as well!

Hi there.
I strongly recommend that you see a lactation consultant (which dramatically improved my breastfeeding problems!). Don't try to do this only on advise from people, go to the experts before it is too late! I suggest Janaki Costello at:

____@____.com

and ###-###-####

She's great and I often hear that she's the best around.

GOOD LUCK!!!

N.

I had a similar situation 2 years ago. I got so sick of pumping, refridgerating, warming up etc. that I just stopped offering the bottle all together. She fussed and fought it for a few feedings, but eventually she latched on. My Dr. said I did the right thing, that babies won't let themselves starve and they just figure it out. Don't feel guilty, when she's hungry enough she'll eat and you'll be glad you did it when she's holding on to you and looking in your eyes. It's too special to miss out on. I'm doing it again with my 11 week old son and I practically cry when I watch him nurse! (I'm kind of a wuss) Good Luck!

Go to the lactation center at your hospital. They have a device that can drip formula in his mouth while you nurse to get him to suckle so you can have let down. Start with that and then wean him off the formula device.
Tell them - that is what they are there for.

I had a similar problem with my daughter and agree with everyone who suggested you see a lactation consultant. I worked with one and it was totally worth it. I do recommend that you go as soon as possible. If you wait, it gets more difficult as your baby will "get set in her ways." I, also, am able to give you lactation consultant recommendations if you need.

You just have to quite giving her the bottle and start just giving her the nipple at first she may not want it but if she gets hungery then she will. just don't give her a bottle..

hi E.,

have you tried putting a few drops of breast milk on your nipple when you are latching your baby? sometimes just the taste will get them to start sucking...

or you can try pumping for a few minutes so that your milk is flowing and then put the baby on....

the nipple shield may really help too. do you know where to get one? i know they have them at Maternal Connections at El Camino Hospital in Mt. View and they can show you how to use it too. they also have great lactation consultants there too if you need advice or someone to watch or help with breast feeding.

good luck to you. keep on trying cuz it's really worth it for you and your baby.

G.