The challenge: When Marcy Walsh realized her daughter wasn’t able to latch on after birth, the Los Angeles mother visited a lactation consultant. The consultant immediately grabbed Walsh’s nipples and announced, “No wonder she isn’t latching on! Your nipples are too short!” The consultant advised Walsh to wear nipple shields (silicone “nipples” that are worn over the actual nipple) when nursing until her baby learned how to latch on.
“My kid loved the silicone so much that it took her 17 weeks to latch onto my actual nipple,” says Walsh, who pumped for 10 minutes after every feeding to increase her milk supply. “Then one day, I said, ‘If you don’t latch on, I’m going to try formula,’ and bang—she latched on.”
What the expert says: While Walsh’s use of nipple shields helped her baby nurse successfully, many babies are able to nurse from flat or inverted nipples without shields. Nipple shields can reduce milk flow, as Walsh found, but pumping makes up for the shortfall. And when a baby weans off a nipple shield to the actual nipple, he usually is able to drain milk from the breast more efficiently, which in turn likely increases the mother’s milk supply.
As for the fear that a baby will come to favor the stand-in nipple, there’s nothing to that. “Parents often ask, ‘Will my baby become a nipple-shield junkie?’” Petok says. But she says that in 20 years as a lactation consultant, she has yet to see a baby fail to wean off nipple shields to the breast.
BORN TOO SOON
The challenge: Born five weeks premature, Becca Williams’ daughter had difficulty nursing because of her early birth. “I would try to nurse her and she wouldn’t wake up,” Williams says. “I was sore and engorged.” She pumped to relieve the engorgement and applied hot washcloths for the discomfort.
Five weeks later, when Williams’ original due date arrived, her daughter was mature enough to nurse—and to stay awake long enough to do so. But the baby wasn’t latching on properly, and at her seven-week checkup, the pediatrician determined that she had a tight frenulum, a thin membrane that extends from the floor of the mouth to the underside of the tongue. To correct the problem, he recommended a simple procedure in which the frenulum is clipped by a specialist, after which the baby latched on like a champ. “Once she latched on, she liked nursing so much that she wouldn’t quit,” Williams says.
What the expert says: This baby’s problem was twofold: premature birth and a tight frenulum. Prematurity can make nursing difficult because of a lack of physical development, but this problem usually corrects itself once a baby hits her due date, as it did for Williams’ baby. As for the tight frenulum, once a pediatrician or lactation consultant determines the problem, it’s easily corrected with a simple (though not always necessary) procedure.
Engorgement and soreness can be a consequence of nursing a baby who is unable to nurse properly, and Williams managed her situation well. The best treatment is to apply heat (warm washcloths, a hot shower or a heating pad will work), then massage the breast while nursing, and follow that with pumping, if necessary, to empty the breast. “If the breast is not drained well, it can cause a backup of milk, which can in turn lead to a breast infection,” Petok says. Symptoms are fever, pain and redness in the breast, chills and flu-like aches. If any of these occur, call your doctor immediately.