Goodbye, My Silicone Friends!

Me feeding Rosa at 8 months with no nipple shields – hurrah!

It’s not what you’re thinking. Although this post is boob-related. After 8 months, we have finally stopped needing to use nipple shields to breastfeed.  I never thought that this would happen, so I’m over the moon!

When Rosa was born, she couldn’t latch on properly. There was a lot of licking and rooting going on, but she just could not latch on to my rather flat nipples.  Added to this, she was ill and in SCBU and had a naso-gastric tube fitted for a while so it was always going to be a bit more difficult for her to breastfeed well.  A nurse in SCBU suggested we try nipple shields so we bought some Boots own-brand ones and although it still took up to about 20 attempts each time, we managed to achieve a workable latch.  Then after leaving SCBU we got some new Medela nipple shields and never looked back. I could get Rosa to latch on first time every time and I was thrilled.

If you look through breastfeeding information, virtually everything you read about nipple shields is negative.  They can affect milk supply, stop babies receiving as many antibodies in breast milk and make feeding last a lot longer.  However, the research quoted in these articles mainly focuses on the old-style nipple shields which were a lot thicker and often made of rubber.  The Medela Contact shields that I used (tee hee, past tense!) are thin silicone with a cut-out area at the top. This is so that the baby’s skin can make contact with your skin, as it’s not just removing milk from the breast that stimulates supply, but the skin to skin contact involved too.  Silicone shields affect the milk transfer rate much less than the old rubber ones.

I will always be immensely grateful that the lovely nurse, Sonia, suggested nipple shields. If it had not been for her, and them, Rosa would never have been a mainly breastfed baby. It was very hard work getting Rosa to breastfeed, in fact the hardest thing I’ve ever done, but so worth it.

From my experience, I would say the following about nipple shields:

  • Do seek out breastfeeding support as soon as you experience problems. Expert peer supporters from La Leche League, the NCT or the Association of Breastfeeding Mothers might be able to sort out your attachment and positioning issues very quickly and you may not need to use nipple shields.
  • Nipple shields are not evil and can save the breastfeeding relationship, as in our case.
  • They should only be used as a short-term measure if possible, as they can make it more difficult for the baby to get the hang of latching on to a bare nipple. But with the new silicone type it’s so not the end of the world.
  • They did not affect my milk supply, but then for the first few weeks and months I did express a lot.
  • Feeding Rosa with nipple shields took a long time.  For several months it took me an hour to feed her.  This is because the milk transfer rate is lower as babies feed from nipple shields using just suction rather than suction and tongue action, which is how normal breastfeeding occurs.  Feeding her without the shields is a revelation.  Often less than 10 mins each side.
  • Breastfeeding in public with nipple shields is a faff and makes it harder to feed discreetly.  Use a pashmina or breastfeeding shield if this bothers you.
  • If you do end up using nipple shields, keep trying to feed without them every few days or weeks.  I would often manage one or two feeds without them but it would become too painful after a few goes.  In that eventuality, whip the shields back on, let your nipples heal again and forget about trying without for a little while.  It could be that a few weeks or as in our case, months later, your baby’s mouth may have grown enough to overcome any issues.
  • They don’t need to be sterilised after every use, as breast milk is naturally anti-bacterial. I would wash them with hot soapy water between feeds and then sterilise them each night.
  • Buy 2 pairs, so that you always have spares, because you will lose them temporarily!
  • On a stranger note, be aware that for some reason kids LOVE nipple shields and the bright yellow case that came with the Medela ones. Whenever toddlers or older kids were around, they pretty much always picked up my freshly washed nipple shields to have a closer look.

Slow Weight Gain And The Evil Red Book

My baby is a skinny minny. She was 8lb 7oz at birth but has only gained weight slowly.  She’s now nearly 13lb at just coming up to 5 months old. She has never, ever lost any weight. She is and always has been incredibly alert and active and developmentally she is either bang on or ahead of her milestones.  She is also a very cheerful little soul.  I say this because I am 100% certain there is nothing wrong with my baby.

Every Mum in the UK is given a red book when she has a baby. This is your child’s personal health record. It contains various forms for medical professionals to fill in, so it has details of our daughter’s six-week check, batch details of vaccines she has been given etc. It also contains growth charts. These chart your baby’s weight against age. It has centile lines marked, one of which your baby is supposed to follow. The red book has become the bane of my existence!

My baby is not following a centile line (sorry, I don’t think she’s read your policy) and as a result, I have felt really under pressure.  I am quite certain that the reason the small one is not piling weight on is that she is rubbish at breastfeeding. As a result, at the health visitor’s suggestion, we give her one formula feed per day.  I want to mainly (if we can’t manage exclusively) breastfeed her until she is at least 6 months old, especially as she had an infection just after birth and spent 3 weeks in the Special Care Baby Unit. She needs the antibodies in breast milk more than most. I won’t be bullied into giving her more formula and less breast milk just because she isn’t following a centile line.  If there were any other indication that she were in anything other than rude health, I would do so.

The poor breastfeeding (more about this in another post – trust me, I have sought out every bit of help available) and slow weight gain have caused me so many tears.  There’s something really primal about feeling like you’re feeding your baby adequately.  I dread attending the Well Baby Clinic for weigh-ins.  Not least because our health visitor wanted us to come weekly and kept calling me at home to “remind” me.  Not that I ever didn’t turn up when I said I would. She once came to our house to weigh my daughter 3 times in a week, with 2 of these visits being just 24 hours apart. I have no idea how a baby is supposed to gain a significant amount of weight to that timescale. I ended up giving the baby a massive bottle of expressed milk just before she arrived to get the health visitor off my back!

The interesting thing is that the red book states that babies should not be weighed more often than once a month. Illness, teething and various other things can cause a baby to gain weight slowly or remain static for a week or two and this is normal.  That’s been the case with my little one.  Because she’s rubbish at breastfeeding, any change in routine or even a snuffle can stop her gaining weight for a week or two.  She always piles it on in the next few weeks then and averages out ok over a month.

It has taken me some months to stop worrying almost obsessively about my baby’s weight and be able to relax enough to really enjoy being her Mum. I think that as a Mum you know if your baby is unwell or if something is amiss.  If your baby is alert, developmentally spot on and generally happy with him or herself, then weight should be seen as part of the picture and not all of it. Surely that’s just common sense.

PS Happily, our GP and Paediatrician also see things my way and that’s made me feel a lot more confident about my daughter’s weight being ok.