Friday, December 23, 2011

In praise of (and with deep loathing for) nipple shields

I have never in all my life been so conflicted over a product as I am with nipple shields, or as Pete calls them, "boob sombreros."

They're flexible silicon nipple covers meant to help baby latch during breast feeding if the nipple is flat or inverted. They also protect damaged nipples allowing them to heal. Or in my case, they provide a better latch for a struggling baby and a mom with otherwise normal nipples. I don't know what people did before this product existed. Without it, I'm sure I would have given up breastfeeding almost immediately for Walt's sake - he would have lost even more weight and that would have been really awful. I am deeply grateful for the existence of this product.

I loathe nipple shields. I hate them so violently it's a little shocking. No matter how much they've done for me, they're one of the most frustrating products I've ever used. If Walt so much as grazes the shield, it falls off. Unlike the breast, which responds immediately to baby's sucking with milk, the nipple shield has to adhere to the nipple first and milk has to make it to the tip before baby can taste it. This means when Walt is at his hungriest, he interprets my attempts to feed him as a cruel, food-less joke. Hand expressing into the nipple shield is an exercise in irritation. They also appear to be messier than feeding directly at the breast. Somewhere between 10 and 25% of the milk Walt sucks dribbles out the bottom of the damn shield. My shirt is damp, Walt is damp, the towel over the nursing pillow is soaked most of the time...

Once we started supplementing each feeding with an ounce of formula, following our pediatrician's advice, Walt became a lot calmer. For a couple of days, anyway, this seemed like a godsend. But over the last couple of days, reaching a fever pitch last night, Walt has become increasingly intolerant of the breast, and increasingly greedy at the bottle. I don't blame him - bottles are way less work. I love my son more than anything, and if it came to it, I would swallow my distaste for it and pump breast milk to bottle feed him if that was the only way he could get it. But I hate that idea even more than I hate nipple shields. Pumping is exactly as glamorous as it looks, and about half as fun.

Last night was just the worst of the worst. He slept really well the night before last, so I had been up since 10 am with no nap around dinner time. Last night he slept hardly at all. He wanted to feed every hour, but screamed like I was hurting him every time I lined him up with the nipple shield. At most, he'd nurse poorly for about 10 minutes, pulling off all the time to register his displeasure with the process. But right around the 10 minute mark at the first breast, he'd fall asleep, like he was passed out cold. 10 to 30 minutes later, he'd wake up and we'd go through the same process at the second breast, only he'd finish by screaming instead of sleeping. He was burping poorly too, so I can imagine there was some discomfort playing into it as well.

The scoop in the formula makes 2 oz of liquid, so we've been making up a 2 oz bottle, feeding him half and refrigerating the rest for his next feeding. Each time I gave him the bottle, he'd scream bloody murder when I tried to remove it at the 1 oz mark. And then he'd cry and cry and cry like he was still starving. This went on from about midnight through 6 am. At 4 am, I just let him drink the whole bottle and he was calm for 10 or 20 minutes, but between diaper changes and gas pains and whatever else, he was back to crying again. I was finally so exhausted and so sick of struggling with the nipple shield, around 5 am I pulled it off and shouted something along the lines of "I hate these stupid things!!" and hurled it at the wall. "That's IT!" I vowed. "No more nipple shields! EVER!" And by god, Walt breast fed without one, possibly out of fear. But more probably because he was really hungry and nursing without one isn't impossible, just difficult. After Pete got up to go to work, Walt and I retired to the bedroom and both slept from about 7 until maybe 11. Maybe just 10:30. And when we got up to nurse again, will wonders never cease, Walt ate well without a nipple shield throughout the whole feeding.

Walt has nursed better directly at the breast today, and we're still not fully done with the shields, but there's a light at the end of the tunnel. He's also appreciably bigger today than he was yesterday, so maybe some of last night's trouble were growing pains. The thing I (and probably most people) find most difficult about being a parent is deciding if I'm doing the right thing for my child. Walt isn't gaining weight fast enough, but overfeeding him can't be good. But if he's actively growing and needs more food, how will I know if it's overfeeding? And how much is it worth it to struggle at the breast if he's decided he really won't eat? Should I just give him a bottle and hope it calms him down? Should I let him cry and insist that he nurse at the breast? Should I let him cry and pump so that we both (eventually) get our way? Is modern formula good enough for it not to matter if he wants to insist on a formula-only feeding once in a while? How much should I let Walt determine his own eating patterns? There are lots of opinions on these questions out there - some of them are evidence based and some of them are just personal preference. It's hard to know who to turn to, what's over protective and what's just common sense. It's a little discombobulating to realize that "common sense" is actually hard to identify when it comes to your own kid.

1 comment:

  1. Oh Syd. What a tough gig it is to be a nursing mother. Especially if your little one is how shall I say.....particular. You are experiencing a slight window of Walt's personality. I know it seems nuts but it's true. His eating habits are him. I struggled with Adelynn for months. Some days it was great, we were the picture of Mother and babe in the magazines perfect. Other days I wanted to pull out my hair because I just could not figure out why my super angry hungry baby just would.not.nurse.dammit. She'd throw these tantrums of insanity for what became hours starving herself silly putting us thru an emotional vortex that seemed hopeless. I can't count the number of days I burst into tears because I felt inadequate and incapable to satisfy her basic natural need. And to think me a mother for 11 years and I thought I knew a thing or two! She showed me the importance of patience and tossing worry aside. When I stopped obsessing with getting her to eat and stressing when she went crazy things got better. Not perfect but better. At least I felt better.

    When it does not work I've been there too. I had to give up nursing with Olivia at 6 months. She refused me more often than not and I just could not keep pumping to maintain her needs. Loathed the pumping. If you are not happy it's not worth suffering and torturing yourself. I felt like a failure but accepted that Olivia was a different person and she just did not like nursing at all, a bottle was easier as she was a big eater. She began eating table food at that point and was off formula a few months later anyhow. This is the baby who ate hot salsa on tacos at 8 months old. Today she is a smart, strong, healthy athlete that hopes to be the next top soccer star.

    About weight gain. As a parent of 3 very slight girls who ate (still do) like linebackers I suggest not worrying so much about the weight. Babies go through such ups and downs with growth it can make you bonkers trying to make them fit into what the average gain should be numbers. Leah NEVER gained but nursed (she was such an easy one compared to the younger 2) all the freaking time. I think she was taking about 6 ounces every feeding! She had an impossible to satisfy metabolism. Plus all my girls just moved so much. The were always and still are so darn busy. Those small movements wiggles and such are calorie burners. Adelynn eats like a 3 year old and is in the 20% in weight. I just can't get enough food in her to even get her to gain the pounds those STUPID charts say she should weigh. But looking at Leah, 11 years old nearly 5' tall she weighs 72#, my kids are just on the slight side of those charts. Genetics of body size and shape really can throw those damn charts out the window for accuracy. So long as Walt is eating and looks healthy then it's all good. If he isn't thriving then you'd assume he is not getting enough to eat.

    Don't beat yourself up. This is like the pot calling the kettle black! Ha! I too suffer from this and must remind myself to not be so hard on myself.

    PS: Feed the People: Consider to start him on food around 4 months to 4 1/2 months old. I know, I know, all the books say wait until 6-8 months. But the thing is that is because it assumes you formula feed your baby. Breastfed babies are slimmer than formula fed babies. Breastmilk is metabolized faster than formula which means we have to nurse our babies at least every 2 hours. Adelynn every 1 1/2 hours! Unless they sleep that is! I began feeding Addie rice cereal (once a day) with breast milk very soupy in texture and boy howdy did that make a difference in her attitude. She loved the extra food and actually became a better nurser. Still under weight at 15 months I have to nurse her several times a day in addition to 3 meals, snacks and 12 ounces of whole milk.