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The LC has answered your question below.
=========== QUESTION ===========
I'm asking this question on behalf of my colleague,Sha.
Sha is now breastfeeding a special baby(her baby was born with tongue-tie). Her baby having difficulties to latch on due to his tongue tie and Sha had a severe inverted nipple on her left breast(which cause her baby much more difficult to latch on her left breast and lately refuse to latch on her left breast.
The question goes here, can she maintain her breastmilk production by only doing breastpumping on her left breast? What is the best way of breastpumping if she had to do so?
Is there any other advise for her on her tongue tie baby and inverted nipple problem?
Appreciate your reply soon as she really need help.
Thank you
=========== ANSWER ===========
Dear Zuraifah,
Thank you for writing for your colleague, Sha. Since the baby is now refusing the left breast, can you please ask her to pump the breast every 2-3 hours, even at night to keep up a good supply? She can keep a good supply on the left breast, but it is important to be dedicated to pumping. Is the baby's tongue tie going to be clipped soon? This will probably help with the latch difficulties.
It may be very helpful for Sha to use a nipple shield on the left nipple. This is a thin, pliable, silicone shield that is used when the baby is having latch difficulties. I am sending you some general information on latch for her:
Keep or increase your milk supply. You should be feeding or pumping at least 8 times a day (10-12 times a day for multiples). We recommend pumping with a Lactina, Symphony, or Classic pump and a double pump kit AFTER feeding or attempted feeding. For Medela rental and retail stations, please call 1-800-TELL-YOU anytime or click on Where to Buy/Rent on the Medela website.
Use lots of skin-to-skin contact with your baby. Try putting the baby in soft baby carrier or next to your bare breasts, so that he/she gets used to the feel of your bare skin. This also gives your baby ready access to the breast, and the baby may latch on just because it is right there. Taking baths together is also helpful, as is using skin-to-skin contact while rocking or walking. Don't force the baby onto the breast, but rather make the breast seem like a nice place to be.
Don't "starve" the baby into taking the breast. A very hungry baby may scream and be frantic, and this doesn't help with latch. A baby who is not being fed will be weak and lethargic and may not have the energy to learn something new or to eat well.
Try using an eyedropper to drip milk down on to the nipple while latching the baby on. This will help to give the baby the idea of where milk is supposed to come from. It is also sometimes helpful to pump or express some milk just until the milk lets down, (starts to flow) and then try to latch the baby on, since the baby will immediately get milk.
Try using different positions with the baby: the cross cradle hold, cradle hold, football (clutch) hold or nursing while lying down.
Switch to something other than a bottle for giving the baby feedings. Babies can get really used to bottles, and this is the most common reason for breast refusal. You can use an eyedropper, a medicine syringe, a spoon, or a cup. Small medicine cups, paper bathroom cups, shot glasses (glasses that adults drink small amounts of liquor from) or a slow-flow sipper cup work well. You can also finger feed the baby. In finger feeding, tubing from a Lactation Aid (see www.drjacknewman.com) or Supplemental Nutrition System (SNS—see info on these below) is used to feed the baby. The tubing is taped to a parent's finger, and then babies suck on the finger to get the milk they need. Eliminating bottles temporarily can be an important step in getting the baby to the breast.
Stop using a pacifier (dummy, soother), if you are using one for your baby. You want to encourage all sucking to be at the breast.
Some mothers are successful in getting their babies to breastfeed using a nipple shield, a thin, pliable, silicone shield on the breast while breastfeeding. Sometimes, a Supplemental Nutrition System (SNS) or a Starter SNS is used with or without the shield to keep the baby at the breast. These products are available from Lactation Consultants who are also Medela retail and rental stations.
Good times to try breastfeeding are when the baby is sleepy, either just going to sleep or just waking up from a nap. Nighttime feedings are also a great time for this, as the baby may be too sleepy to realize that he or she is trying something new. Try many times day and night, and keep trying to latch the baby every day.
Try not to be stressed! One mother I personally helped explained that when she acted like she didn't care whether the baby latched on, the baby would latch. When the mother was stressed and tried to push the baby onto the breast, frantically trying over and over again to get the baby to latch, he wouldn't. I find this true for many mothers and babies.
Go to www.drjacknewman.com. Dr. Newman has outstanding articles there on latching and breast refusal. For babies who will latch on, but then tune out or go to sleep when the flow slows down, try using breast compression to keep them going. You can read about this at Dr. Newman's pages also.
Limit visitors and phone calls while you are working on getting your baby to breastfeed. Try to surround yourself with people who support your efforts.
For the next 24 hours or more, take the baby to bed with you, getting up only to eat and go to the bathroom. This suggestion has worked for many mothers and babies with latch on problems. I realize that this is more difficult to do when you have older children (I have six children myself, so I can definitely understand), but try to get help to watch the older ones. For information on safely sleeping with your baby, please see: http://www.askdrsears.com/html/7/T070100.asp.
I hope that these tips help your baby to latch and feed well at the breast.
Quick Tips for Problem Solving:
1. Find a professional and experienced lactation consultant (IBCLC) who can help you and your baby with your concerns, and who can answer questions and evaluate your situation thoroughly. To find an IBCLC, scan the listings for IBCLCs at 1-800-TELL-YOU, Medela's Breastfeeding National Network, go to www.ilca.org, or ask for an IBCLC at your local hospital maternity floor. It is best to SEE an IBCLC and not just talk to one on the phone.
2. Contact La Leche League, an organization which offers mother-to-mother breastfeeding help. You can find a local LLL Leader, an experienced breastfeeding mother, at www.lalecheleague.org. Attend a La Leche League meeting (a friendly place--come and have tea and talk to other breastfeeding moms--everyone brings their babies!) to get some hands-on help from a friendly experienced breastfeeding mom - one who knows how to find local resources to help you. The Womanly Art of Breastfeeding is a great book to read both before and after your baby is born.
3. Keep in touch with your doctor and midwife as you work through these problems.
4. Your local Health Department or WIC agency may have breastfeeding experts who can help you.
5. You can find Medela products by calling 1-800 TELL-YOU anytime, by clicking on Where to Buy/Rent at www.medelabreastfeedingus.com, or by calling Medela Customer Service at 1-800-435-8316 during business hours, Central Time, USA.
I hope that this is helpful to her. Please write again if you have more questions.
Sincerely,
Mary Bibb, BA, IBCLC
Mail to: askthelc2@medela.com
International Board Certified Lactation Consultant
Independent Consultant, Medela, Inc. |
