# Nipple confusion--how to deal with it?



## tomatofruit (Mar 27, 2009)

DD is 3 1/2 weeks old, and as far as I can tell, she's having some nipple confusion. We had latch problems in the first couple of days that resulted in horrible cracked, bloody nipples that just wouldn't heal--every time she nursed, she'd tear the scabs right off. Finally, about 5 days ago, I just couldn't take the pain anymore and I decided to pump and bottle-feed until they started healing up a bit.

It seemed to be going okay--I pumped during the day and nursed at night so I could at least get a little sleep, and yesterday I finally felt like I could go back to nursing full-time. But now it seems like DD has gotten lazy from all that bottle-feeding. She'll latch on okay, but once she's on she doesn't really do much. She'll usually give a couple good sucks, but mostly she just gnaws on the tip or does these tiny shallow sucks that are so light they tickle. Now she's constantly hungry because she's not getting enough milk, and I'm at my wits' end. I keep on giving her the breast, but she just won't nurse properly, and I end up giving her a bottle when she gets hungry enough to start screaming. Which is probably making things worse, but I just don't know what else to do!

I've looked up nipple confusion online, and I can't really find any advice beyond "keep trying." Is that really all I can do? Just keep offering her the breast and hope she starts sucking again? Has anyone else dealt with this? How did you get back on track, and how long did it take?


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## tinyblackdot (Aug 31, 2007)

Maybe a nipple shield?

I know not many mamas here advocate them, but if its between that a giving a bottle, i would choose teh shield. Maybe if you try using it she will be more apt to suck, and then once she gets used to her having to work for her bm then you could switch back and try not using it....or even get her started with it, and then slip it off.


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## Friday13th (Jun 13, 2006)

I would stop the bottles altogether, they're just making the problem worse. Get a syringe, like the kind that come with baby Tylenol, fill it with pumped milk and squirt a little at a time into the corner of her mouth once she's on the breast. You just want to keep her sucking and occupied until your milk lets down so she doesn't get so frustrated she stops nursing. Once she's gotten a few good let downs at the breast and no bottles, she'll be more likely to stay on the breast long enough to get full.

Also, relax, it'll help your milk let down faster and maybe have a big glass of water right before you sit down to nurse her, I always found that helped.

Good luck!


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## nataliekat (Dec 3, 2002)

Stop giving her bottles, find an alternate way to feed her.

Spend as much time as you can skin to skin with her, you naked from the waist up, her in just a diaper. Just hang out that way as much as you can. That seems to reawaken the instinct to nurse.

When milk starts to flow, do breast compressions to keep her sucking and swallowing.

Here's Dr. Jack Newman's info on breast compressions:

http://www.drjacknewman.com/help/Breast-compression.asp

Here's his info on finger and cup feeding:

http://www.drjacknewman.com/help/Fin...%20Feeding.asp

Cup feeding might be a good way to go when she's done trying at the breast and just needs to eat. It's simple and uses equipment you already have (a small cup).

PAY ATTENTION TO LATCH SO YOU DON'T GET SORE AGAIN!

http://www.drjacknewman.com/help/When%20Latching.asp


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## Llyra (Jan 16, 2005)

I've fought nipple confusion twice. Once, I succeeded-- with DS. Once, I failed-- with DD1. I failed with her, because I was reluctant to completely give up the bottle. Just throw it away. With DS that's what I did, and it worked. I had a good LC and she told me that a very young baby has a very strong urge to suck. If all artificial sucking is discontinued, baby will be back on the breast within a few days. The idea is to keep baby hydrated and keep supply up, while allowing baby only to suck at the breast.

Here's what I'd do:

1. Stop giving bottles. Don't allow pacifiers, either, or finger sucking, or anything that allows baby to suck on anything but the breast. Get them out of the house completely, so there's no temptation to give in in the middle of the night when you and baby are frustrated.

2. Attemept to nurse often. Like every 15 minutes often. Get somebody else to handle absolutely everything else. Take baby to bed, and just nurse all the time. If baby refuses to latch, stop when baby is frustrated or you are. Then try again a short time later. Stay topless; keep baby in only a diaper if baby will tolerate it, or swaddled in a blanket but unclothed otherwise, if baby gets fussy when naked. Try nursing in odd positions-- in a warm bathtub, walking around, laying down, reclining, standing, etc. Try getting baby to sleep, then try to tempt baby to nurse while sleeping or drowsy. Try nursing outdoors. Give baby lots of chances to be successful.

3. Try putting a few drops of pumped milk on the nipple before attempting to latch baby, or pump long enough to elicit letdown and then quickly remove the pump and put baby on the breast. That will give baby instant gratification for the effort of suckling. A supplemental nurser can do the same, if you have access to one.

4. Until baby is latching well, pump frequently and store the pumped milk. Use it for #3, or for #5, or save it. This helps you to maintain supply.

5. If baby is persistently refusing the breast, offer pumped milk every two hours or so-- BY A METHOD THAT DOES NOT ALLOW BABY TO LATCH AND SUCK. I recommend either a tiny medicine cup, like what comes with children's cough medicine, or with a medicine dropper like what comes with baby tylenol. Whatever you choose, wash it well between feedings. This allows baby to stay hydrated and continue gaining weight, while the issue is resolved. Always try to nurse first, though, and don't offer alternative milk once baby is no longer refusing the breast. You don't want baby to be too sated to nurse. This feeding method takes enormous patience. Try getting your partner or somebody else to help with it, so that you can take a short rest, and so that baby will only associate you with nursing. If baby stops peeing and pooping, offer more supplement.

6. If at all possible, get expert help. You want to keep an eye on baby's weight, on a good quality baby scale that's sensitive to at least half-ounces. You also want somebody who can keep an eye on the quality of the latch, and support you through the process. Stay away from anybody who might try to undermine your nursing relationship by suggesting that you're doing all this for nothing. I recommend a good LLL leader or certified lactation consultant. Medela's website has a database of breastfeeding counselors, if you can't find anybody any other way.

7. Once baby is latching again, enforce good latch. It's so hard, if baby has taken a half hour to get latched on, to take baby off and go through that again, but you have to. If baby has a poor latch, take baby off and try again. Repeatedly. Baby WILL get it right, if you keep practicing and insisting on a good latch.

And hang in there. It's a lot of effort and heartache and trouble to overcome this, but it can be done in only a few days if you're committed, and think about how worth it the effort will be. Pumping longterm and bottlefeeding is terrible. I did it with DD1, and I would never do it again. With DS, we fought the battle, and in a week he was nursing well again, and went on to nurse into toddlerhood. You can do this!


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## tomatofruit (Mar 27, 2009)

Thanks so much for all the suggestions! She seems to be doing a lot better today--at least, she's sucking for a couple of minutes before she gets bored with it. I'm doing lots of skin-to-skin time, trying to nurse more often, and varying positions more. I'm hopeful that she'll keep on the right track, but if she doesn't, I'll try the alternate feeding methods suggested here.

Fortunately, we do have all the latch problems worked out--my soreness happened in the first couple of days after the birth. I didn't get to see the hospital's lactation consultant until 4 days after, and by then the damage had already been done. Now she's latching on just fine, she just doesn't want to start sucking once she's on there. So frustrating...but it could be a lot worse, I suppose.


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## Llyra (Jan 16, 2005)

Quote:


Originally Posted by *tomatofruit* 
Thanks so much for all the suggestions! She seems to be doing a lot better today--at least, she's sucking for a couple of minutes before she gets bored with it. I'm doing lots of skin-to-skin time, trying to nurse more often, and varying positions more. I'm hopeful that she'll keep on the right track, but if she doesn't, I'll try the alternate feeding methods suggested here.

Fortunately, we do have all the latch problems worked out--my soreness happened in the first couple of days after the birth. I didn't get to see the hospital's lactation consultant until 4 days after, and by then the damage had already been done. Now she's latching on just fine, she just doesn't want to start sucking once she's on there. So frustrating...but it could be a lot worse, I suppose.

Oh, I'm so glad she's nursing! That's great news! Keep doing what you're doing!







Let her nurse as long as she wants, whenever she wants. Don't worry about getting her to stop sucking. Newborns are supposed to nurse constantly; it's normal and good for your milk supply.


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